In NSW, falls have been identified as the most common causes of injuries in older people, accounting for 22% of all adult injuries and 49% of all injuries in people aged 70 years or over (National Centre for Health Promotion, 1995). A study conducted by the Australian Bureau of Statistics revealed that approximately 20% of all people aged over 65 years reported that they had fallen in the last twelve months prior to October 1995 (ABS, 1995).

   A telephone survey conducted by the NSW Health Department to evaluate the Falls Prevention in Older People Campaign in 1995 found that 73% of fallers reported sustaining an injury. Bruising and lacerations were the most common injuries. Thirteen percent suffered fractures, and they were likely to be women (NSW Health Department, Falls Prevention in Older People Campaign, May 1995)

   Hospitalisation for falls have been increasing in recent years. In 1995/96 falls were the leading cause of injury hospitalisation in every age group except 15-29 years (Report of the NSW Chief Health Officer 1997).

   More than 1000 people die annually from falls in Australia and the public health cost has been estimated at $2.5 billion (Fildes, 1994) In NSW whole of life costs were estimated taking into account the direct and indirect costs of injury related to a fall in the 65 years and older age group. The estimates were then calculated using the Victorian cost of injury model. The results are:

Cost of fall injury in NSW aged 65 years and over
1995-1996

Table 1. Cost of fall injury in NSW
Source: Patterns of Injury cost in NSW 1995-96. NSW Health Department. Consultant J Moller

Major causes
The major causes of falling by older people are:

• unsafe footwear
• changes in eyesight or eye disorders
• poor balance or walking patterns
• lack of physical activity
• inappropriate medication use
• chronic health conditions
• hazards in and around the home
• hazards in public places

PREVENTION STRATEGIES:

Medical

   Have regular medical check ups and tell your General Practitioner if you have had a fall even if you did not sustain any injury.

Footwear

   Choose footwear which will be comfortable and suits the occasion. Something that is a good fit, has laces or velcro fastenings, is not a high heel, has a sole that grips. Ask a shoe repairer to make your existing shoes safer by applying vulcanised rubber heels and half sole.

Eyesight

   It is normal and natural that eyesight becomes less acute as people get older. These problems progress slowly and are often not noticed at first, it is therefore important to have regular eye examinations.

Balance

   As you grow older your balance may be affected. This may be due to weak muscles, medication, ear problems, sudden movements, head colds or the weather. If you are in doubt have your balance tested by a General Practitioner or a Physiotherapist.

Exercise

   Exercise is an important component in reducing falls. Exercise increases muscle strength, balance and positive well being. The other benefits of physical activity are that it maintains good heart function, ensures efficient lung capacity, helps the digestive system, repairs the nervous system, contributes to mental alertness, helps fight infection, assists in better sleep and reduces stress.

Medication

   Ask your General Practitioner or Pharmacist about the drugs you are taking. Take a list or take the medications for review as some prescribed and over the counter medications may have side effects which may contribute to a fall.

Home modification

   Reducing the risk of falling in your home is an important strategy. There are some basic principles in making your home safer at any age. These include ensuring that your home has:

• adequate lighting
• hand rails in showers and toilets
• hand rails on all stairs
• non slip surfaces on the edge of steps

• remove any cords or obstacles which you can trip on
• remove loose mats and rugs
• keep walkways and pathways clear
• clear up any spills as soon as they happen
• keep a torch by your bed

Information source: Stay on your Feet. North Coast Public Health Unit. 1994

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