Dying naturally of old age is one thing - but there is nothing natural about a Fall.
So often the Fall is the beginning of the end: the pivot from active independent living to one of pain, depression and dependency. So often, it is the Fall which leads to losing the will to live.
In A&E where i volunteer we see it every day. Elderly women arrive with paramedics in the early hours, often confused, distressed and in pain. They often collapsed during the night on the way to bathroom in the dark and in the cold - and in the words of the paramedics "there have been a lot of cold houses this winter", a reminder that the winter fuel allowance cut has meant that many pensioners' houses are not heated and when combined with the socio-economic likelihood of increased pension poverty caused by lifetime caring responsibilities and the motherhood penalty, ethnicity, as well as health inequalities such as osteoporosis and musculoskeletal conditions linked to the menopause - elderly women, significantly more than men, are more likely to be frail and victim to the Fall.
The Fall can be a broken hip which is life threatening because of the risk of the loss of blood. This can lead to long periods of bed-ridden care which can lead to blood clots and heart and lungs risks.
Oder women are more likely to be carers including at age 50, 22% of women, equivalent to 3m women, are caring for parents, partners or loved ones, many leaving the workplace in order to provide unpaid care. Many ethnic minority communities are even more impacted by this age and caring duality.
In an ageing population, there are 14m women over 50 today in 2025 making up 53% of the population and there will be almost 17m older women by 2045 in the UK. The population pyramid gender disparity increases as age increases, and with it the poor health expectation. One in three of women over 65 are living alone, often widowed or divorced. Of women over 75, 68% live alone, more than double that of their male counterparts. One third of women over 50 have a disability. Around half of women over 50 have experienced a fracture related to osteporosis.
The experiences of of elderly women are mostly invisible, not least because of institutionalised ageism and sexism and because they are tucked away behind closed doors, especially in low income and minoritised communities - until we see them arriving on a stretcher after a Fall in A&E.
My own concerns revolve around corridor care, in A&E, when demand exceeds capacity. A triage and patient flow model which recognises frailty and vulnerability can make a major difference in safeguarding these patients by allocating safer environments where they will not feel the cold and the stress of the ambulance admissions entrance, where they will be screened away from mental health patients or substance misuse patients accompanied by security and police, which increases anxiety. Not unsurprisingly, dementia can also complicate the picture with many elderly patients not knowing where they are or what has happened to them. This exacerbates the nursing challenge with some elderly patients wanting to leave their bed to go home. Another indignity and anxiety for elderly women arriving in A&E and waiting in the corridor is the need to use the bathroom if they are incapacitated.
With the unfunded exorbitant cost of social care everyone should worry about elderly women prone to a Fall. Prevention is better than Cure. Staying strong in old age with strengthening exercises and physio care in the community should be a priority as part of a health care plan overseen by GPs. Home accessibility assessments and modifications could also provide reassurance to families and women living alone. Mobility guidance and training could also educate elderly women and their wider families about the risks and precautions. Adapted living accommodation and care options with onsite medical assistance could be considered before rather than after a Fall, with financial packages that offer flexible and tailored options. A live-in younger relative would provide security and companionship as well as offer free housing to young people starting out in life.
This week Age UK launched their ground breaking research report on Older Women in the UK and the health inequalities they face.
https://www.ageuk.org.uk/siteassets/documents/reports-and-publications/reports-and-briefings/older-women-in-the-uk---age-uk.pdf
