Domestic accidents among the elderly

Aging is a universal, normal, inevitable biological phenomenon. The combination of high fertility and declining mortality during the 20 ^th century has resulted in larger and rapid increases in elderly populations as successively larger cohorts step into old age. Further, the sharp decline in fertility experienced in recent times is bound to lead to an increasing proportion of the elderly in the future. Demographic transition for last three decades reveals fastest growth among those aged 60 and above. ^[1] Within the next 5 years, the number of adults aged 65 and above will outnumber children under the age of 5, and by 2050, these older adults will outnumber all children under the age of 14. The majority of older people live in low- or middle-income countries. By 2050, this number will have increased to 80%. Demographic changes are accompanied by new challenges like increased prevalence of non-communicable diseases (NCDs), various disabilities, need for long-term care, large number of people with dementias and maltreatment at home. ^[2]

Domestic accident is an accident that takes place at home or in its immediate surroundings, and more generally, encompasses all accidents not connected with traffic, vehicles, or sport. Domestic accidents are worldwide public health problems. The problem is graver in developing countries, particularly in rural areas, shanty towns, or informal dwellings. Every domestic accident brings a varying measure of distress to the victim as well as the family members. The consequences may be disastrous both for the individual and the society when the accident results in permanent disability, as the victim loses his earning capacity and may not be able to enjoy a normal active life. Domestic accident cases are a special group in themselves, reflecting the character and way of living of people. Quite a new pattern of injury attributable to domestic accidents emerges with each technical or cultural change. ^[3]

Various hospital-based and community-based studies carried out to find out epidemiological perspectives of domestic accidents conclude that domestic accidents are more common in extreme age groups (>80 years and <6 years age group) and in females (>60%). In case of females, the reasons may be the higher amount of time spent at home and greater participation in daily home activities. The likelihood of suffering from domestic accidents increases with age. Falls are the most frequent accidents among seniors. A simple fall can change the life of senior citizens with serious physical and psychological consequences that limit their autonomy and generate social isolation. From a healthcare perspective, elderly falls are a major clinical issue in terms of frequency, disability, institutionalization, and overall mortality, with an outgrowing socioeconomic burden. ^{[1],[3],[4],[5],[6]}

Recent surveys have estimated a huge expenditure on direct medical cost for domestic accidents (in the USA, more than US $19 billion for non-fatal falls in subjects >65 years of age; in the UK, US $1.9 billion for emergency services and hospitalization, while an Australian study reported a national healthcare cost for elderly falls of US $66.1 million). Interestingly, two-thirds of the overall medical costs are due to falls requiring hospitalization. ^[6]

Prevention of domestic accidents must be based on a comprehensive approach that begins with the epidemiological surveillance of the phenomenon. Present study conducted in rural parts of Karnataka State, India, highlights the risk of accidents among elderly in domestic environment and observance of safety practices by them to prevent the same. Use of simple LOT quality sampling technique and standard home safety checklist tool, modified to the Indian scenario, promises the opportunity to set uniform guidelines for epidemiological surveillance of prevalent risk factors for domestic accidents among elderly in different areas and different situations. The study underlines the further scope to look into this issue for the long-term benefits to our elderly and promote the movements like CON MAYOR CUIDADO initiated by Spanish society. The campaign CON MAYOR CUIDADO (More Carefully) has been born with the intention of encouraging and favoring actions in the area of accidents prevention at the homes of those senior citizens who wish to maintain their independence and personal autonomy. Society which fosters research to save and extend human life cannot escape the responsibility for the life thus extended. World Health Day 2012, with its slogan, “Ageing & Health – Good Health Adds Life to Years” also focuses the attention toward maintaining our senior citizens in the best of physical, mental, and social health. ^[7]

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.95950