trip hazards

It is important to decide how the older person can call for help. The older person (especially if they are often alone) should be given a watch with a fall sensor or at least a telephone (preferably with large buttons), trained in its use and accustomed to always carrying it with them.

Fall risks – prevention or how to protect yourself from injuries

Fall prevention should be comprehensive and all-encompassing. Risk factors must be reduced and a safe environment created. Special children's furniture is developed for children, playgrounds are appropriately equipped, children are taught the rules for crossing the street, etc. A safe home environment is created for older people, especially those suffering from Alzheimer's disease, senile dementia, multiple sclerosis, Parkinson's disease or epilepsy created. Special communities help relatives adapt their homes to the changed conditions and teach them how to care for the weakened people.

Health checks for abnormal blood pressure, vision, hearing, macronutrients and trace elements in the blood should be carried out early so that they can be corrected or treated in time.

Alcohol damages the liver, memory and sometimes hearing. It increases the risk of falls. In addition, excessive alcohol consumption carries the risk of malnutrition and thus a calcium deficiency. This leads to weakening of the bones. It is not necessary to avoid alcohol completely. For women, the World Health Organization (WHO) recommends a maximum daily amount of 10 g of alcohol (e.g. approx. 0.1 liter of sparkling wine, 11 vol.-%). For men, no more than 20 g (e.g. 0.5 liters of beer, 5 vol.-%).

Unfortunately, an accident at home is not uncommon. How can you protect yourself from a fall?

• Do not wear socks, knee socks or tights around the house as they are much more slippery;
• avoid small rugs that slip easily; in the bathroom the carpet should lie on suction cups;
• Make sure there are no high thresholds in the apartment;
• Make sure there are no broken tiles, loose linoleum or damaged parquet;
• keep hallways clear and do not put objects against walls - if a person loses balance or has a tremor, they may lean against a wall;
• In or above the bathtub, handrails and a rubber mat in the bathtub itself make sense;
• A bedside lamp should be placed at the head of the bed so that it is easy to reach;

1. Strengthen your muscles

Strengthen your muscles – do sports, go to the swimming pool, find exercises that train strength and endurance. Sign up for group classes that promote balance and stability – yoga, Pilates, body balance, dance.

If you are afraid of falling, use a cane. If there is black ice, wear boots with gaiters or special 'spikes' on your shoes. Older people can use special protectors for their knees and hips.

Test: How at risk of falling are you?

Fall prevention also involves a person assessing themselves (or others) to determine their risk of falling. Below are questions to assess your risk of falling:

• Has your gait become slow or unsteady?
• Are there imbalances?
• Are there problems with your legs and feet?
• Do you need help walking?
• Has your mobility noticeably worsened or is it difficult to walk?
• Is there a noticeable worsening of standing?
• Are you taking four or more medications that increase your risk of falls?
• Have you had two (or more) falls within a year?
• Has there been a deterioration in mental performance?

trip hazards

Tripping hazards are associated with loss of balance when the foot comes into contact with an object while moving. Causes of tripping hazards include:

• a sudden change in surface condition, a sudden difference in height on an area;
• the presence of loose cables, loose wires or other objects in the path of the worker;
• the type of footwear and the condition of the soles (high-heeled shoes are particularly at risk of tripping);
• physical factors such as adequate lighting;
• the physical condition of the person who might stumble.

The severity of the consequences associated with tripping hazards depends on the environment (presence of furniture with sharp corners, etc.). If a person trips and loses balance, they may become injured while trying to prevent a fall by holding onto surrounding objects, which can result in injuries such as bruises, fractures, and dislocations.

Dangers associated with falls

Falls are usually the result of a loss of balance due to slipping or stumbling, but can also result from other causes such as improper use of ladders or scaffolding. There are two main types of falls: falls on a flat surface and falls from a height.

The first step is to identify problem areas. Regular inspections of workplaces are planned, taking into account the condition of the floor (surface quality or contamination) and ladders (surface and handrails), as well as their lighting.

Once problem areas are identified, the risk levels associated with them are determined and actions to reduce or control the risks are prioritized.

It is recommended to consider measures to reduce the level of risk according to the priorities already described.

Hazards can be eliminated by preventing contamination of surfaces by reassigning cleaning personnel most exposed to these hazards from night to day work to reduce fatigue by placing wires and cables in ducts or ducts , by installing additional electrical outlets to reduce the number of dangling cords, by leveling out uneven floors, by replacing flooring material with less slippery material, or by installing carpeting in the most dangerous areas.

If it is not possible to eliminate the hazards, it is recommended, for example, to equip cleaning staff with cordless (battery-operated) cleaning devices or to use alternative cleaning methods, such as: B. Dry cleaning of floors with limited use of water and mops, use of microfiber materials for floor cleaning, limiting the use of water and disinfectants.

If these measures are not sufficient, organizational control measures such as access restrictions to risk areas, fences or warning signs are recommended.

As an additional measure, personal protective equipment such as non-slip footwear is recommended.

Ergonomics at work keeps you healthy

Poor ergonomics in the office are widespread and lead to many complaints. Many of these complaints are caused by incorrect desk positioning, uncomfortable chairs, or bending and stretching that force uncomfortable postures. If you care about your employees' well-being, your company should have an ergonomic workplace assessment.

You can prevent illness through office ergonomics by paying special attention to workstations and display devices.

• Provide footrests to support legs.
• Use chairs with adjustable height and backrest.
• Allow your employees to set up their desks at the right height.
• Advise employees that they should place keyboards and mice at a height that does not require them to bend or stretch.
• Position computer screens so that employees do not have to lift or bend over to use them.

Poor office lighting can also lead to a number of health problems, including:

The solution to inadequate lighting is simple: light your office with adequate lighting in the center of the room and task lighting at each workstation.

If possible, consider adding an anti-glare coating to computer screens. These screens prevent unnatural computer glare from reflecting into people's eyes. If the natural light from outside is too bright, install blinds or tinted glass.

Encourage your employees to get an eye test every one to two years. In open-plan offices, individual lighting options increase employee satisfaction.

Electrical accidents

Even voltages below 50 volts can cause an electric shock. Many electrical accidents can cause muscle spasms and difficulty breathing. Most offices are equipped with electrical devices, so you need to ensure that these devices are properly connected. You also need to make sure that they are not damaged and that no live wires are exposed.

Make sure all devices and wires are in good working order to avoid electric shock. Check the devices regularly for errors and dispose of anything that is defective, damaged or no longer functional. All electrical equipment should have a sticker indicating that it has passed electrical safety tests.

pathogenesis

Falls are caused by the inability to maintain balance when the center of gravity shifts. This is prevented by the vestibular and musculoskeletal systems. Normal posture is maintained by tensing the muscles of the lower limbs, stepping reactions, or leaning on surrounding objects.

After the age of 30, the number of muscle fibers and muscle strength gradually decrease, causing muscle weakness in the elderly. Sarcopenia occurs, which is more pronounced in the fast muscle fibers. The mobility of the ligaments and the range of motion of the joints decrease. As a result, the ability of fast muscles to maintain balance suffers.

A short step forward in the older people's step response is followed by an additional step to the side. Smaller steps result in one foot hitting the other. This change in step pattern leads to frequent sideways falls with the risk of hip injury and femoral neck fracture.

classification

Currently, fall syndrome in older people is classified based on 2 criteria: by the causative factor and the presence of trauma. The etiopathogenetic classification is essential for causal statistics and subsequent preventive measures. According to her, falls are divided into:

• Unintentional. Associated with environmental causes. These include tripping over obstacles and underestimating the position of objects in the environment. Darkness is one of the causes.
• Predictable. Is related to the physiological condition of the patient. Patients with dizziness, muscle weakness, parkinsonism, and cognitive deficits are more likely to fall.
• Unpredictable. The patient falls due to an unpredictable pathological condition. Unpredictable causes include myocardial infarction, stroke, hypoglycemia, and syncope.

The classification of the syndrome according to the traumatic complications present and their severity is of clinical importance. It is crucial for determining the patient's further treatment. Two main groups are distinguished:

• Falls without trauma. These are not accompanied by any visible injuries or discomfort. In some cases, X-rays, CT scans and other instrumental examinations are required to rule out trauma.
• Falls with trauma. This includes cases in which the victim was injured. Minor injuries are characterized by bruises and abrasions, moderate injuries by sprains and wounds that require stitches. Serious injuries include fractures, traumatic brain injuries and injuries to internal organs.

Prevention of fractures and falls

Preventing falls, which can lead to serious injuries or fractures in older people, must be comprehensive and on several fronts at the same time. It should include the following:

• Creation of safe housing and living conditions;
• exercise and physical therapy to strengthen limbs;
• adjusting medications to reduce the risk of side effects;
• taking medications to treat osteoporosis and anemia;
• Supplementation with other vitamins and minerals important for the skeletal system;
• Correction of the diet, increasing the proportion of foods containing calcium and vitamins in the diet.

It is important that older people are monitored, especially if they exercise poorly, and that their diet is corrected with more whole foods containing minerals and vitamins that affect the skeletal system. Vitamins are needed in the form of pharmacy preparations in combination with mineral preparations, several times a year. Physical activity, at least daily walks, is necessary to promote the absorption of vitamins.

The role of exercise in prevention

Older people should not lead a passive lifestyle - they need to move, train their muscles, be in the fresh air and do regular physical exercises. This activates blood circulation and metabolism, strengthens muscles and promotes calcium exchange in the tissues and bones. At least older people should be advised to go for walks and do morning exercises every day, which is already good exercise at this age. When walking and at home, shoes with a non-slip surface should be chosen and slippery mats, wires or thresholds should be removed from under the feet. This helps reduce the risk of a fall, which can result in a fracture due to slipping or tripping.

It is important that the home is well lit, even at night when the elderly person gets up to use the toilet or take medication. Lights should be on in easily accessible areas, both general light and spotlights. All items and medications for the elderly person should be within easy reach so that they do not have to reach for them or bend over. The bathroom should be equipped with handles, rubber mats and a special seat for washing. Very hot water should not be used when bathing.

Exercise program for older people

Older people should always plan responsibly so as not to harm their health - an exercise program should be discussed with a specialist. It is important to inform your specialist in advance if you have any chronic diseases or medical contraindications. The basic exercises can be performed at any fitness level.

'Sit up and stand up'.

This exercise can even be done in front of the TV. The technique is very simple and regular practice strengthens the ankles and knees and makes the gait more stable.

Sit on a chair and place your feet shoulder-width apart. Place your heels just behind the edge of the chair. Stand with your heels as if you were going to shift your body weight onto them. Stand for a few seconds and then sit back down. Repeat the exercise 8 to 12 times. You can use an armrest if you find it difficult to stand without support.

professionals from Yale University conducted a large-scale experiment. 440 volunteers were divided into two groups. The older people in the first group thought that old age was something terrible. The participants in the second group viewed age-related diseases as a completely natural process. The experiment showed that the optimists got sick less often and lived about 7-8 years longer than the pessimists.

'Ankle 'circles'

The ligaments become less stable with age and therefore need to be strengthened regularly. The ankle is the 'weak spot' of older people, so it is not uncommon for them to twist their leg. To avoid injury, it is important to perform ankle strengthening exercises.

Sit with your leg slightly forward without fully extending your knee. Rotate the ankle counterclockwise, making 8-12 circles. Then also perform circles in the opposite direction 8-12 times. Perform 5 to 7 series for each leg.

Fall prevention tips

An important aspect that can help reduce the risk of falls is prevention. First and foremost, avoid wearing flip-flops. These shoes can provoke a fall and also cause a wobbly gait, resulting in an irregular gait.

At home, doormats should be removed as they can cause trips and falls. Slippers should be comfortable and have a secure fit. If you are visually impaired, rooms should be well lit. Bedside lamps can be installed so that the light can be conveniently turned on from anywhere in the room. Wires, cords, and other items that often lie on the floor should be routed along the wall or removed entirely.

It is important to do all exercises regularly - only then will you achieve good results. Older people should pay attention to their health and seek medical examination in a timely manner. If discomfort or pain occurs during movement, a specialist should be consulted.

Even a seemingly simple fall by an elderly person can result in serious injuries. Broken bones, dislocated hips, bruised ribs, wrists and other injuries can not only temporarily reduce quality of life, but can also be fatal. That's why it's so important to take preventative measures and regularly perform coordination and balance exercises.

The simplest coordination exercise is standing on one leg. Start with 10 seconds and try to gradually increase the time to 1 minute. Older people may find it easier to stand on one leg than the other. In this case, it is worth training the weaker side.

Symptoms of cardiac arrhythmias and their causes

The classic symptom of cardiac arrhythmias is an irregular heartbeat and skipping beats. This is usually an expression of extrasystoles.

In most cases, it is a harmless feature of the patient's physiological condition. However, they can also indicate a serious pathology, especially if they occur in conjunction with chest pain, shortness of breath, fatigue or fainting.

Cardiac arrhythmias can also have an organic cause. The pathologies associated with cardiac arrhythmias include angina pectoris, myocardial infarction, heart valve defects, cardiac ischemia and inflammatory processes in the heart tissues. An overactive thyroid, certain medications and narcotics can cause cardiac arrhythmias. More often, however, no organic or other obvious cause for the cardiac arrhythmia can be identified.

Examination of the patient

The most important examination method for heart palpitations is the electrocardiogram (ECG). In many cases, the ECG can be used to detect abnormalities that affect the contraction of the heart muscle. The ECG results indicate uncoordinated atrial activity (atrial fibrillation), impaired impulse conduction (AV block) and unplanned additional muscle contractions (extrasystoles).

If the electrocardiogram is inconclusive, Holter monitoring, in which heart rate and blood pressure levels are monitored daily using a portable Holter device, is indicated.

symptoms

Fear of falling is normal, but only when there is a serious threat. Sometimes the fear is greatly exaggerated and disproportionate to the actual situation. The symptoms of this condition can be almost unnoticeable. An elderly person who encounters such a problem

• looks for support when walking (e.g. the arm of a companion, a cane, or the wall of a building);
• Even a small amount of support is reassuring;
• staggers in open areas because he is afraid of losing his balance and falling;
• holds onto a railing when climbing or descending stairs;
• moves slowly and carefully.

Constant, unfounded fear can create unnecessary restrictions in an older person's life and cause them to refuse to do what they are capable of. Many people are so afraid of a possible fall that they avoid walking and even leave the house.

How to help older people cope with anxiety?

To get rid of the fear of falling while walking, it is important to understand the cause. Sometimes it is a sign of a health problem – poor vision, neurological problems or joint pain.
Then the problem is solved through consultation and treatment with an ophthalmologist, neurologist, podiatrist, etc.

More often, the fear of falling is due to the fact that the older person has already fallen before. Maybe they got dizzy or simply slipped. The fall may have involved hospitalization, joint replacement, a long period of rehabilitation with limited mobility, and loss of independence.

On a subconscious level, this can trigger a conditioned reflex that associates walking with fear.

There are many ways to get rid of the fear of falling.

• If an older person has been prescribed a cane or walker, encourage them to become familiar with it so they can maintain balance and support themselves.
• Some exercises help improve the balance and coordination of the elderly. Strengthening the muscles in the legs, buttocks and core is important for balance. Pilates and yoga classes are helpful. Try exercises that don't pose a risk of falling, such as: B. with stationary cycling.
• If an elderly person has suffered a fall with serious consequences, the help of a physical therapist is essential during recovery. He or she will help restore strength and range of motion and provide recommendations for safe training.

Causes of falls

Why do older people often fall? When an elderly person falls, there are internal, external and situational causes.

• Age-related changes in the musculoskeletal system: Older people have a slower walking pace, shorter stride length and reduced joint mobility, resulting in a wobbly gait, shuffling legs, poor balance and poor motor coordination;
• Diseases of the nervous and circulatory systems;
• visual and hearing impairments;
• Taking medications (psychotropic drugs, antiarrhythmics, sedatives, hypnotics, antihypertensive agents, hypoglycemic agents) that may cause side effects;
• Fear of falling – if a person has already fallen and suffered an injury, they fear that this situation will happen again.

Older people diagnosed with various pathological conditions are more likely to fall while walking and out of bed:

• reduced visual acuity and color sensitivity, allowing the person to miss obstacles;
• Increased adaptation time to light or darkness
• increasing the time needed to adequately judge distances;
• Impairment of the auditory analyzer and the ability to distinguish between sounds;
• Impaired attention, increasing the likelihood of stumbling;
• Impaired motor coordination, loss of balance during impacts and other external factors;
• Abnormalities of the musculoskeletal system (swelling and deformation of the joints, reduced mobility, development of arthritis);
• Cardiovascular abnormalities (orthostatic condition - rapid drop in blood pressure during ascent leading to dizziness and darkness in the eyes, cardiac arrhythmias, heart failure)
• endocrine disorders (hyperglycemia, hypoglycemia);
• neurological disorders (stroke, multiple sclerosis, dementia, Parkinson's and Alzheimer's diseases, muscle weakness, cerebral circulation disorders);
• mental disorders (confusion, disorientation, anxiety and depression);
• nocturnal polyuria (increased frequency of nocturnal urination, delayed urination).

Prevention of falls in the elderly and elderly

Preventing falls and fractures in older people is very important. She focuses on creating a safe living environment to prevent and minimize falls.

As a preventative measure, it is recommended that:

• remove unnecessary items and cables from the floor;
• to use non-slip floors (rough linoleum, carpet is suitable);
• if possible, remove thresholds;
• Arrange furniture so that it does not obstruct passageways or restrict freedom of movement;
• discard unstable furniture with wheels and protruding legs;
• Choose bright but glare-free lighting (pay particular attention to stairs);
• Install rubber mats in the bathroom;
• Install a soap dispenser on the wall near the bathroom so that the elderly person does not have to bend over to pick up soap that has slipped from his or her hand;
• installing handrails on the walls of the hallway, bathroom and toilet;
• placing a high toilet seat on the toilet bowl;
• At night, place a dressing table near the bed so that you do not have to walk across the entire apartment to go to the toilet, or leave night lights on in the toilet, kitchen and hallway;
• avoid mezzanines and high cabinets in the pensioner's room so that he does not have to climb ladders;
• special devices (e.g. a grab bar) so that the elderly person does not have to bend over;
• Use of assistive devices (canes, walkers);
• Treat underlying diseases in a timely manner (if you have diabetes, make sure your condition is normal to avoid hypoglycemia; if you have poor eyesight, wear glasses or have cataract surgery; if you have hearing problems, buy a hearing aid).

Pay attention to clothing and footwear. Clothing should be loose (but not too loose and not too long) and comfortable, and shoes should be non-slip (orthopedic if necessary) and have toes (ordinary flip-flops, although comfortable, significantly increase the risk of falling, since they do not have Allow backward movement) and have rubber soles.

• Winter boots for the elderly.
• shoes for the elderly.
• shoes for the elderly.
• Shoes for the elderly with sore feet.
• Unsteady gait in the elderly.
• insoles for walking.
• amputation set.
• A wobbly gait means.