Long lie falls and health complications

• Introduction
• What is a long lie?
• Health risks from long lie complications
• Long-term impacts on health and independence
• How to reduce the risks from long lie falls
• Falls risk assessment: Understand your risk of a fall
• Maintain your health, eyesight and manage medications
• Prevention is better than cure: Falls prevention services
• Know how to get help after a fall
• How a fall alarm product can help after a fall
• Where to get further help about long lie falls

Introduction

A "long lie" refers to the extended period an individual remains on the floor after a fall due to an inability to get up independently. This situation is particularly concerning for older adults, especially those living alone, because there may be no one nearby to notice the fall and provide immediate help.

Prolonged time on the floor can lead to serious health complications, such as pressure sores, dehydration, hypothermia, and even increased risk of long-term mobility issues. In severe cases, the injuries from a fall can be fatal.

Falls and long lies can be a worry to family members, as well as having long-term physical and psychological consequences for older adults.

This article explores what can be done to reduce the risk of a long lie and the services available to support fall prevention and provide a response to falls emergencies.

What is a long lie?

A “long lie” is the time a person spends on the floor following a fall when they are unable to get up without assistance. People who are unable to get up from a fall and are lying on the floor until help arrives can suffer health complications, as well as emotional distress.

Studies show that 1 in 5 people over the age of 65 who experience a fall will remain on the floor for over an hour.

Health risks from long lie complications

Physical risks

Falls can result in bruises, fractures, and blood loss, especially if you are unable to break your fall. Spending time on the floor following this can cause more physical harm. As we get older, it takes longer for our bodies to recover from injuries, and this can worsen the complications. This is why falls are so dangerous for the elderly.

Here are some of the most common physical complications from a long fall:

• Hypothermia: Lying on the floor for an extended period, especially on a cold surface, can dangerously lower body temperature, leading to hypothermia. This is a particular risk during winter months.
• Pressure sores: Spending a long time on a hard floor can lead to skin and tissue damage, causing painful pressure sores. These can become infected if not treated.
• Dehydration: Being unable to have a drink increases the risk of dehydration, which can affect cognitive and physical health. Older adults can be more susceptible to dehydration due to medication side effects, kidney disease and a decreased sense of thirst, particularly if they are experiencing cognitive decline such as dementia or Alzheimer’s.
• Muscle breakdown: When there is prolonged pressure on muscles, the muscle tissue can breakdown. This can release proteins into the bloodstream that can potentially cause kidney damage.
• Breathing issues: Being in a prone position for a long time can impair breathing and circulation, potentially leading to blood clots or respiratory difficulties.
• Mobility: Remaining on the floor for hours can lead to joint stiffness and muscle weakness, slowing recovery and potentially impacting long-term mobility. If older adults have reduced mobility already or arthritis, then they can be particularly affected by this.

Psychological risks

The risk to older adults is not only physical. Falls have a long-term effect on a person’s confidence, impacting independence. Worrying about a fall can lead to a decline in physical activity as a result of avoiding the risk of falling again. This can become a vicious cycle of doing less, loss of muscle strength and a greater likelihood of falling.

Other potential consequences include:

• Feeling helpless: The inability to get up after falling can affect self-esteem and lead to worries about relying more on others.
• Social isolation: Someone who has fallen can be discouraged from going out or staying active. This can lead to increase isolation and feelings of loneliness, as well depression and low mood. Read our tips to address social isolation.
• Reduced quality of life: Limiting activities that we enjoy can reduce our overall happiness and lead to a more restricted lifestyle.
  
  

Long-term impacts on health and independence

Being unable to get up after a fall can result in longer recovery times and decreased mobility. This in turn leads to a loss of independence and increased reliance on family members and carers. 

Government health studies indicate that about 20% of hip fracture patients require long-term care within 12 months of the fracture.

Recovery times can be longer following a long lie as additional treatment can delay the healing process. Weakened muscles and stiff joints also make it harder to regain mobility and strength rehabilitation can be needed.

Falls also impact our health and social care services. According to the NHS, falls cost an estimated £2.3 billion in the UK every year and are one of the main reasons for elderly people to be taken to A&E, with more than 250,000 hospital admissions in the over 65s every year.

How to reduce the risks from long lie falls

The risk of falling doesn’t have to be an inevitable part of getting older. There are steps you can take to reduce risks before an accident occurs and improve frailty through exercise and diet.

Reducing risk around the home

Between 30% and 50% of falls are due to hazards around the home, such as poor lighting and slippery falls. Simple home improvements and adaptations such as grab rails can reduce risk. Complete our Falls Risk Score assessment to understand your risk of falling and download our free falls prevention guide for lots of useful tips and advice.

Maintain your health, eyesight and manage medications

Poor eyesight and balance mean you are more likely to lose balance or find it more difficult to judge the distance of objects and surfaces.

Certain prescriptions, or combinations of medications, can affect blood pressure and balance, which increase your risk of falling. Around 20% of people in the UK take more than three medications to manage health conditions and correct medication management can address side-effects as well as positively affecting the effectiveness of the medicines.

It's important that patients who already have an increased risk of a fall, in particular the elderly, are aware of which medications can increase the risks of a fall. In many cases, just a single medication can increase your risk and multiple medications make this risk higher.

Peter Thnoia
Prescribing Pharmacist at PillTime

Find out more about medication management for the elderly.

Prevention is better than cure: Falls prevention services

Fall prevention services can encourage activity, which improves strength and balance, and highlight the risks of falling. One such service is Taking Care Prevent, which monitors health and physical activity. By using a Fitbit tracker, the service can predict the likelihood of a fall and alert a specialist Prevention Team.

The Prevention Team can recommend actions to improve strength and balance, reducing frailty and the risk of falling.

 If someone does have a fall, its important to know how to safely life someone and what to do after a fall.

Know how to get help after a fall

From our own research, we know that personal alarms can reduce overall hospital admissions in older adults by 50% and reduce the length of a stay in hospital from 15 days to 8 days by providing older adults with a quick and easy way to call for help in an emergency.

Personal alarms with fall detection can help further, ensuring an alarm is raised when a fall is detected without the wearer needing to do anything.

How a fall alarm product can help after a fall

A fall alarm is a lightweight wearable neck pendant or watch-like device. Fall alarms have a built-in sensor that makes an alarm call to a 24-hour Emergency Resolution Team when it detects the wearer has fallen. Find out more about how fall alarms work.

Falls alarms are easy to use and ensure that help quickly reaches you if a fall does occur. By reducing the length of a long lie, health complications can be avoided. Fall alarms also have an emergency button that can be pressed in other emergencies, providing reassurance to family members and older adults. Some fall alarms include GPS technology, so they are able to work anywhere in the UK with a mobile signal.

Where to get further help about long lie falls

Although most falls do not result in serious injury, knowing what to do can be reassuring. The NHS falls advice is to say calm and if you are not hurt and are able to stand then to do so slowly. Read more advice about what to do after a fall.

If you are a keyholder or contact for one of our personal alarm customers, it might be helpful to read the advice for keyholders when responding to a personal alarm alert.

While the risks of a long lie are real, understanding the risks and preparing for long ambulance wait times can improve outcomes. Family, friends, and neighbours can provide invaluable help in an emergency. However, you may not be able to want to rely on them, particularly if they are busy or if you fall late at night. A monitored alarm service can address this and a combination of falls prevention services and falls prevention tips can reduce the risk of long lies following a fall.