By Dr. Gbonjubola Abiri
The fall took only a few seconds but the fear lasted for months. At 72 years, Mama had always prided herself on being independent.
She woke up by herself, prepared her meals, walked to the sitting room, attended church and occasionally complained, like many mothers do, that her children worried too much about her.
One morning, there was a loud thud. Her carer heard it and ran in, only to find, she slipped in the bathroom and was lying on the floor. She lost her balance while trying to move around. Fortunately, she survived.
She was treated by the best doctors. While her wounds healed and bruises disappeared, something else did not heal so easily as she became afraid of the bathroom, initially, and then she became increasingly afraid of walking without support. The fear grew daily and affected her going out, visiting neighbours, attending church and social functions. Slowly, her confidence faded right before all their eyes.
Her children thought they were protecting her.
“We are here for you mummy.”
“Don’t walk without somebody holding you.”
They were loving her, the best way they knew to, by being there for her.
Without realising it however, they were also telling her something else:
“You are no longer capable, alone.”
And slowly, Mama began to believe them.
One of the hidden consequences of falls in older people that we don’t talk about enough is the fear of falling again. While a fall can injure the body, it can also injure confidence. Following a frightening fall, an older person may begin to see previously ordinary activities as dangerous. The bathroom becomes a threat. Stairs become frightening. Walking becomes something that requires permission or assistance. This may lead to increasing anxiety, isolation and withdrawal. Losing the ability to do previously easy things may lead to depression. They may move less, putting them at risk of weaker muscles, poorer balance and reduced physical confidence. These factors can increase vulnerability to another fall.
What may often seem like stubbornness or disinterest in an elderly person, may just be anxiety, depression or a loss of confidence. Beyond the fracture and physical bruises, there may actually be fear of falling or feelings of inadequacy as they have their independence taken away. While we offer to help and be there, as well as put protective measures in place, it is important to allow them do some things at their own pace and in their own way. We must however never be seen to take their independence or their dignity away.
Beyond asking “what bones broke or what injuries were sustained”, let’s also ask “What did they become afraid to do, after the fall”. Healing for the body may be quick. That of the mind, may take time, especially when unrecognised or ignored. Many times, the answers that we seek lie in those responses, as beyond the fall, the elderly person is afraid of a shrinked life.
Remember there is no health without mental health.
Dr. Gbonjubola Abiri is a consultant Psychiatrist, Associate Lecture and Mental Health Advocate