In addition to the most serious consequences of a fall, which can lead to death, older adults who survive a fall often experience a variety of physical and mental impairments that affect their health and well-being. About half of the older adults who suffer injuries from falls require hospitalization, and the poor healing capacity of older adults significantly impairs recovery and can lead to the worsening of pre-existing conditions that can affect physical activity. In addition, the fear of falling can reduce the mobility of the elderly, limit their range of activities and cause a decline in quality of life, and significantly increase the burden on families and society. According to Director Liu Yuanbiao, falls can be avoided and prevented. Statistics in the United States show that two-thirds of deaths due to falls can be avoided. In fact, falls in the elderly are the result of a combination of potential risk factors, so taking effective measures against these risk factors can reduce or avoid the occurrence of falls. If we can help these people avoid falls, we can naturally help them to maintain good health and live a peaceful life in their old age. Why the elderly are prone to falls The three stages of a fall are disturbance of balance, falling downward, and finally the body part hitting the ground. If you can adjust your body posture in time and not let your body contact with the ground in the process of falling down, you can avoid the occurrence of falls; even if your body hits the ground, if your body is strong enough, then you can also reduce the physical damage caused by falls to a minimum. Director Liu Yuanbiao said, from the kinematic point of view, the body’s center of gravity will change when the human body moves and the balance will be disturbed; the greater the magnitude of the movement, the greater the impact on balance. For example, standing at the edge of the dining table to get a glass of water on the table has less interference with balance; while standing one step away to get the same weight of the glass of water, the interference with balance will become bigger. When balance is disturbed, the balance system in the body senses the information and sends a command to the trunk and leg muscles to contract and produce a balance response. If the balance response is timely and adequate enough to readjust the body’s center of gravity, the body may avoid continuing to fall down. So what are the situations in which falls tend to occur? Falls are most likely to occur during walking, especially when starting, stopping, changing direction or avoiding obstacles, followed by postural shifts (such as standing up from a sitting position), going up and down stairs, or slipping and tripping. The elderly spend most of their time at home, which is also the place where most falls occur; because in a more familiar place, the elderly are more relaxed and less cautious than in unfamiliar environments. From the fall prevention point of view, home is the most dangerous place. The most dangerous places in the home include the living room, bathroom and toilet, dining room, bedroom and kitchen. Falls cause physical and psychological injuries Liu Yuanbiao, director of the fall prevention department, said that clinically, fractures top the list of physical injuries caused by falls, followed by head trauma and soft tissue injuries. About half of the older adults who fall require hospitalization for serious injuries, and a large percentage of them are unable to regain their ability to care for themselves and live independently after a year. Statistics in the United States suggest that one-third of all accidental deaths among older adults are caused by falls. Even if there is no physical injury after a fall, the elderly may develop a fear of falling or even fall-phobia, avoiding activity for fear that they will fall at any time, remaining seated for long periods of time, or even staying in bed all day. Long-term inactivity, the body is like a suspended machine will rust, the overall function of the decline and the formation of a vicious circle. Older women are more prone to fractures than men due to postmenopausal osteoporosis. Thigh-femoral neck fractures are the most common of these fractures. If the physical condition can cope with surgery, hospitalization is required for major surgery such as incisional internal fixation or even femoral or hip replacement. In addition to the risk of anesthesia, there is also the risk of deep vein thrombosis, pulmonary embolism, and inability to move independently for a longer period of time after surgery. It has even been noted that a quarter of the elderly with thigh fractures will die within a year. In addition, fractures in the wrist area caused by hand support during a fall are also more common, and other fractures include vertebral compression fractures. Falls can really be prevented The prevention of falls requires a comprehensive management strategy. The first step is to emphasize healthy and safe habits for older adults. Older adults should have a thorough assessment and self-awareness of their physical condition, recognize that some bodily functions will decline as they age, and take appropriate countermeasures in their daily lives in response to these changes. Director Liu Yuanbiao points out that falls often occur when reaching for objects from a distance or reaching for things from a height on tiptoes. Therefore, it is important to store commonly used items in a convenient and easily accessible location to avoid or reduce the chances of the elderly using these dangerous movements. Second, slow changes in body posture are also an effective fall prevention measure for older adults. All activities that require changing the position of the body’s center of gravity, such as sitting and standing, turning, squatting and other posture changes will put the body in an unstable state and make it easy to fall; and some drugs (such as antihypertensive drugs) can cause postural hypotension in the elderly, so the elderly should remember to slow down when changing body posture. Furniture placement should be fixed and not changed frequently. Older adults should be skilled and use as many assistive devices as possible, such as handrails. Older adults should abandon the mentality of being competitive and unwilling to show weakness, and make full use of handrails in places with handrails, such as stairs and steps; don’t believe too much in the idea that “if you are careful, you won’t be in danger”, because it is inevitable that passersby or their belongings will bump into older adults in stairs and other workplaces. Older people’s bodies, which are not very stable, are bound to fall easily under the action of external forces. According to Liu Yuanbiao, the first thing to do is to fully assess the functional status of the central nervous system, peripheral nervous system, musculoskeletal system, sensory (vision, hearing, vestibular sensation, proprioception, etc.) and cardiovascular system through a comprehensive physical examination once a year, and consult with a specialist if there is a need to adjust the medication being taken. Based on the history of falls and current basic physical condition, the elderly can be divided into low risk, moderate risk, high risk and extreme risk groups. Each group of older adults requires a complete assessment and effective prevention strategies. What to do after a fall Proper handling after a fall can reduce the occurrence of re-injury, so it is necessary for the elderly to know how to get up after a fall, and it is also necessary for social work to know how to deal with the emergency scene in case the elderly fall and become unconscious (coma). According to Director Liu Yuanbiao, if you are conscious and have no obvious pain in any part of the body after a fall, you can try to get up by yourself. After resting properly to eliminate the feeling of panic and basically calming down, first try to make yourself into a kneeling position by turning over and putting yourself in a prone position, supporting the ground with both hands, lifting your hips and bending your knees; then try to stand up with a sturdy and reliable chair or other object around you. Rest for a few moments and call your family or a medical institution for help when you have recovered your strength. When family members or passersby see an elderly person who has fallen, they should deal with the situation according to whether there is loss of consciousness or not. For a fallen person who is unconscious, the person who finds the fallen person should immediately call an emergency number for professional assistance. Check whether the patient has vomiting, convulsions, cardiac arrest, etc. and take emergency measures on the spot. For vomiting, head should be tilted to the side and the vomit in the mouth and nasal cavity should be cleared to ensure a clear airway; for convulsions, attention should be paid to prevent tongue bite; if the breathing and heartbeat have stopped, first aid measures such as chest compressions and mouth-to-mouth artificial respiration should be performed immediately. If the fallen elderly person is conscious, it is necessary to find out whether he/she can recall the fall process, if not, there may be central nervous system injury, so he/she should immediately call the emergency number or be escorted to the emergency room for treatment; if there is inability to move the limbs on their own, slurred speech is unfavorable, it indicates the possibility of stroke, so call the emergency number immediately, and avoid moving the body. If a fractured limb or spinal injury is considered, it is usually recommended not to move the fallen person at will to avoid causing new injuries. Seniors, exercise to prevent falls Although many environmental risk factors that may lead to falls can be ruled out, it does not mean that seniors in a safe environment will not fall, because lack of balance control is the main and most fundamental cause of falls in seniors, the so-called exogenous factors work through endogenous factors, said Lu Peng. Proper, reasonable and adequate balance response is the most important basis to avoid falls, and the balance response ability depends firstly on the ability of the central nervous system such as the brain to quickly identify the balance disturbance factors and start the balance response in time and quickly; secondly, the whole body joints should have enough flexibility to ensure the completion of the balance action; finally, the corresponding muscles should have enough strength to complete the fast balance response. However, the above three functions of the elderly have different degrees of degeneration, so it is necessary to improve the balance reaction processing function of the brain, improve joint mobility and enhance muscle strength through proper exercise training, so as to achieve the goal of improving the balance reaction ability and reducing or even avoiding falls. To prevent falls, there are specific sports training Lu Peng said that good joint mobility is the basis for us to complete the movement, and elderly people will have different degrees of reduced mobility even without joint injury, which is directly related to the aging of muscles, ligaments and joint structures and lack of exercise. Therefore, older adults should be targeted with joint mobility training based on a comprehensive assessment to maintain or improve joint mobility. There are two main types of joint mobility training: active and passive training. Active training is the mobility training that older adults perform with their own strength or weight, with their bare hands or with the help of tools. Passive mobility training, on the other hand, does not involve the elderly themselves, but mainly relies on the help of therapists or assistants. Take the ankle joint as an example, Figure 1 shows active training and Figure 2 shows passive training. Balance control is one of the most important physical qualities. It is the ability to maintain normal body posture, especially the ability to control the body’s center of gravity on smaller unstable support surfaces. Stability is the ability of a joint or a segment of the body to maintain good posture and work safely and effectively during physical activity. Stability is the basis of balance control ability. If stability is poor, not only are the joints and muscles prone to injury, but it also weakens balance control and increases the risk of the body falling. The stability of the human body depends mainly on the strength and power contrast of the muscles around the joints, as well as the ability to work in coordination. Therefore, stability training should not only train the strength of joint-related muscles (active and antagonistic muscles), but also train the ability of these muscles to work together. Stability exercise considerations: ① Strength training is the foundation. ②Train on stable support surfaces first, then on unstable support surfaces. (3) Single joint training first, then multi-joint training. ④Bilateral limbs first, then unilateral limbs. ⑤ Trunk stability (core stability) training should not be neglected. ⑥Two to three sets of 10-12 reps for each part, with the rhythm following the principle of “fast start and slow release. Take the ankle joint as an example: The first step is to perform strength training on a stable interface (such as the floor) with increasing difficulty, first with support for bilateral heel lifts, then transition to supported unilateral heel lifts, then transition to unsupported bilateral heel lifts, then transition to unsupported single-leg heel lifts. The second step is to perform strength training on a relatively unstable interface (such as a soft mat) with increasing difficulty, transitioning from supported to unsupported, and from bilateral to unilateral movements. On the basis of stability training, older adults should further target balance control training. Balance training should also be conducted first on stable support surfaces from easy to difficult, such as walking on the playground first, then fast walking, then jogging, or even taekwondo, square dancing and sports. Then train on unstable interfaces, such as walking, brisk walking, jogging on flat grass or soft track. We can also use equipment for strengthening training, such as standing on both feet on a soft mat, standing on one foot or accepting interference from others. Sports training must be professional and safe Lu Peng said that sports training has specificity, meaning that each sport has its own special effect, not just sports can achieve the effect of reducing the risk of falls. The elderly must be based on the previous content, based on a comprehensive assessment of physical condition, according to their own characteristics, targeted development of individualized special training programs. Researcher Lu Peng suggested that obtaining guidance from medical personnel is the primary condition to ensure safety, especially for older adults with common diseases. Always pay attention to your condition during exercise, and stop exercising immediately if you experience dizziness, obvious shortness of breath, chest tightness and chest pain or nausea and vomiting. Safety first, the elderly balance training must be gradual, must not be rushed. The body and mind need a slow adaptation process, to start with a small amount of exercise simple, gradually increase. Older people who rarely exercised in the past or suffered from diabetes, hypertension and cardiovascular diseases should pay more attention to avoid triggering or aggravation. The improvement of balance is a slow “re-learning” process, which cannot be achieved overnight, and cannot be practiced if you want to, but must be persistent.