When is a fall more than just a trip?

By Dr. Neil Richards

General Practitioner, Intercare Blaauwberg

Falls are the leading cause of injury related hospitalisation in people older than 65 years of age. A fall may not be due to an unintended event such as a trip on a pavement, but rather a manifestation of an acute or chronic underlying medical problem. As such, all falls in the elderly must be thoroughly assessed and managed by your GP or local emergency department.

An assessment after a fall will include whether one has had a previous fall and review of:

  • Medication: Certain medication is sedating and can affect coordination e.g. sedatives, anti-depressants and analgesics.
  • Vision: Onset of cataracts or the need for review of glasses.
  • Impaired balance: Vitamin D deficiency, vitamin B12 deficiency, medication and onset of neurological illness.
  • Dizziness/syncope: Blood pressure changes and possible underlying heart disease.
  • Cognition/memory
  • Environment: Review of the home environment and safety around the home.

One of the major consequences of a fall is the fracture of a bone needing hospitalisation and follow on morbidity and mortality. The best preventative intervention a person can undertake is exercise to improve balance and strength. Supplementation with calcium and vitamin D will reduce the incidence of fractures and the necessary screening for osteoporosis. A proper assessment to reduce falls can improve an older person’s ability to function and live independently and thus their quality of life.

(Reference: Modern Medicine, March 2013)

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