Experiencing a fall can affect a senior in more ways than just the initial injuries if any.
Many aging individuals develop previously not exhibited emotional responses such as fear, anxiety, withdrawal and even anger. The root could be a commonly experienced conditioned emotional response. Caregivers can take steps to help their senior patient recover from both the physical injuries and the emotional impact of a fall event.
In this article, you will learn how to help a senior recover from the emotional impact of a fall. We will also cover the topic of emotional response, conditioned response, the area of the brain that’s responsible for emotions, and how to develop strategies for assessing, evaluating and preventing falls in senior care.
What Does Emotional Response Mean?
Following a fall that is considered relatively serious, seniors may experience a significant emotional stress response that could hinder both the initial physical recovery and affect long term health and emotional status.
This differs from falls experienced by younger individuals. While some children or young adults are initially startled and can be upset following a fall, most still recover fully and leave the emotional turmoil behind them as they get back to their regular routine.
Seniors often react differently to a fall even if the injuries are not that serious. It is common for older individuals to fear having another fall. This fear can create increased anxiety that can negatively impact physical health and emotional well-being.
Seniors often withdraw from activities and similar situations that might have led or attributed to their fall event. Sleep can be disrupted, and anxiety can affect a person’s mood, eating habits and other activities of daily living or ADLs. Many seniors will avoid going outside, walking without assistance, riding or driving in cars or might avoid previously enjoyed social activities. Some withdraw from others or will avoid talking about the fall or their continuing emotional distress in an effort to control their inner emotions.
What is a Conditioned Emotional Response? How to Determine Appropriate Emotional Response from Emotional Response Due to Stress or Pain.
A conditioned emotional response refers to a learned behavior or reaction in response to an unexpected traumatic event. Sometimes, neutral stimuli that the person identifies with the adverse and now feared to be repeated event actually becomes the stimulus for an immediate fear reaction. The person has an immediate fear reaction to anything that the person has recognized to be a possible cause of their fall.
What is the Part of Brain Responsible for Emotions?
Our limbic system that is located in the brain’s temporal lobe carries out our body’s emotional responses like fear, love or anger. This is made up of multiple brain parts, and the very central emotional processing center is called the amygdala. This brain part receives input signals that our brain sends such as our attention span and brain function levels.
Strategies for Assessing, Evaluating and Preventing Falls in Senior Care
After a senior falls, it is imperative to accurately and thoroughly assess the circumstances that led up to the fall to determine possible causes. Abnormal emotional reactions or a strong emotional response to something after a fall should be looked into. The person’s health status should be evaluated along with a full medication evaluation. The caregivers should come up with a plan of action to prevent future falls.
Some important things to consider include:
- Current medications taken before fall, pay attention to new ones
- Thorough physical exam to rule out health conditions like low blood-pressure, low blood sugar levels or infections
- Professional evaluation of structural components used in ambulation and balance like spine, hip, knee and foot problems. This should be investigated by the appropriate physical rehabilitation therapist to recommend any appropriate assistive devices like walkers, canes or wheelchairs
- Assess and evaluate home-environment safety. Suggest safety additions like raised toilets, BR hand-grips, lift bars, non-slip products and safety alert devices
- Complete blood workup and lab tests
- Lying, sitting and standing BP readings
- Inner ear problems that could affect balance
- Assess and evaluate pain and provide appropriate remedy measures
- Check for any underlying health conditions including heart conditions like irregular atrial fibrillation, breathing/oxygen levels, neurological issues like seizures or Parkinson’s disease
- Podiatry assessment
- Vision evaluation and concerns involving eyeglass prescription changes, cataracts and glaucoma
- Rule-out endocrine diseases like thyroid issues, diabetes and hormone imbalances
How Using the 4 W’s Can Aid in a Fall Investigation and Recovery
Just like writing a good article, caregivers can use the 4 W’s rule to help uncover the specific circumstances surrounding a fall event in senior patients. Ask the patient to elaborate on these four descriptive questions.
What – Ask the patient to relate what happened up to, during and immediately after falling. To nudge the memory process, ask the patient to elaborate on shorter answers to obtain a full and accurate picture. Jot down everything stated.
When – Determine when the fall took place. Was it before breakfast? After lunch?
While making dinner? Ask open-ended questions that could trigger the patient to recall these details.
Where – Ascertain exactly where the fall took place. Was it in the bathroom, or did it happen while walking to the bathroom during the night? Determine if the patient was sitting in a chair, walking down stairs or anything else that could be pertinent.
Why – Ask the patient to indicate why they believe the fall happened. Did the patient feel dizzy, or did they take their medications? Get as many details as possible.
How Chronic Condition Affecting Health Can Contribute to Falls
It is crucial for the fall victim to have an immediate physician evaluation. Many seniors develop underlying health conditions that might contribute to a fall. Common examples are UTI’s or kidney infections, autoimmune disorders like lupus and Grave’s disease affecting the thyroid. Assess for acute illness like pneumonia or a chronic condition like diabetes.
Investigate Any Strong Emotional Response. Common Emotional Reactions After Falling Include:
- Increased fear or paranoid behavior
- Depression new onset
- Agitation or apathy regarding previously enjoyed activities
- Anger due to being afraid of becoming useless and dependent on others
- Exaggerated flippant behavior to hide true emotions about the fall. Some deny a fall even with prevailing evidence present
- Withdrawal, sadness or severe mood swings
The Importance of Identifying, Evaluating and Appropriately Treating Senior Patients with Signs Indicating Emotional Stress
Senior care should include a methodical assessment. Part of senior recovery involves identifying, evaluating and appropriately treating senior patients that show signs of emotional stress. Family caregivers should make a complete list of every small detail they can glean regarding possible triggers that led to a fall. These should be given and reviewed by the family or ER doctor.
Any identified triggers that cause the patient emotional distress following a fall event should be noted and addressed. Patient education regarding older individual’s risks for falls and common possible causative factors should be relayed to the patient.
While aging does not automatically mean that one will increase their chances of falls and possibly become immobile, many older patients secretly have these fears. Concrete steps to address any concerns about another fall can offer the patient some relief for worry and clear up any confusion regarding the aging process.
Older patients often worry that they will become bedridden leading to a decreased quality of life or fear becoming a burden. Important considerations for post-fall senior recovery care involves in-depth assessments, accurate recall information and preventive measures to alleviate concerns about another fall.