Big rise in number of elderly people falling over in
nursing homes

Louise Hall Health Reporter
March 4, 2009
Sydney Morning Herald

THE number of frail, elderly residents admitted to hospital after a fall in a nursing home or other aged care facility has significantly increased, putting further pressure on beds in the public system, a report has found.

Figures published yesterday show that for those aged 65 and above, the number of falls in residential homes was more than five times the number of falls of those living in the community, including in their own home.

Bob Cumming, Professor of Epidemiology and Geriatric Medicine at the University of Sydney, said that while a fall was often the catalyst for older people to enter aged care, it was no guarantee against injury.

"If older people are put into a nursing home by their kids, they can't think it is going to prevent their parents falling and breaking bones," he said.

Professor Cumming said a concerted effort to reduce falls in hospitals had not translated to improved prevention in aged care, but the introduction of better lighting, higher staffing levels and reduced use of psychotropic medication could help.

The Australian Institute of Health and Welfare report said the higher rate of falls in aged care facilities was primarily because those residents tended to have much higher care needs and were more likely to be frail.

The chief executive of the Aged Care Association Australia, Rod Young, said a recent push towards getting residents out of bed and walking around was also contributing to the rate of fall injury cases increasing from 6404.3 per 100,000 in 2003-04 to 7237.5 per 100,000 in 2005-06.

Fall-related injuries cost the health system more than any other trauma, including road accidents, and the total financial cost is estimated to exceed $1 billion a year.

The report found the number of people aged 65 and over admitted to hospital following falls increased by 10 per cent in the two years to 2006 to 66,800.

Simple trips and slips on level ground were the most common type of fall, and falls at home were often on stairs. Men had a higher proportion of falls from ladders, buildings, trees and cliffs.

Almost 65 per cent of in-patients had at least one broken bone, and the mean length of stay was more than 16 days, bringing the total bed days to more than 1 million a year.

Head Injuries and Seniors

Children are not the only individuals at risk for head injuries due to falls. Senior citizens also have a great risk of head injuries. When children fall, it is because of new found abilities such as walking, running, and climbing. Older individuals fall for a number of reasons. These reasons can range from sicknesses that disrupt normal balance, eyesight failure, weakening reflexes, and dizziness. While there are a number of other attributing factors that can lead to a fall, these are by far the highest ranking risks.

Dizziness is a huge risk factor because when an individual becomes dizzy it is nearly impossible to get a grip on anything, let alone stay upright. There are some common illnesses that can causes extreme dizziness in an aging individual, such as vertigo. A person with vertigo, no matter what the age, can rarely tell which direction is up, and which direction is down, so as you can imagine keeping their feet planted firmly on the ground is almost impossible.

Being unable to regain balance after a slight slip is another common cause of traumatic head injury after a fall. An older person has what some people like to call a dulling sense of reflexes. When we are young our reflexes are weak and untrained, as we age we tone these reflexes. However, when we reach our golden years these reflexes have a tendency to slow and become weak again. Therefore, when a senior citizen starts to slip, their reflexes are not responding quickly enough to correct the slip, or grasp on to a stable object to catch them.

It is so very important to prevent these falls. Falls are so very detrimental in the elderly where weakened bone structures can lead to fractures and even serious breaks. This includes the protective boney shell around the brain…the skull. Closed skull injuries in the elderly are basically the same as with a toddler, however, the elevated risk of skull fracture resulting in direct brain trauma in an older person is extremely high.

The difference between elderly and small children is the height and speed at which they fall. Toddlers are low to the ground and don’t gain much momentum during a fall, while the elderly are tall and do gain momentum during the fall. This means they hit the ground harder, which has a higher chance of resulting in head trauma.

It is possible to correct some of these problems that are caused by the normal aging process. There are exercises and supplements to help aid in your effort to fight back these aging problems. However, slips and falls related to illnesses are not so easily corrected and caretakers must ensure that every risk factor is eliminated in order to prevent falls.

If the person lives at home all precautions must be taken to eliminate normal risks, such as skid proofing the bathroom… a common site for falls. Preventing a fall is not always feasible, however a great majority of the time it is and we should do everything in our power to see that our loved ones never have to endure such pain and fear.


© C.King Brain Injury Centre 2009