By Paula Butler
Fall prevention is a hot topic at Riderwood, and for good reason. Falls are the second leading cause of accidental or unintentional injury deaths worldwide. Knowing the factors that could increase the likelihood of falling (certain medications, improper footwear, poor vision, unsafe environments, underlying medical conditions and loss of balance/mobility) is important to mitigate the risk, but there is one factor that is often overlooked: the fear of falling.
Almost half of community-dwelling older adults report that they are afraid of falling, and rate it highest among other fears like criminal violence, a financial crisis, or an adverse health event. Fear of falling was once considered to be the result of psychological trauma associated with a fall, but now it’s recognized as a specific health problem that even affects individuals who have not fallen, and poses a threat to a person’s physical and mental well-being.
The Fall Cycle (pictured) illustrates the physical aspect of how the fear of falling can increase the risk of falling again. When a person falls, he or she can become afraid of falling again, which leads to an avoidance of activities. Moving and doing less for an extended period of time can cause reductions in strength and balance, which increase the likelihood of falling again. Having better awareness of situations that may lead to a fall and how to avoid them is a good thing; excessive restriction that leads to socializing less and doing less in general is not a good thing. This can cause a decline in physical capabilities, a lower quality of life and life satisfaction, and increased anxiety and depression. Anxiety can affect a person’s gait (anxious people take shorter strides and move more slowly) and reduce accuracy with foot placement, causing more missteps and trips. Rumination about falling can be a distraction, bringing attention away from maintaining balance and posture.
To conquer the fear of falling and break the cycle, confidence is the key. Strengthening muscles that improve balance and posture is a good start. Increased caution with certain activities can be protective, but it’s important to keep moving and maintain a good social network of support.