Fear of Falling

Oct 1, 2020 | Blog, Knowledge Exchange

October 2020 blog post by Marguerite Oberle Thomas, RN., BScN., and Alison Stirling, MHSc., MISt.

Fall?  No, we are Fearless!  Or Not!

Barry and Sherry were a happy retired couple just enjoying their everyday life. Without warning, Sherry fell in the kitchen, breaking her wrist. Shortly afterward, Barry slipped off the second rung of a ladder. While not injured, he was shocked with his near miss and started being less active. Then one day on Facebook, they saw Be Ready, Be Steady as the theme for the 2020 Fall Prevention Month. They agreed that they could be more ready to be more steady, whether fearful or not. Fear of falling refers to a persistent concern about having a fall that leads an individual to avoid daily activities. Is it a rational fear? Yes, the fear is based on reality. According to the Canadian Institute for Health Information (CIHI), 81% of hospitalized injuries were due to falls in 2017-2018 with the majority for older adults age 65 and over. The balance to that fear needs to be informed motivation, not paralysis. Fear of falling may start earlier than we might expect. Middle aged and older adults who report a fear of falling share some factors. They are likely less physically active. Other factors can include limitations in daily activities, higher levels of anxiety and depression, chronic conditions, and the use of walking aids.  Did fear of falling come first to limit mobility or did decreased mobility lead to fear of falling? Fear of falling can be tough on both physical health and the quality of life. We can be ready to be steady by using multiple approaches:

  • Create a safe indoor and outdoor environment. Check out the Fall Prevention Month website section for adults and their caregivers   (Insert your own local Public Health or Senior Centre Contact here) for home safety checklists, along with ideas as how to make improvements to reduce fall risks.
  • Be physically active. It encourages muscle strength, balance, and flexibility. Many programs are available online. During this time of Covid 19, creating a safe space for exercising in your home, with online programs – also found on the Fall Prevention Month website. (Insert local here or leave as is)
  • Check out cognitive behaviour therapy (CBT) The McMaster Optimal Aging Portal article on Cognitive Behavioural Therapy describes a  useful technique to address fears. It has been used with some success.
  • Consider a medical alert button, which provides a measure of confidence that, should a fall occur, communication to needed help is readily available. This should be worn or kept always within reach.
  • Learn how to get up from a fall. This skill increases confidence that, should a fall occur, there won’t be the “long lie” of being stranded while possibly being injured as well.
  • Avoid letting fear cause social isolation. The company of others is essential for good emotional health.

While our own home safety can be more within our control, outdoor conditions conducive to tripping and falling may present bigger challenges.  Outside our homes, it might be time to:

  • correct cracked sidewalks, uneven levels
  • ensure there is good lighting indoors and outdoors
  • install handrails and grip bars on stairs and by slippery surfaces in public spaces, and in homes
  • wear safe footwear indoors and outdoors to reduce slips
  • advocate for safer public spaces

Barry and Sherry recognized that Covid 19 isolation had increased their need for physical activity to keep their flexibility, strength, and balance. They  checked out the Fall Prevention Month website and found resources for in home exercise programs, home safety checklists and other fall prevention materials. So, should we fear falling? Or perhaps, this Fall Prevention Month, we should just choose to have a healthy respect that it can happen and Be Ready, Be Steady.

About the Authors
Marguerite Oberle Thomas, RN., BScN., Consultant Liaison, and Alison Stirling, MHSc., MISt., Knowledge Broker, both seniors, work with Loop Fall Prevention Community of Practice of the Ontario Neurotrauma Foundation.