The 14th September 2009 saw
patients falling over themselves to fill the hall and hear a
fascinating talk by Dr. Jo Bernstein, FRCP.a Consultant Geriatrician,
whose speciality is ageing and the concomitant risk of falls.
She has worked in the UK and New Zealand. Her researches are based on the work of Professors Mary Tinetti, USA Rose Anne Kenny, UK & Ireland, and AJ Campbell of New Zealand.
There are many reasons for falls, which are not always inevitable.
Risk factors
are, in no particular order: frailty, obesity, bad diet, hearing and
vision defects, wrong glasses for the person, disease, mental health,
eg. Dementia or Alzheimers, alcohol, ‘Funny turns’ or even an
unacceptable melange of medication, some bought over the counter. A
good pharmacist is important to spot incompatible medicines despite the
inbuilt checks on the computers used by the doctors.
Dr. Bernstein
mentioned high risk medication such as anti depressants, beta blockers,
diuretics, anti-anginals, analgesics, night sedation, anti-convulsants
or medication for Parkinson’s disease. Some people suffer Syncope,
which is a transient loss of consciousness. Genetics do play a part as
well as an awareness of one’s environment which could contribute to
falling. Of course the elderly could also be prone to incontinence, or
suffer from Cerebrovascular diseases or there may be Cardiovascular causes. Constant immobility is not good, exercise is.
There is much
one can do to prevent overbalancing and falling. One should learn how
to right oneself, there is a NHS leaflet entitled ‘What to do if you
have a fall’ available from all good hospitals and PCTs. Tai Chi is a
proven good exercise among others. It is possible to buy hip
protectors.
However
help is at hand at falls clinics where a history is taken and one is
examined, lying and standing BP, ECGs over a period, or CT Scans,
resulting in a diagnosis and an offer of specific treatments. There is
follow up, as once one has fallen a recurrence is likely. One should
always report falls to one’s GP.
The old
conundrum remains, should one walk tall with straight back or bend
forward and peer so as not to fall on the notoriously ill kept
pavements.
Hans Danziger