Elderly people and falls: how healthcare can better support the UK’s ageing population

The UK has an increasingly ageing population, with more and more people living for longer. Currently, our health service is not set up to support older people, meaning many do not receive the care or help they need to help them live fulfilled and happy lives for as long as possible.

In the below report, we explore Britain’s changing elderly care landscape, exploring the options available to provide improved care for older people, allowing them to live longer, independently at home.

At TakingCare, our elderly fall alarm staff are often the first point of call when our customers have a fall, so we understand the challenges older people face when it comes to fall treatment and recovery.

Contents

1. How is the UK population going to age over the next 20 years?
2. How many elderly people fall each year?
3. How many elderly falls result in hospital visits?
4. What are the ambulance wait times in the UK?
5. How much does it cost the NHS to use ambulance call outs for falls?
6. How much money could telecare save the NHS if it was used to monitor falls?
7. Which areas of the UK have the highest falls risks?
8. When do elderly people fall the most?
9. What are the main causes of falls in the elderly?
10. What to do if an elderly person falls down?
11. How to prevent falls in the elderly

How is the UK population going to age over the next 20 years?

Forecasts show that there will be 7,138,800 people in the UK aged over 75 by 2035, according to data from the Projecting Older People Population Information (POPPI). This will equate to 15 per cent of the total population.

Currently there are over 5.5 million people aged over 75 in the UK (ONS), which is eight per cent of the total population. The UK population continues to age, with over 11 million people aged over 65 in the most recent Census data (2021 Census), which equates to 18.6 per cent of the total population, and 3.2 million people over 80, which is roughly four per cent.

How will the number of people aged 65+ in the UK grow over the next ten years?

How many elderly people fall each year?

An elderly person (aged 80+) falls every ten seconds in the UK, according to analysis by TakingCare Personal Alarms. This means around six elderly people fall every minute in the UK, equating to around 8,500 falls a day.

Studies show that one in three over 65s have at least one fall a year, however the risk of falls increases to one in two for people aged over 80.

According to 2021 Census data, there are currently 3.2 million people aged over 80 in the UK. Of this age group, one in two will have a fall, meaning there is an estimated 1.6 million elderly people who have at least one fall every year in the UK.

The risk of having a serious fall increases with age due to age-related health conditions such as frailty and arthritis. It’s important to note that not all falls are serious or require medical attention. Whilst 1 in 3 over 65s have a fall, these falls are less likely to require hospital care than falls experienced by the over 80s.

According to data from the Projecting Older People Population Information (POPPI), the number of people aged over 80 is expected to grow to nearly 4.5 million by 2035. Over 65s will make up a third of the population.

The below chart highlights how the over 85’s typically experience the highest number of falls, and how this will change as the population ages over the next ten years. 

How many elderly people fall each year in the UK, by age group

How many elderly falls result in hospital visits?

One in five falls experienced by people aged over 80 result in hospital visits, according to data from Projecting Older People Population Information (POPPI). For people aged over 70, one in ten falls result in a hospital visit.

The chance of a fall requiring hospital attention dramatically increases once people enter the 75+ age bracket. The risk of a fall requiring a hospital visit increases as follows as people get older:

• Four per cent of falls result in hospital visits for people aged 65-69
• Six per cent of falls result in hospital visits for people aged 70-74
• Ten per cent (one in ten) of falls result in hospital visits for people aged 75-79
• 20 per cent (one in five) of falls result in hospital visits for people aged 80+

The below chart highlights that whilst the risk of a fall increases as people enter the 65+ age bracket, the chance of a serious fall occurring which requires hospital care is much higher for people aged over 75 and 80.

Number of elderly falls that result in hospital care in the UK

What are the ambulance wait times in the UK?

Ambulance wait times vary across the UK and depend on where you live. Ambulance wait times also vary depending on what category a patient’s needs fall into. The ambulance category scale runs from one to four, with one being urgent responses to life threatening conditions and four being responses to less urgent calls. Typically, elderly falls sit under category three and four calls, unless there is an immediate threat to life.

On average, the South West has the overall longest ambulance wait times in the UK with an average of over 14 hours. The East of England comes in close second with an average wait time of 14 hours.

Ambulance wait times are also impacted by the number of incidents that occur, as an increase in incidents puts additional pressure on ambulance resources.

From a regional perspective, the West Midlands has the highest amount of ambulance usage when compared to the total population, with 1.2 per cent of the population using the services in December 2022. The South East has the lowest percentage for ambulance usage at just 0.06 per cent of the population needing an ambulance.

Number of incidents compared to population

How much does it cost the NHS to use ambulance call outs for falls?

The NHS has around 14 million ambulance call outs every year and more than a third of these (35 per cent) were to tend to people aged 75 and over. That equates to more than four million call outs for the older generation.

According to data from the National Library of Medicine, between ten and 25 per cent of ambulance call outs for those aged 65 and over are due to falls, which means around one in ten ambulance call outs in the UK are to people over 65 who have fallen.

Falls are classed as a category three ambulance call-out, meaning they are considered urgent calls that are not immediately life-threatening but require treatment to relieve suffering, such as pain management as well as transportation or clinical assessment.

This means that this could be costing the NHS as much as £350m per year to respond to older people who have experienced a fall, particularly if the older person requires A&E triage and an overnight stay in hospital.

How much money could telecare save the NHS if it was used to monitor falls?

Personal alarms could help save the NHS over £200 million in ambulance and falls-related costs, data from TakingCare reveals.

TakingCare currently resolves 65 per cent of calls to their call centres without needing to call an ambulance, through channels such as contacting a next of kin or registered emergency contact and alternative support options. Often, words of reassurance suffice to support older people who wake in the night feeling confused.

Based on this figure, TakingCare estimates that 313,950 ambulance call outs could be saved a year if the elderly patients had personal alarms in place, which could save the NHS over £226 million in ambulance, A&E and hospital costs.

In the UK, there are 14 million ambulance call-outs a year on average, 34.5 per cent of which are for people aged over 75 years old. This results in 4,830,000 ambulance call outs a year for the over 75s, ten per cent of which are due to falls.

This means that based on this data, an estimated 483,000 people a year utilise ambulance call outs specifically for falls. If more people use personal alarms and have alternative care contingency plans in place - such as support from next of kin, local communities and care networks - then this could alleviate significant pressure on ambulance services for the NHS.

Which areas of the UK have the highest falls risks?

Some areas of the UK have a higher density of people aged over 80 years old, so the chances of falls impacting ambulance services in those areas is higher due to an older population.

The South West has the highest density of people aged over 80 compared to the rest of the UK, with six per cent of the population sitting in this age bracket. Unsurprisingly, London has the lowest density of elderly people, with just three per cent of the capital’s population consisting of over 80s. 

Percentage of over 80s per region and overall

When do elderly people fall the most?

With one in three over 65s and one in two people aged 80+ likely to have at least one fall per year, older people face increased likelihood of falling during periods of extreme weather; both hot and cold.

The excess winter mortality index (EWMI) in 2020/21 showed that over 30 per cent more deaths occurred in the winter months in England and Wales, and insight from TakingCare’s Excess Winter Deaths report revealed that there is an increase in deaths among the over 60s during the winter.

Bad weather can mean that older people are more likely to fall when venturing outside to run errands, with icy pavements increasing their chances of falling.

However, periods of bad weather and dark evenings also mean that many elderly people stay indoors more.

Data from TakingCare’s Falls Survey also found that:

• 74 per cent of falls occurred inside the home
• 13 per cent of falls occurred out and about (e.g. down the shops)
• 12 per cent of falls occurred in the garden

This means that particularly in the colder months when older people may wish to spend more time indoors, their risk of a fall is far more likely.

In recent years, we have also seen a significant uplift in the number of heatwave-related deaths, sometimes due to medications that may respond poorly to warmer temperatures. We also see a rise in the number of deaths caused by respiratory and cardiovascular conditions, which are exacerbated in warmer weather.

TakingCare also sees an increase in calls to their Emergency Resolution Team over periods of extreme weather. We see inbound calls rise as we head into the winter months, dropping off as we head into the Spring, with a sharp uplift during July where we have seen significantly warmer weather in recent years.

What are the main causes of falls in the elderly?

According to the NHS, falls cost an estimated £2.3 billion in the UK every year and are one of the biggest reasons for elderly people to be taken into A&E, with more than 250,000 hospital admissions in the over 65s every year.

Thankfully, many of these falls don’t end up as life threatening / serious injuries. However, they can still cause pain, distress, and result in a loss of confidence and loss of independence for the person who fell.

There are many potential hazards at home that could contribute to a trip or fall in an elderly person, so it’s important to be aware of the risks and make the home as safe as possible to minimise the chances of a fall incident.

The main causes of falls in the elderly are:

1. Clutter: Clutter in the home, especially at low levels or on the floor, can be a real trip hazard.
2. Poor lighting: A poorly lit room can make possible obstructions, changes in level or other hazards even more dangerous for elderly people at home.
3. Uneven surfaces: Changes of level between rooms that can be a fall hazard. Uneven surfaces are most common in gardens or with steps to and from doorways.
4. Slippery surfaces: Icy and slippery conditions are well-known, but there are also potential risks of slipping in the home too such as anywhere where water is involved, such as in the bath, showers or spills on the kitchen floor.
5. Dizziness or loss of balance: Some elderly people find that simply standing up a little quickly or getting out of the bath can cause a dizzy spell that might lead to a fall.
6. Poor vision: Vision issues can mean that obstructions or other hazards in the home aren’t noticed until it’s too late to avoid a fall.

What to do if an elderly person falls down?

The main thing you should do if an elderly person falls down is first, stay calm and encourage them to do the same - panicking isn’t going to help them. You should also wait until the shock has worn off before trying to move them and to find what the cause of the fall might have been.

If it appears that the older person has injured themselves, lost consciousness when they fell or they’re complaining about head, neck or back pain, it is advised to call an ambulance.

You should only move them if you feel confident that it is safe to do so, as you don’t want to make their injuries worse.

How to prevent falls in the elderly

With falls being a primary concern for people as they grow older, it’s important to have a proactive approach to mitigating the risk of a fall as well as a plan in place for when a fall does occur.

The UK has an ageing population, with more people living longer than ever before. In order to support the elderly community, more needs to be done to promote preventative care measures that will proactively prevent falls among older people.

This involves a cultural shift to the way in which the UK responds to elderly care, transitioning from a reactive to proactive approach, arming older people and their carers, families and support networks with the technology and education needed to support a happy lifestyle and promote healthy ageing.

Technology Enabled Care is paving the way for a digital-first approach to elderly care, reducing NHS pressures and providing a preventative solution for older people. This will allow their family and friends to introduce an effective care plan before an older person experiences a fall or hospital stay.

TakingCare has developed an online falls risk calculator, to help people understand whether their older friend, relative or neighbour is at risk of a fall.

From here, a personal alarm solution provides a simple way of introducing a contingency plan to ensure that an older person is able to remain safe, live independently and most importantly, get help in an emergency situation.