Falls and Incontinence

Falls are common among older people. Falls often result in injury, fear of further falling can lead to or increase disability. Falls account for many hospital emergency department attendances and hospital admissions. Incontinence is one ot the many factors that can increase the risk of falling.

One in three people aged over 65 expereince one or more falls each year with 10-20% of these falls causing serious injuries, including fractures. An unintentional fall is the leading cause of injury-related admissions for people of all ages to Victorian hospitals and Emergency Departments, with the actual numbers and severity of consequenses being greatest for those aged over 75 Years. (DHS)

Incontinence and Risk of Falling

Urinary incontinence has been associated with a risk of falling. This can be due to a numberof factors including:

Urge Incontinence - when a person experiences urgency on a regular basis they rush to the toilet as they fear not getting to the toilet on time and leaking urine (incontinence). The act of rushing to the toilet places the person at risk of falling as they can slip or trip.
Night time can be particularly troublesome as the person wakes up becasue of the urgency. Often they then rush out of bed before fully awake. Nocturia is the term given to people who need to get up more than twice overnight to go to the toilet
The risk of falling increases if the incontinence occurs on hard surfaces such as bathroom tiles, vinyl or floorboards as the person may slip on wet surfaces.
Mobility issues - a person with some kind of disability or impairment which limits movement and balance can fall when trying to get to the toilet becasue of poor visual impairment and lower and upper limb impairment.
Some medications used to treat incontinence can also cause a drop in blood pressure following a change in position such as from lying to standing eg upon getting out of bed. This causes a reduced blood flow and lack of oxygen to the brain which may lead to light-headedness and fainting.
Poor fluid intake

Strategies for reducing risk

Sit when urinating and sit for a while on the bed on waking or when getting up to go to the toilet to allow time for the nerves and circulation to adjus
Ensure the path to the toilet is free from clutter and obstructions that become trip hazards
Use a night light or small torch to increase the visibility in the dark, if you have to get up to go to the toilet during the night
Wear a pad if leakage is a problem
Have a commode near the bed
Drink adequate fluids
Seek help to have your incontinence problem assessed and treated

Other Falls Risk Factors

Other factors associated with higher risk of falling include:

Some medical conditions that affect balance and reduce physical ability
Some medications (or combinations) can affect balance
Inactivity - results in loss of bone and muscle strength and poorer balance
Gradual changes to eyesight occur with age
Painful feet and unsupportive shoes affect balance
Slip, trip and fall hazards in and around the home and public places
Lack of acceptance of current capabilities may result in risky behaviour
Fear of falling can lead to a reduction in physical activites and social contact

It is recommended that people who expereince a fall or who are frail and elderly or have a disability have a falls risk assessment by a qualified health professional. This will help determine appropriate strategies to prevent future falls.

Other Information about falls prevention

Further information about falls prevention is available from the following websites:

Department of Health Victoria: Aged Care

National Ageing Research Institute: Tips on Healthy Ageing

"Go For Your Life": www.goforyourlife.vic.gov.au