Lying on the Floor after a Fall . . .

Researchers at the University of Cambridge, UK, have investigated cases where people in the ‘oldest-old’ category have had a fall and lain on the floor for a considerable time. They published their findings in the British Medical Journal.

Ninety women and 20 men over the age of 90 participated; they were members of a population-based group called the Cambridge City over-75s Cohort. Information was obtained during a one-year follow-up of patients, based on phone calls, visits, and ‘fall diaries’.

During the year, there were 265 fall reports. In 82% of the cases the fall occurred when the person was alone, and in 54% the victim was found on the floor. Among those who fell, 80% were unable to get up after at least one fall, and 30% had lain on the floor for an hour or longer.

When analyzed further, the data showed that lying on the floor for a long time was strongly linked with serious injuries, admissionto hospital, and subsequent moves into long-term care.Cognitive impairment was commonly seen in these subjects.

The prevalence and use of call alarms was also investigated. Although such alarms were widely available, they had not been used in most cases with long floor-lying times. Older people and caregivers indicated that there are issues with these alarms – perceptions about irrelevance, associated lack of independence, and practical difficulties in use. Such personal emergency response systems may be cost-effective in reducing hospital admissions, but their actual acceptance and use is quite limited.

It seems likely that these findings are relevant for the USA. What’s needed is training in how to get up from the floor, wherever possible, and the availability of well-designed call alarms with instruction and encouragement in their use. Obviously shortening the time of helplessness after a fall will result in fewer after-effects for these ancient citizens.

(This is where I’d like to give a link to a review of home medical alarms, but I was unable to find one on Google – just a long list of products; this was the best I could do.)