No more hazards, no more falls, mum

Preventive steps, such as clearing potential hazards at home, help keep older people safe

Getting up after a fall can be difficult, especially for older people.

For them, the risk and severity of injury caused by a fall rises sharply with age.

And the best cure? Prevention.

Fall prevention is an increasingly important area of focus as countries around the world, including Singapore, come to grips with ageing populations.

The number of people aged 65 years and above here is expected to rise from 8.7 per cent of the population in 2008 to 19 per cent in 2030.


ST PHOTO: DON CHI

MUM, ARE YOU OKAY?

We can't take for granted that our parents will be okay, even at home. When we're out, we'll check on her with a call or through WhatsApp.

MS RAUDZAH OSMAN (above, right), on being concerned about her 69-year-old mother, Madam Maryamah Abdol Moen (above, left), who has had a few falls before.


FOCUS ON EXERCISES, NOT PAIN

No matter how careful you are, there is no guarantee you'll not fall... but if you do fall, concentrate on recovering by doing your exercises and not on your pain. The pain will soon vanish.

MRS CHANG SENG HUA, 75, a volunteer teacher who recovered after six months of physiotherapy sessions. She suffered a fractured ankle after a fall in 2014.

The World Health Organisation (WHO) estimates that about a third of adults above 65 years old fall at least once a year.

In Singapore, 63 per cent of the patients who needed hospitalisation after a fall in 2013 were above the age of 65, according to the National Trauma Registry. There were 1,840 cases in 2013, up from 1,436 in 2012.

Falls accounted for nearly 90 per cent of all trauma cases requiring hospitalisation among patients above the age of 65. The injuries ranged from cuts and bruises to fractures and some even died.

"Falls are not only associated with greater morbidity and mortality in older people, but are also linked to reduced overall functioning and early admission to long- term facilities," said Associate Professor Benjamin Ong, the Ministry of Health's (MOH's) director of medical services, in a set of guidelines issued last year.

In July this year, the Health Promotion Board (HPB) launched its Falls Prevention Awareness Campaign for older folk and their care- givers. HPB released two guides as part of the campaign, one each for older people and their caregivers. The guides describe the consequences of falls and advise them on how to neutralise potential hazards at home and elsewhere.

According to the HPB, almost 70 per cent of the falls among older people occur at home.

Madam Maryamah Abdol Moen, 69, fell for the first time more than 15 years ago when she was standing on a stool to clean the cabinets at home.

The former nightshift operator, now retired, slipped and fell on her back.

Luckily, the X-rays did not show any fracture. She had pain in her lower back for about six months but eventually recovered, she said.

However, she had a few more minor falls in the last couple of years and that got her 45-year-old daughter Raudzah Osman, who lives with her, worried again.

Ms Raudzah said: "At her age, she was still climbing to clean the fan. I discussed this with my siblings and we decided it was time for her to stop doing these chores."

Ms Raudzah, a teacher, is the oldest of four siblings. The rest have moved out.

She added that she had taken steps to ensure that their home was free of clutter, with no furniture that had sharp edges.

Potential home hazards include slippery surfaces, poor staircase design and unsecured objects, such as carpets or rugs.

Volunteer teacher Chang Seng Hua suffered a fracture in her left ankle after a bad fall in 2014.

  • PATIENTS ABOVE THE AGE OF 65 WHO NEEDED HOSPITALISATION AFTER A FALL

  • 1,436

    Number of cases in 2012

    1,840

    Number of cases in 2013

    •Figures from the National Trauma Registry

Now 75, she was then attending her mother-in-law's funeral in Kelantan, Malaysia, where her husband's extended family lives in a kampung house on stilts.

The steps were wet and the stair railings were in disrepair as Mrs Chang made her way down.

She said: "There were many pairs of slippers and shoes lying on the steps of the staircase. As I was walking down, I stepped on a shoe, slipped and fell backwards."

Fortunately, she landed on some laundry baskets, which broke her fall. "I was very lucky. Even so, my knee and foot were bent inwards and I was in great pain," she added.

She suffered a fractured ankle and a doctor put it in a plaster cast.

During the six months of physiotherapy sessions, she performed the recommended exercises assi- duously.

Mrs Chang, who has two children and a granddaughter, still keeps up with her fitness routine, visiting the gym regularly to do exercises such as leg curls.

The HPB recommends regular exercise as it develops strength and good balance, which help older people to reduce the risk of falls.

Lower body strength and balance exercises are most effective when done at least twice a week.

Madam Maryamah keeps active by going for walks. When she is outdoors, she is extra careful as she knows that previous falls tend to put older people at an increased risk of falling again.

Her daughter, Ms Raudzah, said: "We can't take it for granted that our parents will be okay, even at home. When we're out, we'll check on her with a call or through WhatsApp."

Mrs Chang now makes sure to hold onto the handrails whenever she climbs the stairs and avoids uneven ground outdoors.

"No matter how careful you are, there is no guarantee you'll not fall," she said.

"But if you do fall, concentrate on recovering by doing your exercises and not on your pain. The pain will soon vanish."

SEE Regular exercise helps reduce risk of falls

A version of this article appeared in the print edition of The Straits Times on November 01, 2016, with the headline 'No more hazards, no more falls, mum'. Print Edition | Subscribe