Falling for accident prevention

“The NHS treats elderly patients with broken hips as a ‘low priority’ by failing to give them prompt and high-quality treatment that could extend their lives,” reported the Daily Telegraph on June 22.

This may be true – indeed, this information was provided by NICE (the National Institute for Health and Clinical Excellence) – and it’s worrying that the older population is growing, so the problem is not going to go away.

However, on this issue, the media appears to have missed the obvious – in that scant, if any, mention is made of preventing these injuries in the first place.

According to NICE, up to 75,000 people suffer hip fractures each year. This figure is expected to rise to 100,000 by the end of the decade – a consequence of an ageing population.

To put the issue into perspective: broken hips affect more women than breast cancer does.

People’s quality of life is vastly reduced following a fall-related fracture, and older people’s independence is often curtailed. Health problem follows health problem, and about 10 per cent of people with a fractured hip die within one month – and around a third will die within 12 months. Add to this the stress and worry to family and friends, and the increased burden of care, and we have human tragedy on a massive – and increasing – scale.

If the human costs of fall-related injuries aren’t enough to convince you that things need to change: in terms of financial costs – at the forefront of everybody’s minds at the moment – hip fractures are estimated to cost £2 billion a year in medical treatment and social care.

What about preventing the fall in the first place? Accident prevention can and should play a starring role in the UK’s public health plan.

At the moment, accident prevention advice and information is being delivered by numerous smaller, extremely dedicated and hard-working organisations around the country.

There have been some great examples of successful working between local NHS organisations and local authorities. In Dudley in the West Midlands, for example, a falls prevention initiative, the £158k a year costs of which were funded by the Primary Care Trust and the council, saved £3 million over five years due to the corresponding reduction in hip fractures.

The problem of falls among older people was highlighted during Northern Ireland’s recent Home Accident Prevention Week (June 6-10).

Accidental falls claimed the lives of 155 people across Northern Ireland in 2009, of whom two thirds (103 people) were aged 65 or over. The most serious accidents usually happen on the stairs and injuries can have long lasting and life limiting effects – as we have seen.

We know that the risk of falling in the home and of suffering a serious injury as a result increases with age. We hope the simple prevention tips shared below will be shared among communities and families and reach as many people as possible.

  • Keep landings, stairs and hallways well lit
  • Insert a dual handrail on stairs where possible
  • Replace worn carpets and remove loose rugs and mats (or use non-slip backings)
  • Wear suitable footwear
  • Remove clutter from floors and stairs
  • Use stepladders for household jobs instead of climbing on chairs
  • Store everyday items in easy-to-reach places
  • Review medication with your GP/pharmacist
  • Wipe up spills straight away, and use bath/shower mats
  • Ensure you get your eyes tested
  • Keep active!

These last two points deserve to be expanded upon a little.

The Daily Express reported last week that two million over-60s have not taken advantage of free eye tests, even though 270,000 older people have had falls as a result of poor vision in the past two years. These figures came from a study to mark Age UK’s Falls Awareness Week.

Age UK is rightly concerned that many older people are not aware that they are entitled to free eye tests. Their study found a range of reasons were given for not going to the optician: 42 per cent felt there was nothing wrong with their eyes, nine per cent were concerned about the cost of buying glasses, and six per cent simply said they forgot to go and have a sight test.

Raising awareness of the connection between poor eyesight and falls may encourage more older people to take advantage of this free service.

As far as keeping active goes: this is extremely important in improving mobility and balance among the older population. However, it goes deeper than that. Keeping fit and active from a young age and throughout life will help to ensure that you stay fit and healthy into old age.

These issues highlight the fact that accident prevention is intimately linked to many other areas of healthcare – and could save a lot of pain in the long run.

So why is it underreported? Why is the media missing the obvious when reporting on falls, and ill health relating to accidents? I guess it’s not “sexy”, not headline grabbing enough. Perhaps. Then it’s down to accident prevention charities and organisations to make the subject newsworthy – spread the word.

Everyone has parents and grandparents or elderly friends and neighbours – not to mention the fact that we are all (hopefully!) going to live to a ripe old age, and reap the benefits of this type of accident prevention advice ourselves.

Ita McErlean, RoSPA’s home safety manager for Northern Ireland

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