As noted in my past blog on falls and the elderly, there are many risk factors for falls in the elderly and some of these factors will be discussed individually.
Fear of falling is one of the risk factors for falls in the elderly. It is an anxious state where the person feels a fall will occur if he or she stands or walks or even just generally mobilises. This is a psychological component of falls which can trigger a vicious cycle that include sedentary lifestyle (decreased activity level) which leads to decreased muscle strength and endurance, joint stiffness that offsets balance, decreased cardiovascular endurance, reduces confidence and increases the fear of falling and thus leads to fall or more falls. Typically, fear of falling occurs more in women than men and increases with age.
The big question is, why the sudden fear of falling? Well, the simple answer is nobody wants to fall. The elderly are very much aware that falling could have dire consequences; from sustaining major injuries to losing their mobility entirely. Fall is one of the leading causes of morbidity and mortality in the elderly. The fear of falling could stem from decreased cognition, near falls, falls, perception of decreased balance, gait changes, poor vision, frailty e.t.c.
The treatment for fear of falling is primarily to identify the reason for the fear or the cause of the reason for the fear. The problem is best solved if the particular cause is identified. However, in most cases the cause is multifactorial, so a holistic approach to problem identification is the best way for assessment. Afterwards, intervention is tailored towards addressing any of the factors identified as being responsible for the fear of falling. Improving physical functioning which includes teaching the seniors to perform activities safely simultaneously is the best approach to therapy. Researches have shown that a home based multifactorial falls prevention program, home based exercise and a community based Tai Chi group significantly reduces
the fear of falling and directly the risk of falls in the elderly.
At Onward Home Physical therapy, comprehensive balance assessment including screening for fear of falling and probable causes are carried out and appropriate client tailored treatments are performed.The primary goal is to decrease the fear of falling and thereby increase the confidence in engaging in social activities and carrying out activities of daily living safely.
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