Falls is a common and most frightening nervous disorder in advanced old age. A fall occurs when the vertical line which passes through the centre of the mass of the human body comes to lie beyond the support base and correction does not take place in time.
There are two types of falls in the elderly. The young old person falls occasionally because he unwisely indulges in activities involving large and rapid displacements of which he was once capable, but which now exceeds his capacity. In the second type, the older people who suffer from multiple disabilities fall frequently due to the sharp decline in the efficiency of balance mechanism.
Most falls are trivial and they do not result in injury. It is estimated that nearly 80 per cent of falls do not result in injury. In other cases, injuries may result depending on the intensity and rapidity of the fall. Older people most’ likely to suffer injury are th9se who are moving rapidly at the time of the fall.
All efforts should be made to improve the performance of the patient. The most important step in this direction is to create confidence in the patient’s own ability to remain upright throughout his daily activities. Other steps in this direction include provision of well-fitting shoes with low heels to the patient and improvements in his environment like appropriate floor surface and floor coverings, proper arrangement of furniture, adequate lighting and correct height of chairs and beds. This is essential as some old people are used to walking frames or to clutching on to furniture as they move around the house. Those patients who have recently developed the tendency to fall and are able to maintain balance, should be discouraged from using walking frames as they alter the body postures and the pattern of walking.
Proper training of the patient is also an important factor in treating the condition. They should be encouraged to walk with confidence and supported, if necessary, by a hand held lightly in front of them. The patient’s training should aim at increasing his speed of walking as the more rapidly he walks, within limit, the safer he appears to be. While climbing stairs, the patient should take the support of the railing with one hand and should concentrate on placing the feet carefully and firmly on the steps. He should be encouraged to practice transfers from bed to chair, from chair to toilet and so on. Those who are at a risk of falling and who have shown their inability to rise without assistance, should be taught the proper technique to get up,
.which is to turn on to the side and to bend up one knee. From this position they should be able to roll on to that knee and to bring up the second knee until they are kneeling. They may then be able to crawl or to reach out for a nearby chair and gradually get up with its support.
The patient with a tendency to fall should be given optimum nutrition, well-assimilated with all the vitamins and other nutrients. The emphasis should be on whole grains, particularly whole wheat, brown rice, raw and sprouted seeds, milk, especially in soured form and homemade cottage cheese.
In severe cases, the patients should be put on a short juice fast for four or five days before being given the optimum diet. Carrot, beet, citrus fruits, apple and pineapple may be used for juices.
The patient should avoid white bread, white sugar, refined cereals, meat, fish, tinned foods, tea, coffee and condiments which are at the root of the trouble, by continuously flooding the tissues with acid impurities.