While falls while walking give rise to fears of impact, those that occur at night highlight another vital danger: the inability to get up again.
A crucial point concerning the consequences of falls in the elderly.
1. night-time falls and the problem of getting up: night-time falls, which are often linked to wandering around in semi-darkness or darkness, drowsiness or urgent urination, may result from tripping or slipping. The major risk in this context is often less the initial impact (although this is always present and potentially serious) than the difficulty in getting up unaided and the time spent on the ground. An elderly person who falls at night is more likely to remain on the ground for a long time before being discovered, which, as we have seen, leads to increased risks of dehydration, hypothermia, bedsores and rhabdomyolysis, and can aggravate the initial injuries or even be fatal.
2.Daytime falls while walking in the street and kinetics/fractures: Falls that occur while walking, especially outdoors , can involve greater kinetics and impact on hard surfaces (asphalt, concrete), which can potentially increase the energy transmitted to the body and, consequently, the risk of fractures, particularly of the limbs. The manner of the fall (attempt to catch oneself, direct impact) also has a major influence on the type and severity of injuries.
If we learned to get up again, wouldn't a fall at night be "less serious"?
Learning to get up after a fall is an essential skill that can considerably reduce the severity of the consequences of a fall, particularly a fall at night or a fall where the person is alone. Being able to get up enables you to
- shorten the time spent on the ground, thereby avoiding the serious complications associated with long periods on the ground (dehydration, hypothermia, bedsores, rhabdomyolysis);
- limit the feeling of panic and fear of falling again that can set in after a fall, especially if the person remains helpless on the ground; - retain a degree of independence and self-confidence. So for a fall where the initial impact has not caused any immediate major injury (such as an obvious fracture or severe head injury), the ability to get up unaided can transform a potentially very serious situation into an event with fewer consequences.
However :
- Getting up does not prevent the initial injury:
- Learning to get up does not, of course, prevent a fracture or head injury, which may occur at the very moment of impact of the fall.
- The ability to get up depends on a number of factors: pain, muscle weakness, confusion, loss of consciousness or persistent dizziness, coordination problems may prevent a person, even a trained person, from getting up.
- However, it is surprising to find that simply being told what to do to sit up on the floor and then on the bed (turning over, slow use of hands and limbs, rebalancing the trunk) often enables an elderly person to get up, especially if they have been taught the techniques.
In conclusion, learning to stand up is an integral part of tertiary falls prevention (aimed at reducing the consequences after a fall) and is particularly crucial for people at risk of night-time falls or those living alone. It is not a substitute for primary prevention (avoiding the fall) and secondary prevention (reducing the severity of the fall through planning, improving balance, etc.),but it is a vital skill for minimising the harmful consequences if a fall nevertheless occurs.
Go further