A fall incident is ‘an unexpected event in which the participant comes to rest on the ground, floor or a lower level’, irrespective of whether an injury occurs (Kellogg International Work Group 1987). Fall incidents are often experienced by the elderly and form an important geriatric problem (Schoon et al 2008, Verhaar et al 2007, WHO 2007). Most fall incidents occur among the growing group of the elderly, and the incidence of falls increases with age. Due to a potentially poor outcome with far-reaching consequences, falling is a major problem among the elderly. Moreover, fall incidents affect quality of life (CBO 2002). Healthcare professionals too regard falls as a troublesome and complex problem that is correspondingly hard to tackle. In fact this is an overly pessimistic assumption, because with sufficient knowledge and appropriate diagnostics the problem of falls can be dealt with quite effectively, and preventative action and treatment can be achieved through primary, secondary and tertiary fall prevention (CBO 2002, Gillespie et al 2004, Neyens 2007, Neyens et al 2009, Waaijer and Neyens 2009). Falls also form a significant societal problem (NHS NICE 2004). The healthcare costs associated with falls and fall-related injuries are related strongly and directly to the frequency of falls and the seriousness of injuries. This is a factor serving to increase the workload in the care sector.
Apart from the high incidence of falls, the incidence of fall-related injuries is also worrying. Fall injuries are divided into the categories of light, moderate and serious (Halfens et al 2007-2014). Light injuries are injuries that do not require medical consultation, such as a bruise or an abrasion. Moderate injuries are injuries that require medical consultation, such as a wound being glued or stitched. Serious wounds are wounds that require medical consultation and sometimes even admission to hospital, such as a hip fracture or certain head traumas. So we see that fall incidents can have considerable physical consequences. There may also be psychological and social effects of falls, such as the fear of falling, loss of self-confidence, depression and greater dependence on care, as well as the avoidance of (participation in) activities in order to avoid falling (Halfens et al 2007-2014). Both can lead to social isolation. Finally, fall incidents also have economic consequences (e.g. higher costs, admission to a residential care facility) (WHO 2007).
On 1 January 2015 some 3 million Dutch citizens were aged 65 or above, and the total number of elderly persons is expected to increase to 4.6 million by 2040. This means that the number of fall incidents in this group will increase substantially in the coming decades (Government of the Netherlands 2015).