How to help if your loved one’s had a nasty fall

SURVEYS show that only a small percentage of us knows what to do in a health emergency. Today, in the third part of our essential first aid series with St John Ambulance, we show you how to deal with common health hazards associated with older people.

MANY first aid emergencies faced by older people are rooted in conditions we all face as our bodies age. The longer we live, the more likely we are to have more than one chronic disease to manage.

These conditions — and the medication taken to control them — can alter the way our bodies react to injury — and this may have significant consequences for how to help an older person in an emergency.

As we get older, we can become more accidentprone due to deteriorating eyesight, weaker muscles, impaired memory and poor balance.

Older people can be much more vulnerable to serious injuries from falls, bleeds and burns than a younger person because their bodies do not repair themselves as quickly or efficiently. Skin becomes thinner and papery, particularly on the shins and arms.

It can be very easy for an older person to catch themselves on furniture, for instance, and healing can take a long time. If a person takes blood-thinning medication such as warfarin, they are more likely to bleed profusely if cut.

For some, falls and accidents may represent the beginning of a long, slow decline in health and independence — a hospital stay that leads to immobility forces them to lie in bed, followed by a potential need for care once discharged.

Older people also face health hazards that spring from taking different medications to manage several long-term health conditions. It can be difficult for someone who suffers from memory loss or failing sight to keep track of these — and the medicines may react with each other or lead to other health issues if not managed correctly.

For instance, medication to reduce high blood pressure can lead to dizziness when getting up too quickly, and this in turn could result in an accident.

here, with the help of the experts at St John Ambulance, we focus on first aid advice for older people.

FALLS

ONe in three adults over 65 who live at home will have at least one fall a year, and about half of these will have more frequent falls. Doctors say one in two women and one in five men over 50 will suffer a fracture because of osteoporosis.

Falls are a major cause of older people needing to be admitted to hospital. They can be caused by poor vision, problems with balance, or long-term health conditions such as heart disease, dementia or low blood pressure (hypotension), which can lead to dizziness. Old age is also associated with incontinence, leading people to fall when rushing desperately for the loo. WHAT TO DO Assess the person to see if their airway is blocked and if they are responsive. If they are responsive, remember they may not have good hearing, so speak loudly and clearly and ask what happened.

If they are bleeding, apply direct pressure to the wound with a sterile dressing or a clean non-fluffy cloth. If they can move and suffered a cut or minor injury, help them to sit down. reassure them, clean the wound with alcohol-free wipes and dress with a bandage. Apply an ice pack to the injury site over the bandage to reduce swelling and pain; do not apply ice directly to the skin, but instead wrap it in a tea towel.

FRACTURES

ThIS is a break or crack in the bone. In an open fracture, the bone may pierce the skin; in a closed fracture the skin is intact. Broken bones may cause internal bleeding and the person may develop shock (see overleaf). SYMPTOMS Pain Difficulty moving the limb Limb at an odd angle or bent Swelling Grating noise or feeling from the ends of the broken bones WHAT TO DO

Call 999 or 112. Care for the wound and monitor their responsiveness and breathing while waiting for help to arrive.

For an open fracture, cover the wound with a sterile dressing or clean, non-fluffy cloth.

Apply pressure around the wound — but not the protruding bone — to control any bleeding. Secure with a dressing. encourage the older person not to move. Support the injured limb and place padding around it to prevent it moving.

Secure an upper limb fracture with a sling and a lower limb fracture with a broad- fold bandage. To make an arm sling, place the bandage with the longest side lengthways against the person’s body, with one tip over their shoulder and the corner at their elbow. Fold the hanging tip back up so that it loops around the neck and secure with a knot.

Be aware that the bleeding associated with a fall (whether internal or external) can cause an older person to develop shock (see overleaf).