A Fall Can Be Fatal: Elders Need To Safeguard Against Orthopaedic Injuries In The Time Of COVID-19 

Rising cases of orthopaedic or joint injuries among elderly people during lockdown can be considered a public health problem and India needs to formulate a preventive strategy.

Dr Rajeev Verma, HoD, Department of Joint Replacement & Orthopaedics, Manipal Hospitals Dwarka

In the current COVID-19 scenario, most of us are bound to our homes to protect ourselves against the virus. Many, especially the elderly are paying heed to the governments advice of not venturing outside unless there is a dire emergency. This is the need of the hour and is utmost respected.

During the period of lockdown, we, at the Department of Orthopaedics, Manipal Hospitals, have noticed a new set of problems being faced by the elderly population. Seniors are facing fall at home causing orthopaedic injuries.

Over the past three months of lockdown, we had 52 senior citizens coming to the emergency which warranted admission and surgery. This was more than the usual average when compared with pre-lockdown numbers.

Almost all senior citizens had domestic falls. It (fall of elderly) has become a public health problem and needs special attention. Domestic falls or falls in the house or familiar surroundings is entirely preventable.

Western countries lay a lot of emphasis on these preventive strategies whereas these have not still been educated to the masses here in our country. India needs to formulate a preventive strategy for this public health problem. We believe in the proverb that a stitch in time saves nine

Problems of Elderly

The COVID-19 pandemic has brought to sharp focus some of the vulnerabilities of the elderly. Frailty, related to movement restriction, malnutrition and poor immunity, has surfaced as a major concern.

The problem is compounded with sensory problems that can prevent them from taking adequate precautions. With advancing age, chronic illness and use of multiple medicines are common among them and that calls for increased health-care need and physical support.

Moreover, impaired cognitive abilities that worsen with age pose an extra challenge. All these vulnerabilities are associated with a high risk of falls and associated fractures. The common causes for falls that we came across include wet floor, dim lighting, rugs or carpets are not properly secured, rushing to toilet or storage areas, use of stairs among others.

Seniors mainly fall due to weak leg muscles, poor physical balance, dizziness or light-headedness, blackout or loss of consciousness, memory loss, vision and hearing problems and anxiety or fear of falling.

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Prevention

First of all, seniors need to do a safety check of their home. It is better to clear the clutter from your floors or stairs including small furniture, pet bowls, trailing cables, or other things can cause you to trip.

Secondly, you should avoid walking on slippery or wet floors. Securing carpets and loose flooring, as uneven surfaces can cause a trip hazard particularly on stairs, replacing your carpet with a bright-coloured one particularly if you have problems with your vision.

Thirdly, lighting is important. Adequate lighting on stairways, corridors and hallways is necessary. Darkness (in case of power cut) put you at a higher risk. Hence, avoid darkness with a lamp or light within easy reach of your bed and keep a torch by your bed.

Putting night lights in the bathroom, hallways and bedroom are equally important. It is also important to have stable furniture. Fourthly, in case of balancing problem or dizziness, it always better to store frequently used items such as food containers, dishes and clothing within easy reach. Finally, we need to move around safely with proper support. A stick or frame that’s the wrong height can make your walking, balance and posture worse.

Care Your Bones

Seniors need to pay more attention to their bone health. Eat a healthy balanced diet rich in calcium – Dairy foods such as milk, yoghurt and cheese are good sources of calcium. Small amounts of calcium can also be found in green leafy vegetables, soya beans and tofu, nuts (particularly almonds), bread and anything made with fortified flour.

It is advisable to avoid excessive amounts of caffeinated drinks such as tea, coffee and fizzy drinks as they can prevent the body from absorbing calcium. Stop smoking and limit alcohol intake. Low impact weight-bearing and muscles-strengthening exercises help a lot. Vision, hearing, and feet need extra care. Manage your medications well and take your medication as prescribed by your doctor as certain medications have side effects that may put you at risk of falling.

Measures to be taken in case of a fall

In case of a fall, seniors need to keep calm and should not panic. If there is no injury and you feel strong enough to get up- do not do that. Don’t get up quickly. Here you need proper support, hence look for suitable support in forms of furniture or some other objects. Get up slowly with support.

Take some rest before you again start normal activities. In case of injury and you are unable to get up, immediately call out for help. Try to get access to the phone and dial 011-40407070 for an ambulance. Cover your legs and feet with a blanket. While waiting for medical help and intervention try to change your position at least once every half an hour.

In nutshell, seniors need to be more careful in COVID-19 times. They do not only need to take precautions to safeguard against a fall, but also pay attention to their bone and joint disorders. They should take out time to do simple exercises and meditation. Moreover, seniors should take all precautions recommended by the Ministry of Health to mitigate their risks of COVID-19 infection.

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