Consequences of Falls
Falls do not just cause possible pain and injury which the faller has to suffer and recover from they also have social, psychological and financial effects for the faller, their family and carers and costs to the health service.
Falls can cause cuts, bruises, soft tissue injuries, sprains, dislocations, fractures, increase in pain in existing joint conditions and in the worst cases serious head injuries. 20% of injurious falls result in fractures[ix].
Falls and instability contribute to 40% of nursing homes admissions. Most people want to maintain their independence and continue living in their own home, a fall can have an impact on this as family and friends strive to ensure their loved ones safety and are afraid of the consequences of a fall. This is especially true for older adults living alone.
A fall can result in post fall syndrome or fear of falling where the person has a lot of anxiety associated with falling. They will limit their activities often to the point where their body becomes so deconditioned that they lose function and can no longer walk or carry out their daily activities of living. Reduction in activities can result in social isolation, they may no longer be going out to meet people, and this in turn is associated with decline in mental ability (cognitive impairment). Lack of activity and social contact will affect mood and can result in depression. It is thought that the fear of falling can even be post traumatic stress disorder[x] Fear of falling can be directly responsible for causing an actual fall as fear causes the person to change their behaviour and their gait. ‘Fear’ of falling may be too strong a word, even if the person is aware of THINKING about their moving and walking before they do it, it indicates some level of anxiety.
Even a fall that has caused no injury at all can have serious consequences. In fact a seemingly minor fall can be fatal if the person is unable to get up from the floor or summon help. This can result in what we call a ‘long lie’ – where the faller is on the floor for over 1 hour. We know that a lie of more than one hour is associated with an increased risk of dehydration, hypothermia, pneumonia, depression, kidney failure and pressure sores (Tinetti, 1993 and 1994).
Lying on the floor for a long time after falling is more common among the “oldest old”, one study[xi] shows that in the over 90’s 80% of fallers were unable to get up after a fall and had a ‘long lie’.
Who gets an injurious fall?
Risk Factors for Falls