Monday, 27 June 2016

My father who just turned 80 maintains an active lifestyle with regular exercise and various social activities. One day, we noticed that he had sustained some bruises near his left eye, and it was only upon further probing that we discovered that he actually had a fall while he was out. 

My family became exceedingly concerned, with our subsequent conversations being centered on mobility issues and how to prevent future mishaps. My father was quite calm the entire time, telling us that the fall was light and that he was completely fine.

I realize that as adult children and concerned caregivers with good intentions, we may over-react and unintentionally threaten the autonomy of elders who know that they are fully responsible for their actions and do take precautions to prevent falls. After all, he did not want us to be worried and/or doubt his mobility. As such, we need to learn to trust our parents as well.

A geriatrician friend recounted tensions that sometimes occurred between the elders and their concerned children over fall prevention. While the best way to reduce the risk of falling would simply be to limit mobility, this will ironically serve as a way to increase the incidence of falls. The lack of physical activity will further weaken the muscle tone and strength which then increases the risk of falls when moving about.

Another geriatrician observed that the risks of falls do not necessarily lessen with the presence of caregivers. Elders who tend to be vigilant on their own may not be very much on guard when there is someone else around them to react when they fall.  
As caregivers, we want to encourage elders to stay as mobile, active and as independent as possible, instead of restricting their movements because of the fear that they may fall. 

Hence, steps to prevent falls should focus on the maintenance of autonomy, including various measures to ensure a safe home environment (since this is where falls are most common), consulting the doctors if there are factors affecting steady movement (such as vision problems, medications that affect balance and so on) and also getting the elders to learn tips to prevent falls – which (as I suspect) they are already quite knowledgeable through everyday experiences. 

Visit the Health Promotion Board website ( and have a read on the article named “Fall Prevention Program” for a copy of the Home Safety Checklist.

You can also visit iCare Life - Home Safety and Falls Prevention to learn more about preventing falls.

Dr. Thang Leng Leng
Associate Professor 
National University of Singapore (NUS)
(Writer is a member of iCare Life Advisory Board)


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