Supporting Older Adults to Live Independently: Minimising Harm from Falls

Used appropriately, personal medical alarms are an effective strategy for preventing a ‘long lie’ after a fall in older adults,¹⁵ which could lower the likelihood of serious harm and loss of independence

One of the priorities highlighted in New Zealand’s Healthy Ageing Strategy has been to improve people’s safety and independence,¹ including the funding of services that support older adults to live in their own homes,² also known as ageing in place. In addition to allowing older adults to maintain greater control over their lives and self-identity, living at home encourages interactions with family, friends, and the community, which are critical sources of practical support and social connection for seniors.³

The home, however, is the most common location to have a fall.⁴ According to ACC data, in 2018, nearly 390,000 New Zealanders sustained an injury falling over at home, with nearly 195,000 of those over the age of 65 years. Older people tend to sustain worse injuries from falls,⁴ potentially compromising their ability to live at home independently.

Falls in older adults accounted for 76% of trauma admissions (versus 40% in younger adults) in an analysis of Auckland City Hospital’s trauma database.⁵ Head injuries and fractures are among the most serious forms of trauma resulting from falls.^6,7 Outcomes following hip fracture can impact independence. According to Australian and New Zealand Hip Fracture Registry data from 2021, only 80% of patients living at home who survived a hip fracture had returned to their homes four months after discharge, and only 43% had regained their pre-fracture level of mobility.⁸

Harm from a fall can be greater if the faller is unable to get up from the floor. Unless assistance arrives quickly, a ‘long lie’ on the floor after a fall contributes to poor outcomes in older adults, including severe injury, reduced mobility, and hospital admission as well as a need for long-term inpatient care.^9,10 In a study of older people requiring ambulance attendance after falling, one in eight who fall reported lying for more than one hour.¹¹ Having a fall and a ‘long lie’ after a fall can contribute to older people’s fear of falling again,^10,12 which leads to a cycle of self-restriction of physical activity and loss of physical function that further increases the risk of subsequent falls (the ‘fall cycle’).^10,13

A personal medical alarm is an effective support tool for community-living older adults who are at risk of falling. Benefits reported by users include receiving faster assistance in an emergency, feeling less anxious about falling, peace of mind for families, and living at home for longer.^14,15 Used appropriately, personal medical alarms are an effective strategy for preventing a ‘long lie’ after a fall in older adults,¹⁵ which could lower the likelihood of serious harm and loss of independence.

Older adults have reported that GPs are an influential voice in their adoption of a personal medical alarm.¹⁵ A St John Medical Alarm provides a direct link to Hato Hone St John and around-the-clock response in case of a fall or other acute health-related event, providing seniors with the confidence to live independently.

You can refer your at-risk patients for a St John Medical Alarm simply through your Practice Management System via Healthlink or ERMS. All patients have access to a free trial without obligation.

For more information go to stjohnalarms.org.nz/hcp