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You are in: Staying Healthy > Falls Prevention, Older People’s Health Care
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Staying Healthy
Falls Prevention, Older People’s Health Care
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Older people’s health and wellbeing is a significant area of interest for health improvement and can contribute to the reduction of GP and hospital visits. Falling is a serious and frequent occurrence in people aged 65 and over. Each year, 35% of over-65s experience one or more falls and about 45% of people aged over 80 who live in the community fall each year. Falls Prevention Falls result in psychological problems, e.g. a fear of falling and loss of confidence in being able to move about safely, loss of mobility leading to social isolation and depression, increase in dependency and disability, hypothermia, pressure-related injury and infection. The aim of the Falls Prevention Service is to reduce the incidence of preventable falls, as well as raising awareness of potential risks that may lead to a fall. Falls prevention is a very cost effective intervention - there is clear evidence that comprehensive integrated falls prevention and management programmes reduce the incidence and severity of first falls – and proactive preventative management of ‘first fallers’ reduces the likelihood of a subsequent and more serious fall occurring. Falls prevention advice:
If you fall you should always consult your doctor. There are lots of causes of falls which can be easily remedied. See the Local Initiatives page for information on how to contact the local Falls Prevention Service. Physical Activity and Older People Physical activity – and particularly training to improve strength, balance and coordination – has been found to be highly effective in reducing the incidence of falls. Adults should achieve a total of at least 30 minutes of at least moderate intensity physical activity a day, on 5 or more days a week. Older people should take particular care to keep moving and retain their mobility through daily activity.
See our Physical Activity section and the Physical Activity factsheet for more information, and the Local Contacts page for details of Extend – Postural Stability Classes – Chair Based Exercise Classes and Walking for Health local groups. Hotspots
The Hotspots scheme enables frontline staff across North Yorkshire and York to refer patients, who may be at risk of poor health (physical and mental) as a result of living in a cold environment, for practical support. It involves completion of a simple referral card that offers clients access to benefits checks, a home fire safety check, energy efficiency advice and assessment for home improvements, e.g. insulation. For further information regarding the Hotspots scheme, please contact the Yorkshire Energy Partnership advice centre on 01904 554406. Older People and Hearing/Ear Care General Information Age-related hearing loss (presbyacusis) is due to wear and tear of both cochlea. We cannot repair our cochleae so damage manifests as a symmetrical (the same in both ears), sensorineural hearing loss sometime accompanied with bilateral tinnitus. Most people with presbyacusis find that they can hear relatively well in the low pitches, which provide vowels sounds and make up the middle of words. However, they do not hear so well in the higher pitches which carry consonant sounds, particularly “s” and “t”. These are at the beginning and end of words and provide its meaning, no matter what language is being spoken. To most people with presbyacusis, others might sound as if they are mumbling. They might also find it hard to hear in groups or in background noise and they might find it hard to hear speech on TV particularly if music is also on the soundtrack. The solution is to fit a digital hearing aid to the problem ear(s). People with bilateral aids, or with an aid in the poor ear and good natural hearing in the other ear can better localize sound, have improved balance (a particular problem for the elderly) and experience improved speech intelligibility in noise. Digital hearing aids are fitted routinely throughout the NHS and they are on a par with good quality private hearing aids. Unlike analogue hearing aids which boost all pitches, digital aids only boost the parts of hearing that are not functioning well. They also process sound to remove some of the unwanted background noise which provides a more natural hearing ability. Audiology services for the elderly are not restricted to hearing and hearing aids. Many audiology services offer practical advise on how to deal with tinnitus and also will be involved in determining how well you balance organs are working for people who experience balance problems. Dewaxing The amount of ear wax produced increases with age the removal of the wax is predominantly the domain of a GP or nurse, who use syringing when it’s safe to do so. If a GP practice does not provide this service they may need to be prompted to refer to ENT for microsuction. Over the counter remedies such as sodium bicarbonate in mineral oil will soften wax, but they do not generally remove wax. Patients should be seen by a GP/nurse/ENT as soon as possible after application, and keep applying until seen by the practitioner. How to refer to Audiology Referral usually from GP’s, practice nurses and speech & language therapists for hearing tests. Patients can also be referred for bilateral, long standing troublesome tinnitus. However, it’s best to recommend a visit to the GP first to check for wax and other pathologies. This is essential if the following are described.
In these cases a GP ought to refer straight to ENT because of the risk of life-changing/sinister pathologies. Dental Health Care All adult patients
Those with obvious current active caries, dry mouth, other predisposing factors, special needs All of the above, plus:
All patients should attend a dentist for regular check ups. The NICE guidelines on dental recall interval are available here. Prevention of oral cancer All adolescents and adults:
See Oral Health and the Oral Health Factsheet for further information. Podiatry Foot care and Mobility for the older person The average person walks the equivalent of five times around the earth in their lifetime. As such, it is not surprising that 75% of adults have some form of foot problem. Walking has been identified as one of the easiest ways of keeping fit and healthy. A lower level of activity can lead to weight gain, muscle weakness, reduced mobility and increased risk of falls. The first step in reducing foot pain and increasing mobility is appropriate footwear. For comfort, stability and long-term health a well fitting shoe with lace or Velcro fastening and a shock absorbing sole will make all the difference to an individual being able to walk pain free. While foot health is important to all, for individuals with specific medical conditions such as Diabetes or Rheumatoid Arthritis there are specific risks - there is relevant NICE guidance on these conditions. www.nice.org.uk. If there are specific Foot and lower limb problems, treatment can be sought from a Podiatrist either on the NHS or privately. Further information on NHS services can be found on www.nhs.uk and the referral leaflet. For private treatment, individuals should ensure that the Podiatrist or Chiropodist are registered with the Health Professionals Council (check this on their web site www.hpc-uk.org). You can also find local Podiatrist via www.feetforlife.org – this website also carries a range of information on caring for your feet and common foot conditions. Eye Health Even if a patient’s eyesight appears fine they may have a condition that could threaten their vision and it is important to have this diagnosed as soon as possible. If any changes in vision are noticed or if they have any concerns about their eyes, patients should have them checked out by an optician/optometrist as soon as possible.
You can find your local optician in the Yellow pages, or by going to NHS Choices website. Further information about eye health, including advice on nutrition is available on the RNIB website or telephone the helpline on 0303 123 9999. Low Vision If an eye condition already exists and the patient is struggling to carry out everyday activities, there are many practical things that can be done to make the most of their remaining vision. There are many different causes of sight loss and the type of help needed will vary between individuals, however, these are the key ways to make the most of any remaining sight:
There are a wide range of aids and equipment available which may help patients in all aspects of daily life. The York Blind and Partially Sighted Society is a local charity which is there to help anyone with sight problems. The Equipment and Information Centre has a range of products available for people to see, try out and buy if required. For further advice or information on any of the above please contact YBPSS, Holgate Villa, 22 Holgate Road, York. Tel: 01904 636269 or visit their website at www.ybpss.org. The Scarborough Blind and Partially Sighted Society covers the Scarborough, Whitby and Ryedale area - www.scarboroughblindsociety.co.uk or telephone 01723 354417. Please see the Falls Prevention and Older People’s Factsheet for further information.
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The cold negatively impacts on many health
conditions and the risk of falling is increased as a result of a
decrease in dexterity. The cold is said to be the underlying cause of
80% of excess winter deaths and evidence has shown that experiencing
cold within the home can be linked to more regular use of health
services, and also an increased length of a hospital.
