this raises renewed worry over shortage social care and understaffing in hospitals and care homes.
Doctors are warning of the trend. Office for National Statistics death registration data shows that between 2008 and 2016, among men over the age of 85, the number of deaths has risen by 177%. The rise among women has been smaller but is still significant – up 72%. These figures are for England and Wales.
“I’m surprised and saddened to see this upward trend. No one wants to see their nearest and dearest die of a fall,” said Dr Eileen Burns, president of the British Geriatrics Society, which represents 3,400 doctors, nurses and occupational therapists who care for older people.
Falls can lead directly to someone dying when they bang their head and suffer a bleed on the brain, or develop pneumonia after lying undetected on a floor, or break their hip and do not recover.
Burns said an increase in such deaths is to be expected as a result of a growing frailty linked to Britain’s ageing population. Hip fractures are rising, too. But the fact that such fatalities have risen much faster than the rise in the number of older people – the number of over-85s went up by only 19% but falls deaths by 107% between 2008 and 2016 – raised worrying questions, she added.
“Access to support services has decreased. For example, the proportion of over-65s receiving local council-funded social care fell from 15% to 9% between 2010 and 2015. Were some of these people who died waiting for an assessment by an NHS falls service but hadn’t had their appointment yet because of waiting lists? Austerity, the defunding of health and social care, and reduction in services is certainly a possible factor,” said Burns.
Dr Nick Scriven, the president of the Society for Acute Medicine, which represents acute medical specialist doctors in hospitals, said: “The risk of falling is dramatically increased by the effects of ageing – general frailty, multiple illness and medications. Other factors such as obesity or malnutrition also play a big part. All those also contribute to the after-effects of a fall, including injury and death. A fall with injury can be a final straw.”
Shortages of nurses and healthcare assistants in hospital wards and care homes are also likely to help explain the rise, Scriven said. “The NHS does not lack the will or desire to tackle this but, of all the interventions tried, the only one that consistently prevents falls is having a lot of staff in an area, so people are never left alone. This level is far above the traditional ‘safe staffing level’ and almost certainly out of reach of most NHS units in the current socioeconomic climate.
“To throw a more political line, the current pressure with high bed occupancy, with staff shortages, could be seen as a ‘perfect recipe’ for a falls epidemic in our hospitals.”Burns agreed. “Potentially a lack of nurses and healthcare assistants is a factor here too,” she said.
The data does not reveal where falls deaths have occurred. But few happen in hospital, Burns said. “Most of these falls are likely to be happening in people’s homes, because most older people are not in care homes. But care homes do have proportionately more of them because there’s a higher risk of them occurring there because their residents are more frail than the general population,” she said.
The increase in deaths among men aged over 85 from falls between 2008 and 2016
Increase in number of people over the age of 85 between 2008 and 2016
The proportion of over-65s receiving local council-funded social care in 2015. Down from 15% in 2010