Following concerns over lack of stability and mobility, many senior citizens experience fear of falls. Ptophobia, a phobic reaction to standing or walking, is a common phenomenon among elderly people. Life became challenging for Prasad M a 75-year-old from Mumbai when he had a fall inside his bathroom in August 2022. He thought it was a minor fall and did not sustain any injuries but he was terrified by the incident which affected his mobility.
The fear of falling is always coupled with the consequences such as being bedridden, losing mobility, and being dependent on others. This fear often results in affecting their mobility and they end up confining themselves inside their houses.
Prasad had not revealed the incident to his family thinking it might make them worry. In December 2022, during his regular visit to his geriatrician, Dr Naganath Narasimhan Prem at Jaslok Hospital, Mumbai, Prasad expressed that he had stopped his morning walks for the last few months as he didn’t feel like stepping out. “Initially, he didn’t reveal the exact reason but later I learned that he had slipped and fallen inside the bathroom which made him lose his confidence in stepping out alone,” said Dr Prem.
Prasad lives alone on the ground floor of an independent house in Mumbai while his daughter’s family lives on the top floor. “His family was also worried about his sudden change in lifestyle as he was always physically active. And now, he preferred to stay on his bed or sit comfortably indoors,” said Dr Prem, which was indeed worrisome.
Why is fear of falls common in elderly people?
Many elderly people have health problems like diabetes mellitus, high blood pressure, and poor eyesight. These conditions can mess with their balance, says Dr S G Harish, senior internal medicine specialist, at Sparsh Hospital, Bangalore. “For instance, diabetes can harm their nerves and weaken their muscles, making them unsteady on their feet. When they try to stand up from sitting, their blood pressure can suddenly drop, causing them to lose their balance,” he said.
Dr Harish added that hearing issues in elderly people can make it hard for them to move around safely and loud noises can startle them.
Other causes behind falls include:
Medications: Some medications like alpha blockers for blood pressure, can make them feel dizzy when they stand up.
Urinary problems: Elders with urinary incontinence, a condition where they can’t control their urine, might rush to the bathroom which increases the risk of falling.
Muscle and Joint pain: Joint pain can make it tough for them to move and may lose balance while walking.
Fear of falls or ptophobia in elderly
Prasad had developed ptophobia as a post-fall syndrome and had a fear of standing or walking. “He had sustained minor bruises from the fall. However, he developed a fear of falling as the thought of it haunted him every day. He lost his confidence and this resulted in him becoming inactive by not being willing to step out, even for his regular walk. He feared that in case of another fall, he would become bedridden and dependent on his family,” said Dr Prem.
According to Dr Prem, it is a common fear in elderly people who do not wish to disclose their medical conditions, injuries or accidental falls with their family members.
“With his permission, we spoke to his daughter and suggested she install grab bars inside the bathroom along with a few modifications at home to make it more age-friendly to prevent falls,” Dr Prem said. Prasad underwent physiotherapy and postural exercises to gain muscle strength which gave him confidence and is now back to his active lifestyle.
How can family help?
Family plays a crucial role in taking care of elderly people, says Dr Prem. “Senior citizens may not express themselves and tend to hide their emotions. Family members can spend more time with them to understand and give them the confidence to share their concerns. They can support them without making elderly people feel dependent on them, both emotionally and financially,” he said.
It is common for elderly people to fear being a burden on their family, says Dr Harish. He suggests, “Family can offer assistive devices to help them move around more easily. They can speak to them in a cheerful and uplifting way as it boosts their spirits. They need to encourage elderly people to go on their walks and for their morning exercises to get their daily dose of Vitamin D as it can make them feel healthy and socially connected.”
In many cases, family members ask elderly people not to step out and restrict them from many activities which has a major impact on their mind, says Dr Prem. “They start to feel that they may not be capable of doing any tasks and feel depressed. Family members need to encourage them to do simple tasks and also involve them in family decisions to make them feel involved,” he said.
Having a fall or a near fall experience in older people may result in them developing ptophobia. Due to this fear, most of them confine themselves inside their houses, restricting their mobility. It is important for the family members to identify the reasons that may lead to falls and assist them in overcoming the fear.