Long-term exercise appears to decrease the rate of falls in older people. The most common cause of falls in healthy adults is accidents. It may be by slipping or tripping from stable surfaces or stairs, improper footwear, dark surroundings, uneven ground, or lack of exercise. Older people and particularly older people with dementia are at greater risk than young people to injuries due to falling. People who have experienced stroke are at risk for falls due to gait disturbances, reduced muscle tone and weakness, side effects of drugs to treat MS, low blood sugar, low blood pressure, and loss of vision.
People with Parkinson's disease are at risk of falling due to gait disturbances, loss of motion control including freezing and jerking, autonomic system disorders such as orthostatic hypotension , fainting, and postural orthostatic tachycardia syndrome ; neurological and sensory disturbances including muscle weakness of lower limbs, deep sensibility impairment, epileptic seizure, cognitive impairment, visual impairment, balance impairment, and side effects of drugs to treat PD.
People with multiple sclerosis are at risk of falling due to gait disturbances, drop foot , ataxia , reduced proprioception , improper or reduced use of assistive devices, reduced vision, cognitive changes, and medications to treat MS. In the occupational setting, falling incidents are commonly referred to as slips, trips, and falls STFs.
An unprotected side or edge which is 6 feet 1. The National Institute for Occupational Safety and Health has compiled certain known risk factors that have been found responsible for STFs in the workplace setting. Injurious falls can be caused intentionally, as in cases of defenestration or deliberate jumping. The severity of injury increases with the height of the fall but also depends on body and surface features and the manner of the body's impacts against the surface.
Injuries caused by falls from buildings vary depending on the building's height and the age of the person.
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In unintentional falls resulted in , deaths up from , deaths in They were the most common cause of injury seen in emergency departments in the United States. One study found that there were nearly 7. In , in the USA workers died of injuries caused by falls from ladders, scaffolds, buildings, or other elevations. From Wikipedia, the free encyclopedia.
For other meanings, see Falling disambiguation. Main article: Falls in older adults. Main articles: Jumper suicide and Defenestration. Main article: Fall prevention. World Health Organization. October Retrieved 3 December Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health, 5 1 , Preventing falls in older people: the story of a Cochrane review.
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Ambulatory geriatric care. Mosby Inc. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther. Stride-dependent changes in gait of older people.
J Neurol. Neurological gait disorders in elderly people: clinical approach and classification. Learning the language Once again, it is a question of learning the language; listening, to yourself and to your partner, and noticing what you do when a clash happens. The simple act of making an agreement like this — preferably not in the heat of the moment, but when both partners are cold sober — immediately begins to transform the way you approach conflict, and the way you handle it.
What is the language of conflict? At the simplest level, it arises when one partner tries to express feelings to the other, and is met with either hurt or anger, or both. Defences then come into play, and you will notice that you have favourite ways of reacting. All the many forms of defence can be put into two groups: those that involve withdrawal, and those that involve attack. Withdrawal means closing down, retiring hurt, refusing to talk any more, or — more subtly — trying to move the ground of the conflict, and arguing from your head or shaming your partner for getting into a state.
Attack means trying to wound, bringing up old scores, shouting, physically assaulting. There are, of course, infinite variations on these two themes. Typically, an argument involves a confused and confusing mixture of tactics, with both combatants frequently shifting ground and trying to gain an advantage. It ends with the withdrawal or collapse of one partner, but both usually go away feeling wounded and morally superior.
We may attempt reconciliation, but we tend to skimp on inspecting the wounds too closely, lest we stir up further conflict.
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It is no wonder that conventional wisdom regards conflict as inherently bad and destructive, for unless we learn some better ways of handling it, it cannot be anything else. How can we make conflict constructive? This chapter deals with some of the ways in which we can begin to work with it, and it also looks at the art of forgiveness, or the healing of old wounds.
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I want to emphasise, however, that this is no easy undertaking. It is hard and painful work, and although we gain experience along the way, it will never be effortless, never without pain. It is the effort itself, choosing to go through the agony again and yet again, that gives birth to love, and provides it with the nourishment that it needs to grow. This means that both partners must be willing to explore their own dark places, and to work towards change.
In other words, this is the point at which the issue of commitment arises. Unless both partners are willing to grow with and through the areas where they run into trouble, the relationship will inevitably move towards compromise, stagnation, or death. If they are willing, however, it is immensely helpful to make some conscious statement of commitment.
This is a vital step towards establishing trust, and making it safe within the relationship for whatever needs to emerge. Just as becoming a parent means — in theory at least — making a pledge to be there for the new human being until he can be there for himself, so entering into mature relationship involves the same sort of commitment. Having said that, I want to emphasise that unless both partners are willing to commit themselves to growing and working with what comes up, there can be no deal.
If you are living with someone who is abusive, physically or emotionally, and he or she is not willing to change, then you owe it to yourself to get out. There is no merit in allowing yourself to be abused, and no benefit for either partner if you stay. Unless each can give honour and respect to the other, the relationship cannot evolve.
Most of us find the idea of commitment a little frightening, and for many it is terrifying. We fear being trapped, shackled to someone who may turn out to be a nightmare to live with; and what if someone better comes along? I have seen so many relationships, on the brink of moving into a new and more mature phase, come to grief because one partner or the other could not bring themselves to commit. However, it need not be like that. Some years ago, a friend of mine was considering training to be an osteopath. The course was four years long, full time, and Michael, my friend, had no prospect of financial help.
The only way to make it possible was to make the commitment, day by day and week by week, to be with what he was doing right now. He took the course, and finished it, and is a successful practitioner now. And along the way, his closest friends became those who were also willing to take the risk of throwing their energy into making their dreams come true. It is the same when we make a heart commitment.
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All we can do is to pledge ourselves, as fully as we can, for this moment. However, in the making of a pledge like this, magic happens. We create a place where the relationship can expand, and we can be open to the adventure and the wonder of it, as well as the burdens. If we give it as much as we can today, we are more than likely still to be here tomorrow, and next week; and it will not be the same.
We will be moving, and growing. What are we committing ourselves to? Simply this: to keep company with one another on our journey of self-realisation. As trust grows, and love grows, and we learn to express what we are feeling, so our patterns and issues from the past will surface, seeking resolution. Unconsciously at first, we will play them out within the partnership. Conflict will arise, and in that conflict is the key to becoming conscious, owning what works for us and what needs to be discarded, and healing old wounds. These things will begin to happen whether we commit ourselves or not, but if we do not commit, there will be no container in which to hold them, and the relationship is likely to founder.
Once the commitment is in place, we can begin to look at some other ways of containing conflict, so that rather than simply suffering it, we can begin to use it. Again, this cannot be done at the height of the battle, but at some more peaceful time, preferably when neither partner is actively feeling hurt.
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What it comes down to is the conscious intention to reach an outcome in which no-one is the loser. Creative conflict is not about wounding, scoring points, getting revenge or emerging victorious. It means shifting the focus, from whatever the fight was apparently about — which is often just a hook for all kinds of other things, in any case — to the quality of the interaction that goes on before, during and after the engagement.
It means getting better at listening, and at expressing our feelings so that we can be heard.