The inability to get up after a fall

The world population is aging at an unprecedented rate, bringing both opportunities and challenges that will shape the future of societies around the globe. Advances in healthcare, improved living conditions, and better nutrition have contributed to increased life expectancy, resulting in a significant rise in the number of older adults (≥ 65). According to the United Nations, the number of people aged 65 and older is projected to more than double from 703 million in 2019 to 1.5 billion by 2050.

This demographic shift is reshaping economies, healthcare systems, and social structures. While the increase in life expectancy is a testament to human progress, it also raises critical questions about how to ensure that longer lives are accompanied by a high quality of life:

  1. How can we help people to stay independent and active as they age?
  2. What public health initiatives can encourage active lifestyles and healthy habits among older adults?
  3. How can early intervention and preventive measures reduce the burden of chronic diseases and greater degree of functional dependence of this population?

«Measures to help older adults to stay healthy and active are a necessity, not a luxury» – World Health Organization (WHO).

Curiously, the research is showing that as the numbers of older adults increase, the number of falls also increase. They are directly proportional. These data are alarming since approximately 1/3 of older adults fall each year.

Although the risk of falling is high, the older adults are rarely aware of how they should act after a fall, so they are often unable to cope with a fall, namely how to get up from the floor. «It is recommended that patients at risk of falling should be taught how to get up from the floor. Clinical experience suggests, however, that this is rarely done. » Simpson & Salkin (1993)

The inability to get up after a fall is a common cause of complications such as: dehydration, pressure sores, muscle injury, hypothermia, pneumonia and even renal failure. In the long run, these people are more afraid of falling again and, as a result, start moving less and less. This makes them become more dependent on others and increases the likelihood of being admitted to a long-term care facility.

So, how can we address this problem?

First of all, we need to identify these people who have difficulty lying down and getting up from the floor independently.

For example, recently I had the opportunity to carry out a movement screening at the Senior Living Center of my city (Portimão) where the ability of people to get down and get up from the floor independently and safely was observed. Of the 21 older adults screened, 9 (around 42%) were unable to carry out this task independently. It should also be noted that of these 9 older adults, 5 (around 55%) lived alone, increasing the risk of suffering a long-term fall (> 1 hour). This first screening is crucial so we know who is at risk.

Then depending on each person’s difficulties, strategies were created to help them getting up from the floor or asking for help if they were unable to do so.

Some of these people just needed a plan to move from one position to another, until they were able to stand up. For example: roll onto your side, push up onto your hands and knees, and crawl to a stable piece of furniture. From there, move to a kneeling position and eventually stand up slowly. Each movement is explained and practiced, ensuring that individuals understand how to execute them safely.

For the ones who weren’t able to get up, it’s a matter of reinforcing that they need to have their cell phone close to them to call for help in case of a fall.

Overall, teaching individuals how to get up from a fall is about more than just physical movements. It’s about empowerment, independence, and maintaining quality of life. By equipping people with the knowledge and skills to handle falls effectively, we can help them stay safe and active for years to come.

And of course, in terms of prevention, it would be interesting for us younger adults to start practicing the getting down and getting up from the floor in a consistent way, in order to maintain automatisms that allow us to preserve this movement competence.

By implementing this approach younger adults can not only decrease the likelihood of encountering challenges in getting up from the floor but also preserve their autonomy and overall quality of life. This means they can continue to engage in activities they enjoy, maintain their independence in daily tasks, and feel confident in their ability to navigate their surroundings safely. In essence, it empowers them to live life to the fullest without the fear of limitations imposed by potential falls or mobility issues.

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