Would you like to be safe? - Important information about the risk factor falling (on stairs) and fall prevention

The consequences

The consequences of such a fall are often diverse and can be severe. They often entail lengthy hospital stays and not seldomly are followed by admission into a nursing home. The risk of falling occurs not only in everyday activities but also in sports or in other leisure activities.

A well-trained sense of balance can usually intercept falls in order to minimize the consequences of the fall. But people with restricted mobility have a limited sense of balance and therefore their muscles might not be sufficiently trained. In those cases, the consequences can sometimes be very severe.

Intrinsic and extrinsic fall causes / risk factors

Falls can be caused due to environmental (extrinsic) and personal (intrinsic) causes. Environmental causes include poor lighting, uneven or slippery surfaces, objects on the ground, unsuitable footwear, or the use of poorly adapted mobility equipment. Personal causes, however, may include the fear of future falls or the taking of medication.

Musculoskeletal disorders such as osteoporosis, osteoarthritis, a spinal disc herniation or neurological disorders such as multiple sclerosis, polyneuropathy, infantile cerebral palsy, Parkinson's, epilepsy or strokes are among the intrinsic consequences.

Further, impaired vision and hearing, an impaired sense of balance or muscle weakness and joint problems can be causes of a fall. All of these factors play a role in the restricted mobility and unsteady gait of the person concerned and should be taken into account.

Environmental causes / risk factors for falls (extrinsic)

• Bad lighting
  
• Uneven ground
• Slippery surface
• Use of inappropriate mobility aids
• Carpet rims
• (Loose) cables
• Wet ground
• Missing handrail (one or both sides)
• Too long and loose clothes
• No sturdy /inappropriate shoes
• Objects on the stairs / on the floor

Personal causes / Risk factors for falls (intrinsic)

• Balance disorders or dizziness
  
• Muscle weakness / shortage of strength
• Unsteady gait
• Lack of exercise
• Reduced vision and hearing
• Intake of medication
• Fear of falling due to earlier falls
• Musculoskeletal disorders (osteoporosis, arthrosis, spinal disc herniation, etc.)
• Joint pain
• Neurological disorders (multiple sclerosis, epilepsy, infantile cerebral palsy, polyneuropathy, parkinson's, stroke, etc.)

A significant portion of the falls occur on stairs and those falls in particular can have serious consequences. Every 20 minutes an older adult dies from a fall in the US (https://www.nsc.org/home-safety/safety-topics/older-adult-falls) and stairway use is involved in 1,900 deaths and 1,3 million hospital emergency room visits per year in the US (National Safety Council 2011; Pauls 2011).

In case of accidents on stairs, the victim often bears the blame him- or herself. Not seldomly, a stair fall occurs due to a lack of security awareness or too hasty stair climbing. This makes fall prevention mandatory.

That's why we put together a set of guidelines to stick to to make sure the stairs are safe to use.

Regardless of your age, stairs should always be used in a focused, attentive and calm manner. Always use the handrail, if available, both handrails. In your own home, you should make sure that no objects remain on the stairs. Whether in your own home or on the road, you should wear sturdy and non-slip footwear that provides you with the necessary support. Make sure you have unobstructed view and do not enter the stairs fully packed. As a final guideline, you should be careful not to wear loose clothing that may slip or get stuck in the handrails and therefore lose balance.

1. Concentrated, mindful and calm walking of the stairs
2. Use handrails
3. Do not leave objects on the stairs
4. Wear sturdy and non-slip footwear
5. Unobstructed view when climbing stairs
6. Climb the stairs not fully packed
7. Do not wear too loose clothing

What consequences can a (stair) fall bring for the person concerned?

Whether senior citizens or people with restricted mobility - a fall results often in the fear of future falls. This then can lead to increased immobility and a poorer body balance due to the reduced daily activity over a longer period. Physical consequences are usually bruises, sprains, fractures, lacerations and hematomas.

The most common fractures are thigh and hip fractures, which lead to a lengthy and tedious rehabilitation. However, stair falls not only lead to physical but also psychological consequences.

The fear of stairs and future falls is one of them. Due to the avoidance of climbing stairs both in the home and outside, the victim is often trapped in his own home and is largely encapsulated from his social network - i.e. family and friends. If this fear is not actively treated, it may evolve into social seclusion and / or depression.

Social seclusion and reduced mobility mean that many sufferers lose self confidence and confidence in their own abilities. At the same time, independence and self-determination are disappearing more and more. In the worst case, this can lead to the need for care.

Consequences of a fall

• Avoidance attitude leads to higher immobility and a poorer body balance due to the reduced daily activity
• Social and psychological consequences for fear of further falls (depression and social seclusion)
• Physical consequences (fracture of the femur / hip fracture, bruises, sprains, hematomas, fractures and lacerations)
• Less independence and self-determination
• Less self-confidence
• Possible dependency of care

When elderly people fall, it can be critical. It is not unusual that older people who suffered a fall accident end up with a fractured femoral neck or a pelvic fracture, which often entail a lengthy recovery process with hospitalization and rehabilitation for the person involved.

Especially at an older age, these accidents have a significant impact on the subsequent quality of life of the person concerned. But this does not only affect seniors. People with walking problems, who rely on aids such as rollators, crutches or walkers, experience the staircase as a great or even insurmountable obstacle. This often affects people with neurological diseases such as MS, epilepsy or CP, musculoskeletal disorders or people with balance disorders.

Fall prevention is therefore extremely important.

For the safe use of stairs apply the following essential requirements of the European Technical Assessment (ETA). Amongst other things, these guidelines include a comfortable stair incline with sufficient step size, sure-footed step and platform formation, good lighting and illumination of the entire staircase as well as secure and sturdy handrails on the railing.

For fall prevention, there are a variety of tools. These make climbing the stairs safer and help to avoid falls on the stairs as good as possible. These include handrails (preferably on both sides), anti-slip edges on the stairs, stairlifts, non-slip rubbers (step mats), color markings on the stairs and the wearing of ABS socks or sturdy shoes. Aids used for walking on a level surface, such as rollators, walkers, crutches and walking sticks should not be used on stairs unless it has been trained together with a therapist. However, the tools mentioned above neither actively ensure nor actively support the user in case of danger of falling. So far, there was no stair climbing assistant, which mobilized the user and provided the necessary security and support for the daily climbing of stairs.

Fall prevention on stairs

An innovative stair-climbing aid developed in Norway now offers the necessary support and safety that the user needs when climbing stairs. The stairlift assistant AssiStep is a cost-effective alternative to a stairlift and mobilizes the user instead of passivating him. As a result, the user actively trains walking the stairs and increases the safety on stairs. This ensures a safer usage of stairs even outside your own home and helps prevent future falls. AssiStep can be installed at short notice, as neither permits nor electrical connections are required. The system is module-based and can be installed on almost all types of stairs.

Falls and especially stair falls should not be taken lightly. If you would like to make your stairs safe and conduct fall prevention for yourself, then the guidelines for safety on stairs as well as the essential requirements of the ETA for the safety of use of stairs should be applied.

We also recommend the use of safety aids for the stairs for active fall prevention. Another important issue for people with gait insecurity is to maintain and develop their mobility and strength to ensure safe walking both at home and outside.

See our blog article "Improve Your Mobility and Walking Safety - The Best Tips for Staying Active Through Targeted Training in Everyday Life" for tips. We wish you a lot of safety and more serenity when walking and climbing stairs in the future!