Why the mere fear of falls alters elderly behaviour

By Aavishi Bhatnagar

Falls are one of the major reasons behind deteriorating health among the elderly. But have we ever thought why the mere fear of falls alters the behaviour of the elderly?

Let’s delve into the mindset behind a fall. Falling has always been a concern for us from the time we are born. After all, we are not cats to jump back upright in no time and pretend that nothing happened.

Statements like “Watch your step, or you can fall down” or “Don’t run down on wet floors” or “Hold the railing firmly while walking down the stairs” are more or less embedded deep into our sub-conscious.

As we grow up, we become more confident of our steps and balance. Our mind and body work in perfect tandem assuring and reassuring us time and again that we are less likely to fall on any normal given day under normal circumstances. However, this changes as we grow older. Our joints, co-ordination and organs slowly start weakening with increasing age.

Wet floors in bathrooms, uneven roads or pavements, poorly lit surroundings and staircases become our worst enemies.

As elders we tend to tilt towards the cautious side, but a small mistake and a fall may plummet us into a world of old age from where there may be no return.

Physically, a fall may lead to injuries to the hip, wrist, and lower parts of the body. This may lead to impairment of movement, surgery, complicated post-operation care and even lifelong physiotherapy.

Advanced medical care and support over a period of time helps us heal. However, the more concerning and often overlooked part of the fall is the mental state that we find ourselves in after the fall.

Even as we realize that we have fallen, we refuse to accept in our mind that age slows our healing and recovery process; that we need to slow down and take time out for ourselves.

When ‘old’ becomes a hated word

The entire concept that we are slowly becoming dependent on others for our basic needs is so difficult to reconcile, and most of us don’t do it. Being called or referred to as “old” starts becoming a hated term. Often, over a long period of time it leads to behavioural changes that can either be in the form of aggression, or passiveness. Suppression of emotions over a long time eventually translates into deeper and complex medical issues like depression, dementia etc.

It is not that we are not aware that there are changes happening around us. But we are helpless to overcome them. And sometimes I wonder why? Is it fear? Fear of falling and hurting ourselves. Or imagining worse case scenarios like getting bedridden or moving around in a wheelchair.

Slowly the steps become shorter, more measured and slower. We tend to avoid all physical activity like a casual stroll to the park or the market. There is a reluctance to step out of the security of familiar spaces.

Gradually, we become prisoners of our mind.

We find it hard to adjust to changed realities. Many of us hate walking sticks. We find judgement in every eye that turns towards us. We don’t like to be seen as frail and helpless, and prone to falls.

When a feeling of loneliness creeps in

Social activities and outings diminish over time and a feeling of loneliness creeps in. We are no longer a part of the chosen circle and have to wait for our turn to be included. Sadly, some days we are included and some days we are not. Even if in our heart we want to give it a try, be brave, accept the changes and move out fear grips us. We don’t want to leave our comfort zones anymore.

When we look back, not all blame can be placed on age and accidents for our falls. Sometimes our own family starts making us feel old.

“You are becoming old, Ma. Why didn’t you call for help?” is a much-heard statement in almost all homes. Such statements though made out of genuine concern often make us feel even more old, inadequate and dependent.

A false sense of hurt creeps in. A vicious cycle sets in that feeds on the false hurt and vitiates the family environs.

What can the family caregivers do when this starts happening?

Here are our nine suggestions to help us drive away the fear of falls:

1. Ensure well–lit homes for us.
2. Serve us healthy and nutritious food in small portions for better digestion.
3. Help us do simple exercises to keep our muscles active and toned.
4. Create socializing opportunities to keep us mentally active and happy.
5. Take us out on short trips to build our confidence.
6. Get us regular health checkups.
7. Make sure that we take our medicine on time.
8. Engage us in activities that we like.
9. Most important, make us feel wanted.

(The writer is a trained Clinical Researcher and writes on medical issues.)

Read also: How can we prevent the elderly from falling?