Executive
Summary
Fear of falling (FoF) is a significant
health concern among senior Canadians, as it is directly related to falls, diminished self-confidence, reduced self-efficacy, and a lower quality of life. Fortunately, there are many affordable
measures that can help alleviate this fear in public spaces. While BC offers
some variety of resources to support older adults dealing with FoF, similar
resources are not yet available in Ontario, a province with more snow and ice
than BC. In London, Ontario, many of the risks associated with FoF can be
addressed with a few simple steps, which we propose in the following
suggestions:
- Improve
public spaces and increase regulations to ensure seniors are safer when
leaving their homes. This can be achieved by installing anti-slip matts,
ensuring even road surfaces, providing sturdy railings, and maintaining
clear, uncluttered pathways.
- Launch
awareness campaign and resource advertisement to help seniors access the
necessary assistance, treatment and fall prevention measures. These
initiatives can include educating seniors on appropriate footwear choices,
offering balance exercise classes, providing therapy options, and ensuring
access to necessary medication.
Introduction
Fear of Falling (FoF) is a lasting concern of falling down that is comparable to a phobia or anxiety, affecting
many older adults, especially women. In fact, more than one
in five women over the age of 75 experience FoF. Five
percent of these women are so fearful that they will not leave their
home unaccompanied. In 2014-2015 Ontario reported over 250,000 emergency room visits due to falls
among seniors over 65. Mitigating FoF is a primary concern for the maintenance of
autonomy in the senior population. This fear was intensified during the
COVID-19 pandemic due to reduced physical activity and higher levels of
loneliness and isolation. Implementing preventive measures for FoF can improve
older people’s wellbeing and decrease the number of falls. In fact, reducing fall-related injuries in Canadians over the age of 65
could save the Government of Ontario up to $400 million annually. To address these issues, it is essential to
take effective measures. In this article, we outline several cost-efficient
strategies to mitigate FoF among Ontario seniors.
Policy
Gaps
FoF has been depicted as keeping seniors prisoners in their own homes.
The snow, ice, and slick weather conditions common in Ontario and across Canada
amplify this fear keeping seniors indoors and isolated. While there are many
risk factors, such as medications, past falls, vision problems, weak legs, and
numbness, there are policy steps that can be taken to protect the
aging population and provide them with a better sense of security in public
spaces. These concerns are further exacerbated during the winter months by
inadequate prevention of hazards like slippery surfaces, lack of railings, poor
lighting, and cluttered areas. By addressing these issues through thoughtful
and cost-efficient policies, we can create safer environments for seniors
year-round.
Ontario has a fall prevention collaborative
that recommends the Ontario Government approach the issue with a more unified, holistic, and integrated front, but
it fails to approach the issue with FoF in mind. It focuses on the governmental
pitfalls in addressing the issue of old-age falls without highlighting the
phobia that is associated with this. They recommend that current fall prevention methods are less fragmented and
focus on the patient first to address the multiple causes of falls and the
complex health needs of older adults who are at risk of a fall. They
also recommend that preventative care such as exercise classes are used to
reduce costs and burden on the healthcare system. Ontario currently
has numerous programs in place such as the Geriatric Emergency Management Plus (GEM+ Plus)
at the Ottawa Hospital. This program is designed to “enhance age-appropriate care for older adults in
Emergency Departments (EDs) at high risk of unnecessary hospital utilization”.
However, it does not focus on falls solely. Certain states have implemented
fall based programs such as STEADI (Stopping Elderly Accidents, Deaths and Injuries)
which allows primary care the tools and resources to identify patients who are
not only at risk of a fall, but also to determine modifiable risk factors and
effective strategies to reduce their risk. Although these policies do not
directly address FoF, their proper implementation can significantly reduce the
risk of falls. Unlike Ontario, British Columbia offers specific resources on
FoF, including physiotherapy and occupational therapy services, personal alarms
to call for help, hip protectors and discussing the fear with health
professionals. It is time for Ontario to address FoF mitigation as well. Our
policy recommendations aim to bridge this gap by providing fall prevention
techniques in accessible formats, supporting individuals who already experience
FoF, and improving public spaces to reduce FoF-related anxiety and associated
fall risks.
- Develop fall safety regulations for public spaces
While there is extensive discussion on
making homes safer for seniors, there is limited focus on applying these
principles to public spaces. In London, Ontario, for example, new sidewalks
often have uneven surfaces and tripping hazards, grocery store entrances lack
anti-slip mats, and pathways are narrow and slippery with ice, among other
issues. We recommend that policies incorporate the home safety measures
designed for seniors and extend them to public environments to enhance safety
and reduce fall risks.
- Develop an awareness campaign
Changing public policy takes time, so it’s
essential to provide immediate resources for Ontario’s older adults. Display
information on FoF and fall prevention in primary care offices, hospitals,
community centers, and grocery stores. Launch awareness campaigns to help
individuals access assistance, treatments, and prevention measures such as
proper footwear, exercise classes, therapy, and medication. Since FoF involves
anxiety, mental health support should complement mobility and safety
strategies. Additionally, subsidizing senior-safe fitness classes, occupational
therapy, and physiotherapy services is crucial. Investing in these preventive
measures can save the government millions currently spent on fall-related
injuries.
Fear of Falling is a crucial issue,
especially in snowy regions like Ontario. Ensuring that Ontario’s older adults
feel safe and mobile not only benefits them but also alleviates pressure on the
healthcare system. By launching awareness campaigns and promoting resources for
assistance, treatment, and fall prevention, alongside improving public spaces
and enforcing stricter regulations, more seniors can be protected. Everyone,
regardless of age, should be free from preventable fear and anxiety, ensuring safety
and mobility for all.
