Who is more at risk of falling?
Some groups of people are more at risk of falling, particularly if there are hazards in their homes. Groups of people who are more at risk of falling include those who:
- Suffer from chronic health conditions such as heart disease, arthritis, low blood pressure, Parkinson’s disease, dementia or other cognitive impairments. These conditions can cause lack of co-ordination, dizzy spells and weakness.
- Are recovering from post-operative surgery or a serious injury or who have a physical disability.
- Have a loss of balance due to an infection, injury or fear of falling.
- Take medicines that have side effects such as dizziness, drowsiness or other loss of functioning. Side effects are more likely to occur if the person is regularly taking a number of medicines each day.
- Experience a decline in their muscle strength and joint flexibility. Reduced muscle strength and joint flexibility can make it more difficult for a person to stand up, walk, get out of a chair or their bed.
- Have a slower reaction time. The nerves that carry information to and from the brain can deteriorate as the result of disease and as we get older. This slows reaction time and the ability to move away from obstacles quickly enough. For example, avoiding a slippery patch on a floor.
- Suffer from poor vision. A person may not see as well as they used to which can affect their coordination and balance. It also means that they may not see tripping hazards such as a trailing wire or a pair of slippers left around etc.
Why does age increase the risk of falling and the impact?
As we get older and more unsteady on our feet, the risk of falling becomes greater and the risk of serious injury more likely. This is because of normal age-related physical changes, the prevalence of long term medical conditions and possible side effects of medicines that are taken for those medical conditions.
Older people are more likely to sustain a fracture if they fall, particularly to the wrist or hip. Hip fractures can be seriously debilitating. The likelihood of sustaining a hip fracture, along with the negative side effects, increases roughly tenfold for every decade after the age of 50. Women are particularly vulnerable due to a higher occurrence of osteoporosis.
For people over the age of 75 the impact is even greater. Falls are the most common cause of death in this age group.
Equally important are the significant psychological effects. A recent study by Portegijs (2012) suggested that damaged confidence – not just physical injury – can sometimes be responsible for a reduction in mobility. Portegijs found that adults who were more confident about their balance performed better in balance and mobility tests.
The good news is that older adults do not need to let the fear of falling rule their lives. Regular exercise, a healthy balanced diet, good health care and reducing hazards in the home can all help a person to avoid falls and stay independent longer.
Why is it important to know about the risks associated with falls?
Understanding how trips and falls are more likely to occur is the first step to preventing them.
What can I do to reduce the risk of falling?
We cannot remove all of the risks, but we can certainly reduce them by:
What increases the risk of falling?
Common hazards in the home that increase the risk of falling include:
- General clutter and furniture that is placed across walking areas
- Tripping hazards such as loose or frayed rugs, uneven floors, trailing wires or clothing that trails along the floor
- Poor lighting
- Wet or slippery floors
- Items stored out of easy reach
- Poorly fitting shoes
- Lack of, or the wrong equipment or aids
What are the top 10 tips for preventing falls?
Looking after your health is vital to maintaining your independence. There are a number of things that you can do to keep moving and to avoid the risk of falling.
- Eat and drink well
- Keep active
- Use the right equipment and aids
- Move safely around your home
- Keep your home free from obvious hazards
- Avoid slips in the bathroom and bedroom
- Take care when using the stairs
- Make sure you can see clearly
- Be aware of medication side effects
- Seek help when you need it.
Find out more about preventing falls from the NHS choices website.
Or from Age UK
Why is what I eat and drink important?
To avoid medical conditions that increase your risk of falling it is essential to receive enough essential nutrients. Eat breakfast every morning. Remember skipping a meal could make you dizzy. Drinking alcohol can also make you feel dizzy. It can affect your co-ordination which increases the risk of falling.
Avoid dehydration by drinking plenty of fluids each day. You may not always feel thirsty or hungry so finding ways to remind you to eat and drink throughout the day is often a good idea.
Why is regular exercise important?
Exercise can improve balance, strength, coordination and flexibility. So it is vital to keep moving, for example walking and swimming. Talk to your doctor or a healthcare professional about the type of exercise that would be good for you and follow their recommendation. A doctor may refer you to support from a physical or occupational therapist. They can visit you at home to provide an individual exercise program to suit you that improves balance, muscle strength and gait (how you take steps).
Consider joining a local health and fitness centre where you can meet like-minded people and give each other encouragement to exercise regularly. Group activities can be fun. You might benefit from group exercises such as water workouts in a pool or Tai Chi, a gentle exercise that helps reduce the risk of falling. Yoga and body balance classes are also good for posture, flexibility, mobility and balance.
If you prefer to exercise at home, then Age UK has an excellent free guide on simple strength and balance exercises which you can download for free.
How can I make sure that I have the right equipment and aids?
The secret to reducing the risk of falling is not only moving more, but moving safely. Your occupational therapist can advise you on suitable adaptations for your home to make it safer for you, as well aids to make day to day living tasks easier for you. There are an extensive range of aids and adaptations to meet a wide variety of needs. Depending upon your circumstances these may be available for loan from the local authority or from specialist suppliers. Some examples include:
- Walking aids such as a walking frame, stick or ramps
- Hand or grab rails to make it easier to get in an and out of a bath
- Raised seats for a chair or toilet to help you move between standing and sitting safely
- Aids for accessing those hard to reach places when washing or dressing
If you do not have an occupational therapist, talk to your doctor who can make a referral for you.
What do I need to do to move safely around my home?
Take extra care when standing up, reaching or sitting down. When moving from lying down to standing, sit up first and stay sitting a moment or two. Then stand up slowly and stand a few seconds before trying to walk.
When you first wake up, sit on the edge of the bed for a while to fully orientate yourself before you get out of bed. If you are not close to the telephone when it rings, don't rush to it. Fast, sudden moves could throw you off balance.
Always use your recommended walking aids if you are unsteady. Make sure that you (or someone else) regularly checks the condition of any equipment that you use. For example, check that the rubber tips on walking sticks are not worn down.
Make sure you have access to a telephone or an aid call button that you can reach to call for help if you fall. Consider carrying a portable phone.
Does my choice of footwear and clothes affect my risk of falling?
Yes. It is important to:
- Wear clothes that fit properly. It’s easy to trip on a coat, pair of trousers or bathrobe that is too long
- Have your feet measured each time you buy shoes since your size can change and ill-fitting shoes can increase the risk of falling
- Choose shoes and slippers that support your feet well and that have non-skid soles. Lace ups can provide more stability, but if you find tying laces difficult then select footwear with fabric fasteners
- Shop in the men's department if you're a woman who can't find wide enough shoes
- Use a long-handled shoehorn if you have trouble putting on shoes
- Keep your toenails trimmed.
How can I make my home safer to prevent falls?
You can move around more safely at home not only by using appropriate aids and adaptations, but by making sure that hazards are removed. Regularly check for anything that may unnecessarily restrict your movement or that could be a tripping hazard. For example:
- Don't leave clothes, newspapers or empty containers on the floor or stairs where you may later trip over them.
- Check that there are no tripping hazards from frayed or loose carpets and rugs, uneven floors etc.
- Close cabinet drawers so you won't stumble over them.
- Keep walkways free of clutter and furniture particularly sharp corners.
- Clean up puddles of water or other spillages promptly to avoid slipping.
- Take care around pets. They may suddenly move in front of your feet or jump on you.
Use Bluebird Care’s ‘home safety checklist for preventing falls’ to help you and your family find and fix common hazards in your home.
How can I avoid slips in the bathroom and bedroom?
- It’s never a good idea to grab a towel rack, shampoo holder or soap tray for support in the shower. These will not hold a person's weight. Talk to your health advisor or occupational therapist about fitting a grab rail
- Let the soap suds go down the drain before you move around in the shower to avoid slipping. Using a non-sip rubber mat is a good idea.
- Avoid turning suddenly
- If you are prone to falling, use a shower chair and a handheld shower attachment
- It may be safer not to lock the bathroom door because if you need help, someone can reach you without delay
- Arrange clothes in your wardrobes and cupboards so that they are easy for you to reach without stretching
- Replace satiny sheets with non-slippery sheets made from cotton
- If transferring either from or to your bed is difficult for you, seek advice about suitable aids such as blocks to raise the height of the bed
How can I avoid falling when moving up and down stairs?
- Take extra care when using the stairs
- Avoid carrying any package that will obstruct your view of the next step
- Keep at least one hand on the handrail or if you do not have one, consider having one fitted
- Give all of your attention to moving up and down stairs and try not to be distracted, e.g. by conversations or other sounds
Why does being able to see properly help to prevent falls?
Loss of vision can affect coordination and balance, so being able to see properly can help to prevent falls. Good lighting can help you to see trip hazards such as an open drawer or a spilt drink.
What can I do to make sure I can see clearly?
- Always wear glasses if you need them, but remember to remove reading glasses before you walk
- Have your eyes checked regularly
- Keep areas where you regularly move about well lit. 100-watt bulbs are recommended, except where this exceeds the recommended wattage for your particular light fittings
- Have a torch handy for use in the event of a power failure.
When should I see a doctor about a fall?
If you or someone you care about is 65 years old or over, remind him or her that their doctor should consider their risk of falling at least once each year. Do not wait until the doctor asks you about your risk of falling. You should tell your doctor about any time you have fallen, particularly if you are older. This is regardless of whether or not you were hurt.
Falling or almost falling gives a doctor important information about a person's health. Falls do not always mean that a person is getting weaker. Someone can fall as a side effect of the medicines that he or she is taking or how much of those medicines they take.
Changes in eyesight can also make a person more likely to fall. It is important to tell the doctor if you were wearing glasses or contacts when you fell. Tell them when you last had your eye sight tested. The doctor may also ask you what time you fell because eye problems can make seeing clearly harder at night, for example.
The doctor may ask about your home because sometimes there are things that can be done to make the home safer, even if it is just increasing the watts of light bulbs to 100 to make things easier to see. The doctor may need to know what you were doing when you fell to see if there are ways to prevent further falls. Simple changes like moving pots and pans or dishes in cabinets can make a fall less likely. The doctor may also ask about any pets and talk about safety. The question is not whether to keep the pets, but what can be done to live together safely.
Remember, many falls are preventable. Helping people staying on their feet and preventing falls helps them stay at home.
Can my medication increase my risk of falling?
Yes, in some cases the side effect of a medicine can increase the risk of falling by causing drowsiness, fainting, fatigue or dizzy spells. It is also important to note that some medicines may react with each other, which can exacerbate these problems.
Always read the information about side effects that comes with each of your medicines.
If you are taking any drugs that may have these effects, talk to your doctor. Do not simply stop taking the medicine as this could put your health at risk. With all medicines, the risks and benefits must be weighed. There may be alternative medication that your doctor could prescribe instead. You and your doctor will need to discuss all of the options and consider how best to manage any risks of falling.
With any new treatment it is always a good idea to ask your doctor the following questions regarding medicines and the risk of falling:
- Name of the medicine(s)
- The reason for taking the medicine and what the medicine does
- When you should take it
- Any special instructions about how you should take it e.g. with meals, not with dairy products, at bedtime etc. and for how long?
- What the possible side effects are (how your body might react to the medicine)
- Whether the medicine reacts to any other medicines, foods, drink or herbal supplements that you take
- If there is anything you should avoid doing while you are taking it, e.g. driving
- How you will know if the medicine is working
- When you need to see the doctor again.
Make sure you ask for a review of your medicines if you are concerned or have not had a review for over a year.
You can also talk to your pharmacist who can give useful advice on taking care at home with regards to medication and risk of falling.
I prefer to be independent, is it better to manage by myself?
Having the right care and support when you need it can help you to live more safely and therefore keep your independence. You may have a relative who can help or you may wish to use the services of a professional home care agency, such as Bluebird Care.
How can Bluebird Care support me?
Bluebird Care can provide essential care and support to help keep you safe and to maintain your independence at home.
Different people have different needs, so we will always talk to you about the type of home care that is right for you. Before providing a service, a member of our senior team will visit you in your home to find out about your day to day living experience. We explore the type of services we can provide to meet your particular needs and preferences. Together we then create a personalised care and support plan to help you safely meet the challenges of day to day living.
This might include support with meal preparation, medicines, housekeeping, shopping, bathing and grooming and other important services. Help to do the tasks that you find difficult can significantly reduce the risk of falling.
We regularly review your care and support plan with you, because we recognise that what you want or need may change.
I live alone, how can I summon help if I need it?
It is particularly important if you live alone that someone regularly calls round to see how you are. You might also wish to consider joining one of the alarm or telecare schemes.
These systems usually have three components: a small radio transmitter or help button (some of these can be worn around your neck); a console connected to the user's telephone; and an emergency response centre that monitors calls. When emergency help is needed, you press the transmitter's help button. It sends a radio signal to the console, which automatically dials one or more pre-selected emergency telephone numbers. Most systems can dial out even if the phone is in use or off the hook. Most systems are programmed to telephone an emergency response centre where the caller is identified. The centre will try to determine the nature of the emergency. Centre staff also may review the person's medical history and check to see who should be notified.
What should I do if I fall?
If you or a loved one falls over it can be quite frightening. Remember, your reaction after a fall is critical. What happens next can either reduce further harm or, if not managed properly, can cause more injuries than the fall itself.
It is important to remain as calm as possible. The person who has fallen should take a few deep breaths. Check to see if there are any injuries. If the person says that they are not hurt and that they feel strong enough to stand, encourage them to get up slowly and carefully. It may help them to hold onto furniture, providing that this is stable. It’s a good idea for them to sit and rest for a while until they are properly orientated.
If you believe the person is injured, do not attempt to get them up. Dial 999.
What should I do if I need to call for an ambulance?
The advice on the NHS choices website is:
“Always call 999 if someone is seriously ill or injured, and their life is at risk. Once you are connected to an ambulance 999 operator or call handler, they will ask you a series of questions to establish what is wrong. This will allow them to determine the most appropriate response as quickly as possible.
Do not hang up
Wait for a response from the ambulance control room as they might have further questions for you. The person who handles your call will let you know when they have all the information they need. You might also be instructed on how to give first aid until the ambulance arrives”.
You can find out more from the emergency services page at the NHS choices website.
How can I find a Bluebird Care office near me?