Fear of falling phobia - how to help the elderly remain independent
One of the worries that can occupy the elderly is an excessive fear of falling, both in people who have already experienced a fall and also often in people who haven’t. Anxiety is common after a fall as the shock can cause a negative expectation in the mind that it may happen again.
It’s natural for the person to be apprehensive of walking or a little nervous on their feet for a while after they’ve experienced a fall but if this fear increases and is not dealt with it can lead to inactivity, disability and can actually increase the likelihood of a fall.
If this anxiety grows to such a level that the person begins to limit their activity, and as a result, their quality of life suffers or they become less independent, then this can become a problem. The time to worry is if there is a lasting behaviour change, resulting in the person failing to live life as they previously did.
If not dealt with, a fear of falling can turn into a phobia or larger irrational fear, which in turn can lead to a vicious cycle. A loss of confidence and depression, followed by lack of mobility or activity can then lead to a lack of strength or flexibility in the body, which in turn causes unsteadiness on the feet when attempting to move about. This coupled with the lack of confidence can make the chances of a further fall more likely and the cycle continues.
If the person falls again due to this cycle and becomes physically hurt and maybe hospitalised or dependent on others for a while, the whole anxiety can be exacerbated. This means that rehabilitation can be more difficult. Sadly, at this point, the elderly person often loses their independence and has to go into residential care. If the fear had been dealt with earlier this premature lack of independence may have been avoided or at least delayed, allowing the person to enjoy their life more fully and independently for longer.
What are the practical strategies that can help to lower the anxiety after a fall? If you have an elderly relative or friend who you suspect is suffering from anxiety of falling there are a few ways to help.
According to a recent NHS article, ways to help the person to recover and lead a normal life following a fall, include encouraging the person to stay as active as they can (obviously within their capabilities) while setting themselves small goals to increase confidence slowly. Also continuing to take part in activities and hobbies as soon as possible and mixing with others in local groups and the community, will help to take the mind off any irrational fears.
Talking to someone about any fearful feelings (maybe a friend or family member) and not keeping these thoughts to oneself is also a good idea. Keeping fears inside and not voicing them can cause the anxiety to get worse.
Also recommended is positive thinking. Often when someone is anxious there is a tendency towards ‘all or nothing’ thinking. If the fall occurred during a particular activity, walking to the shops, for example, the belief may form that every trip to the shops in the future will result in a fall and therefore this activity spells danger.
The subconscious mind (the part of the mind which stores all memories, beliefs and habits) doesn’t recognise the difference between reality and fantasy. It often stores and reacts to outdated or irrational beliefs, but the subconscious ultimately wants to protect us. In the case of someone who has had a fall, excessive fear may stop the person from living a normal life. The subconscious is irrational and our responses to the outdated beliefs are normally automatic and unconscious. We simply make the decision that the walk to the shops is too dangerous and so we become dependent on others to do our shopping for us.
To challenge this ‘black or white’ thinking we should help the person put things into perspective by getting them to think about all the times that they haven’t fallen in the past. Also to challenge any depressive thoughts we can ask them to think and remind themselves of all the positive aspects of their life. For example their family, friends, hobbies, abilities etc.
How can hypnotherapy help?
If the anxiety is affecting life negatively, cognitive behavioural hypnotherapy can assist the person to adopt a more positive, confident and rational attitude thus breaking the vicious cycle of the fear of falling.
Hypnotherapy works directly with the subconscious mind and assists change in any negative beliefs held, those that limit the person from enjoying the quality of life. A good hypnotherapist will also teach some effective and simple relaxation techniques and coping strategies to deal with anxiety if it occurs in the future.