“Prevention is better than the cure” and this certainlyapplies to orthopedics as much as any other field of medicine. Problems canarise from injury or from non-traumatic conditions. Two age groups areparticularly vulnerable to injury, toddlers and the elderly; with an importantdifference. “Elderly” implies a loss of independence associated with impairedvision, hearing, memory, mobility, and cognitive functions. A child learning towalk falls repeatedly, but gets up again and again, totally unfazed. In the elderly, the 3F syndrome sets in-“Fearof Further Falls” which shatters their confidence, resulting in a self-imposedrestriction of activities, further aggravating and accelerating the effects ofageing.
Tsao Foundation Senior Citizens Clinic in Singapore,highlighted interesting statistics.778 out of 1000 of senior citizens had had afall. Of these, 1/3rd fell in the bathroom, 1/3rd fell on the stairs, and 1/3rdfell whilst walking. Here is where the family can make all the difference inpreventing these falls.
Falls in the bathroom: - Water on ceramic tiles or marble isa lethal combination. The person having a bath or shower usually bends down tosoap or dry one foot, standing on the other leg on a wet tiled floor and slips.A simple bath mat preferably made of rubber or anti-skid tiles would reduce thedanger. A plastic chair or stool would make the bending unnecessary. A handrail would provide a grip to steady oneself.
Falls on the stairs: It is unfortunate to see contractors failing to provide a banister orhand rail on staircases; an absolute necessity if elderly people are to use thestaircase safely. Not only should stairs be well lit up, but two-way lightswitches should be mandatory. Imagine you are at the top of a dark staircase,and the light switch is at the bottom; what is one supposed to do? The switches must be adjusted to enable theon or off position, either at the top or the bottom of the stairs. Tiles usedfor stairs should have anti-skid features; in case of a wooden staircase, ametal strip can be fixed to the edge, taking care that this is fixed firmly.
Falls whilst walking: - It would be stating the obvious toenumerate the hazards of walking on the average street in Goa. The absence ofpavements, the loose stones and potholes, and other obstacles are something noself-respecting municipality or PWD would accept or permit. In communitydwellings, the path from the gate to the entrance of the house is oftencemented, collecting moss during the monsoons, and acquiring the skidproperties of ice. Sprinkling sand or using palm leaves the way ourgrandparents did, would help. Tiles resistant to moss would be ideal.
Family members should systematically assess the homeenvironment and make necessary changes. Don't wait for accidents to happenbefore you start doing something.
Dr Gladstone D’Costa is an orthopaedic practitioner and a member as well as treasurer of the National Executive Committee, Voluntary Health Association of India
