Falls - Are you doing enough?

This resource highlights the problems associated with falls in the elderly. It contains a simple educational module and a far more detailed practice wide audit of care in patients with falls - suggesting a practice-based falls strategy. It has been developed by the GP section of PGMDE in Cardiff University and the PCQIS of the NPHS in Wales.

It is suitable for use by general practitioners individually, practice nurses and those concerned with care of the elderly in the community. It is also suitable for a practice to use as a team effort in examining care.

by Chris Price and Debbie Davies

Falls – Why Bother?

Falls and not an inevitable consequence of ageing however ageing increases the risk of falls. Falls are the most frequent form of accidents in the over 65s, when coupled with the increased bone fragility in this population, there is a high risk of fracture. It is estimated that one older person dies every 5 hours as a direct consequence of a fall.

Falls not leading to serious injury can destroy confidence, reduce independence and lead to social withdrawal and isolation. Relatively minor fractures (e.g. wrist ) can mean the difference between independent living and dependence on help, even if only in the short to medium term.

Nearly one in 3 of the over 65s living in the community fall on an annual basis, this rises to a half of the over 85s. After a fall an older person has a 50% chance of seriously impaired mobility and a 10% chance of dying within a year. It is estimated that falls cost society £1.8 billion a year.

A multidisciplinary approach is needed. This approach should deal with prevention of falls in vulnerable individuals, prevention of 2nd and subsequent falls, rapid and appropriate responses to injuries caused by falls and an assessment of the health status of those who have fallen.

Identification of underlying health conditions leading to falls, an assessment of the home, an assessment of mobility (including appropriate provision of aids) and consideration of bone density may identify factors that can be modified. Britain has an ageing population, falls are likely to become an even larger health issue in the near future.