Voices and Choices, Chesham Bucks.

Falls Prevention

(Produced for Voices & Choices, April 2018)

A third of people over the age of 65 and half of those over 80 will suffer a fall at least once a year. Falls can cause head injuries, broken bones as well as other injuries; they can also shake confidence and increase anxiety and isolation, and yet half of all falls affecting older people are preventable.

A fall can have devastating consequences, resulting in painful, even life-threatening injuries for the victim, and falls cost the NHS £2.3 billion per year, but we can all reduce the risk of falling.

  • Who is at risk of falls?
  • What causes us to fall?
  • How to avoid trips and falls
  • What help is available?

Who is at risk of falls?

We all are!

Falls are the most common type of accident in the home.

We are all at risk of falls, and more so as we get older.  Most of us expect to have problems with our hearing and vision as we age, and maybe our joints, but what we might not realize is that balance is one of the first things to “go”.   These are not just problems of the very frail elderly:  Saga quote a survey of over 9,000 people in which nearly everyone over the age of 50 underestimated their likelihood of experiencing a fall.

Falls are the number one reason older people are taken to the emergency department in a hospital. Most falls don’t cause serious injury but they can leave you distressed. The good news is that there are lots of things you can do to stay steady on your feet.

Have you, or anyone you know, ever fallen and tried to play down the injury or not make too much of a fuss about it? It is normal to feel embarrassed about it or not want to bring attention to it for fear of creating alarm. Maybe you feel that it would not be taken seriously by your GP or other health professionals or you don’t want to be a bother.

Taking positive action now by talking to experts or making some relatively simple changes to your living space can prevent more falls and make a big improvement to your life and give you confidence to keep moving.

What causes us to fall?

Trip hazards around the home:

  • Clutter – especially on the floor
  • Trailing wires across the floor
  • Frayed or loose carpets, rugs and mats
  • Sharp jagged edges of furniture or table legs that extend out that can obstruct access
  • Dim lighting or light bulbs that need replacing
  • Hooks that belts or a sleeve can get caught in as you walk past
  • Items left on the stairs
  • Certain cupboards or shelves that you find it difficult to get items from

 Are you wearing a trip hazard?

  • Worn out or loosely fitted slippers
  • Shoes that don’t fit well or don’t have sturdy soles with good heel support
  • Any clothing like bathrobes that are too long for you
  • Do you walk around at home with only socks and tights on your feet

Is it what you eat or drink?

  • You may feel unsteady after drinking alcohol
  • Some of your medication may make you feel dizzy
  • Getting enough Vitamin D will keep your bones strong

Is your health to blame?

  • You may need an eye test and a new prescription for your glasses
  • You may feel pain in your feet or have tingly or swollen feet
  • It may just be that you can’t cut your toenails anymore
  • If you had a fall before you may have slowed down
  • You may be less active now for a medical reason
  • Exercises to improve your balance might be the answer
  • Improving your muscle strength and joints may help
  • Do something every day to be as active as you can

Who’s getting under your feet?

  • Young children who come to visit may leave toys and books lying around
  • Pets can cause a trip hazard in their excitement around you

How to avoid trips and falls

There are ways you can reduce your risk of having a fall, including making simple changes to your home and doing exercises to improve your strength and balance. If you’ve fallen in the past, making changes to reduce your chances of having a fall can also help you overcome any fear of falling.

Some older people may be reluctant to seek help and advice from their GP and other support services about preventing falls, because they believe their concerns won’t be taken seriously. However, all healthcare professionals take falls in older people very seriously because of the significant impact they can have on a person’s health.

Discuss any falls you’ve had with your GP and say if it’s had any impact on your health and wellbeing. Your GP can carry out some simple balance tests to check whether you’re at an increased risk of falling in the future. They can also refer you to useful services in your local area.

More accidents take place in the home than anywhere else, particularly in the kitchen and on the stairs.  It’s important to keep your home well-lit and clutter free to avoid falls.

Where do I start to make my home fall-proof?

Tips for preventing falls in the home include:

  • immediately mopping up spillages
  • removing clutter, especially from the stairs
  • removing trailing wires and frayed carpet
  • using non-slip mats and rugs
  • have good lighting, especially on the stairs
  • have handrails fixed on both sides of the stairs
  • using high-wattage light bulbs in lamps and torches, so you can see clearly
  • have a nightlight in the bedroom or a torch by the bed in case you need to get up in the night?
  • organising your home so that climbing, stretching and bending are kept to a minimum
  • always use a step ladder to reach high places and ask someone to help you, never stand on a chair
  • organising your home to avoid bumping into things
  • have a handrail in the bath and a non-slip bath mat
  • getting help to do things that you’re unable to do safely on your own
  • not walking on slippery floors in socks or tights
  • not wearing loose-fitting, trailing clothes that might trip you up
  • wearing well-fitting shoes that are in good condition and support the ankle
  • taking care of your feet by trimming your toenails regularly and seeing a GP or chiropodist about any foot problems
  • keep your garden paths clear and free from moss
  • give your pet a collar with a bell, it’s important to be aware of where they are when you’re moving about

How do I make myself less likely to fall?

As you grow older you may become more prone to falls. Falls can cause serious injury and leave long-lasting physiological effects.

Some health conditions, medications and footwear can affect your ability to stay steady on your feet. You might not notice your health changing as it can happen gradually, so it’s important to have regular check-ups so any issues can be picked up before they cause a fall.

Stay active

Many falls can be prevented by following simple steps, such as staying active. Falls can be caused by weak muscles and poor balance. You can improve muscle tone by taking regular exercise, such as walking, swimming, gentle stretching exercises or doing light gardening. Your local leisure centre or swimming pool may offer free or concessionary exercise classes and swimming for older people. You can find out about local walking schemes by visiting your local library or by visiting the Walking for Health website.

We’ve all heard about the importance of regular exercise for general health. As we get older, our muscle strength and balance reduces, which can lead to a fall. Exercises designed to improve muscle strength and balance can reduce your risk of a fall by maintaining strong muscles and bones, which in turn will help your balance.

NHS Choices have advice on exercises for older people which can be undertaken in the home – including exercising when seated and exercises to improve balance, flexibility and strength.

Regular strength exercises and balance exercises can improve your strength and balance, and reduce your risk of having a fall. This can take the form of simple activities such as walking and dancing, or specialist training programmes.

Many community centres and local gyms offer specialist training programmes for older people. Exercises that can be carried out at home are also available. Ask your GP about training programmes in your area.

It’s important that a strength and balance training programme is tailored to the individual and monitored by an appropriately trained professional.

There’s also evidence that taking part in regular tai chi sessions can reduce the risk of falls. Tai chi is a Chinese martial art that places particular emphasis on balance, co-ordination and movement.

Unlike other martial arts, tai chi doesn’t involve physical contact or rapid physical movements, making it an ideal activity for older people.

You can read more about physical activity guidance for older adults on the NHS Choices website.

Manage your medicines

Certain medications can make you feel faint or dizzy and affect your balance. Let your GP know if you experience side effects like these after taking any medication; they may need to check the dose or look at alternatives. Age UK has information about getting the most of your medicines.

If you’re taking long-term medication, your GP should review your medicines at least once a year to make sure they’re still right for you. It’s particularly important that your medicines are reviewed if you’re taking four or more medicines a day.

Your GP may recommend alternative medication or lower doses if they feel the side effects increase your chances of having a fall. In some cases, it may be possible for the medication to be stopped.

See your GP or practice nurse if you haven’t had your medicines reviewed for more than a year, or if you’re concerned that the medications you or a relative are taking may increase the risk of falling.

Be aware of health changes

Have regular check-ups to monitor your health. If you are feeling unwell, let a relative, friend or neighbour know. If you are taking several different types of medicine, your GP should review them on a regular basis. Let your GP know if the medicine causes you to feel dizzy or unwell. Ask your GP about having a flu jab. You are more at risk of developing a serious illness from catching flu as you get older. Illnesses such as flu can, in the short term, make you far more prone to falling. Each autumn, an annual flu vaccine is provided free to people aged 65 years and over.

Take care of your eyes

Eyesight changes as we age and can lead to a trip or loss of balance. Some eye conditions such as macular degeneration, glaucoma and cataracts increase with age and it’s important that these are detected at an early stage.

Get your eyes and glasses checked regularly, at least every two years. You are entitled to a free NHS sight test if you are aged 60 or over. This will detect any vision problems early before they cause you to lose your balance and co-ordination. You should make an appointment to have a sight test if you’re concerned that poor vision (even when wearing glasses) is increasing your risk of having a fall.

NHS Choices has a useful location finder so that you can find an optician near you.

Not all visual problems can be treated. However, some problems, such as cataracts, can be surgically removed using cataract surgery.

Check for hearing problems

Problems with your ears can severely affect your balance, and the risk of hearing loss increases with age. Talk with your GP if you notice hearing changes are affecting your day-to-day living or social life. The problem may be something easily treated, such as a build-up of ear wax or an ear infection.

Age UK has useful information about hearing loss and treatments

Combined sight and hearing problems can make it difficult to maintain your balance

Contact your local adult social services department to explain how your vision or hearing difficulties, or both, are affecting your day-to-day life. They will arrange an assessment, and specialist staff will explain the help available to make daily tasks easier.

Alcohol

Having a glass of alcohol can be one of life’s pleasures, but drinking too much can have a detrimental effect on your physical and mental health. It can cause insomnia and anxiety, and increase the risk of falls and accidents.

Drinking alcohol can lead to loss of co-ordination and exaggerate the effects of some medicines. This can significantly increase the risk of a fall, particularly in older people.

Avoiding alcohol or reducing the amount you drink can reduce your risk of having a fall. Excessive drinking can also contribute to the development of osteoporosis.

Watch what you eat and drink

Make sure you eat a balanced diet. Remember also to make sure you drink enough fluids, including water. Your GP or pharmacist can advise you on nutritional supplements or any dietary concerns you have.

Support your bone health

Bones become more brittle and fragile with age and you may develop osteoporosis. Strong bones will lessen injury related to a fall; if you have weak bones, a fall can result in a broken bone.

Keep your bones healthy and strong by eating calcium-rich foods, like dairy foods such as cheese milk and yoghurt, fortified soya products and canned fish.

Vitamin D is essential for keeping bones strong – the best source is sunshine. Try going outside without sunscreen for a few minutes around lunchtime every day during summer. Take care not to let your skin redden or burn. You can also get Vitamin D from eating foods with high levels of vitamin D, like oily fish, sardines, mackerel, tuna, eggs and meat and doing some weight-bearing exercises.

Choose the right shoes

Problems with your feet or shoes can affect your balance and increase your risk of tripping or falling. Talk to your GP, practice nurse and podiatrist about any foot issues.

These footwear tips can help you feel more confident on your feet:

  • Make sure your shoes fit well and don’t have a tendency to slip off.
  • Well-cushioned shoes offer comfort and support.
  • Avoid sandals with little support and shoes with high heels.
  • Wear slippers that have a good grip and that fasten and stay on properly.
  • Always wear shoes or slippers, and never walk indoors in bare feet, socks or tights.
  • Trainers can be comfortable to wear, and are sometimes recommended to reduce impact when walking, which may be helpful if you experience knee or back problems.

Wear suitable clothing

It may be a good idea to avoid wearing flared trousers, trailing nightdresses or other clothing that might cause you to slip or trip. If you feel you are at risk of falling, you might consider buying hip protector underwear that reduces the risk of a hip fracture as a result of a fall. It is washable, not visible under clothing and can be worn day and night. Ask your GP or a community nurse for further information about this.

Take care standing up

When you get out of bed or up from a chair, try to do it slowly, as a sudden drop in blood pressure when you stand quickly can make you feel dizzy. Try tensing and then relaxing your arms and legs a few times before you stand. Make sure your feet are firmly placed on the ground before getting up. If you are having difficulty with things like getting into or out of a chair or getting to the toilet, you can ask for an occupational therapy assessment from your local council’s social services department. The assessment will identify if there is any equipment or adaptations that can help you carry out daily tasks.

Look after your feet

Problems with your feet, especially anything that causes pain, can affect your balance.

Fall-proof your home

  • Try to keep your home warm as cold muscles work less effectively which can increase the risk of falls.
  • Have good lighting in your home. You may wish to leave a dim light on at night in the bedroom or hallway, or have a touch-operated bedside light. Ensure good quality lighting is fitted throughout your property.
  • Reduce clutter. Walkways, corridors and halls should be kept clear of objects, wires and clutter that could cause you to trip.
  • Fit a letter box cage so you do not have to bend down to pick up your mail.
  • Highlight the outer edge of steps with non-slip white paint to make them more visible.
  • Use non-slip mats under rugs to reduce the risk of you tripping or slipping on them.
  • Remove or repair frayed carpet edges and loose carpets.
  • Store things that you use a lot somewhere easily accessible.
  • Ask for assistance with chores such as changing curtains or lightbulbs.
  • Use a sturdy set of non-slip steps with a safety chain and handrail, rather than standing on a chair or table.
  • Spread salt, salty sand, dishwasher ‘salt’ or cat litter on wet or icy steps to make them less slippery.
  • Keep a mop to hand and always clear spills immediately to reduce the risk of slipping.
  • Have extra telephone extensions fitted around the home, or get an answering machine, so that you do not have to rush to answer the phone. Or invest in a cordless telephone that you can keep with you in your pocket.
  • Consider installing a community alarm system so that if you did fall, you could contact assistance and/or the emergency services.

Home hazard assessment

You can request a home hazard assessment if you’re concerned that you or a relative may be at risk of having a fall, or if you know someone who has recently had a fall. As well as identifying potential hazards, the aim of a home hazard assessment is to explore how a person’s actual use of the environment affects their risk of falling.

A healthcare professional with experience in fall prevention will visit you or your relative’s home to identify potential hazards and advise on how to deal with them. For example, as the bathroom is a common place where falls occur, many older people can benefit from having bars fitted to the inside of their bath to make it easier for them to get in and out.

Fitting a personal alarm system may also be recommended, so that you or your relative can signal for help in the event of a fall. An alternative would be to keep a mobile phone within reach, so it’s possible to phone for help after having a fall.

Contact your GP or local authority to ask about the help available in your local area. You can find your local authority on the GOV.UK website.

What help is available?

Gentle muscle strengthening exercise can help, whether that is walking, dancing, balance exercises of simply getting up from your chair regularly. See Useful Links below for activities in your area.

How can I overcome my fear of falling?

If you’ve had a fall or you feel that your balance isn’t as good as it was, it’s natural to feel worried about falling. This can become a problem if it’s causing you to avoid certain activities, such as exercise, or stopping you leaving your home.

To feel more confident and in control, think and plan ahead by discussing your risk of falling with your GP and consider if you need to install a personal alarm in the home.

Talk to your GP

Your GP may perform a falls risk assessment which will work out what’s making you more likely to fall. They can also draw up an action plan to reduce your risk of falling. If you’ve had a fall or are worried about falling, tell your surgery, even if you feel okay. There could be many reasons and, equally, many ways to help you feel confident again.

Personal alarms

Personal alarms allow you to call for help, for example, if you’re unwell or have a fall and can’t reach a telephone. Pressing a button on a pendant or wristband you wear all the time will alert a 24-hour response centre. The staff at the centre will then call out the best person to help you – a neighbour, relative or friend, or emergency services.

Telecare

As you get older you may become less mobile, which may cause you to have falls or worry about falling. Moving home to somewhere more suitable could be one option but it may not always be the right solution if it affects other areas of your life, such as staying close to friends, family and neighbours who support you. Remaining in familiar surroundings is particularly important for those with sensory impairments.

Telecare can provide an important safety net. With the use of fall detectors, bed and chair occupancy sensors, and alarm buttons, you can be supported to live in your own home, while ensuring that help can be called for, if you need it.

A telecare system can automatically alert staff at a response centre if you need help, such as if you’ve fallen. For example, a bed or chair sensor can detect if you’ve got up but haven’t returned in a set time, and it will automatically send an alert to a carer or emergency service.

Minor aids and adaptations

Telecare cannot stop you from falling so it is important to consider asking the council for a full review of your needs. This might include an OT assessment, carried out by an occupational therapist, to look at minor aids and adaptations that could help prevent you from falling or having accidents in your home. For more information about home adaptations and Home Improvement Agencies, see

The Independent Age factsheet: Adapting your home to stay independent (0800 3196789, www.independentage.org).

Buckinghamshire Falls and Bone Health 

Falls and the fear of falling can seriously impact on the quality of life.  A fall may not only result in a physical injury but can lead to social isolation, reduced mobility and independence.  You may be surprised to hear that one in three people over the age of 65 and one in two of those aged over 80 fall each year in Buckinghamshire. Our aim is to encourage people to:

MOVE MORE, FEEL GREAT! STAY STEADY AND STAY STRONG!

Buckinghamshire County Council pays for a local Falls and Bone Health service for local residents and it provides a vital service for those who have either experienced a fall, or are at risk of falling.  The service includes a highly skilled team of advisers who offer a range of information and expert advice for service users, carers and families on falls.  Those who have actually fallen will receive an in-depth, multi factorial assessment and offered a Better Balance exercise programmes with a choice of settings, including leisure centres, in a clinic or at your home and delivered by highly trained instructors.  Advice and recommendations following the assessment could include exercise programmes, provision of equipment and teaching you how to get up off the floor or how to get help following a fall. Exercise programmes will be home based or group based at Better Balance classes.

Better Balance helps rehabilitation after an unfortunate fall and improves balance and strength to prevent further falls.

Prevention Matters

The Prevention Matters service is a free and friendly advice service linking vulnerable adults (over 18) in Buckinghamshire to social activities, volunteers and community services.

Prevention Matters can support you in regaining your confidence, independence and getting out and about if, for any of the following reasons, you are:

  • Struggling to remain independent in your own house
  • Having difficulty getting out and about
  • Feeling lonely and isolated
  • Feeling anxious or lacking confidence
  • Recovering from an illness

The service will help you find social activities, volunteers and community services in your area.

You can find out more on the Prevention Matters page.

What should I do next?

  1. Consider whether you need to make any lifestyle changes and get regular check-ups. Book an eye or hearing test if you’ve not had one recently.
  2. Look for and fix trip hazards in and around your home.
  3. Talk to your doctor if you’re concerned about your risk of falling.
  4. Make a falls plan so you know who you’ll call and how you will get help if you fall.

Useful links

We can only be responsible for the content on our site. Websites are constantly trimmed and edited, so any content on a third-party site may disappear.

Care Advice Buckinghamshire

Our website has information and advice on how you can get support and also includes an online directory and marketplace where you can search for all kinds of support services and local resources. This includes both free services and those you can choose to purchase.

This site also has information on how you can get help from the council.

Prevention Matters

When all that’s needed is a little help to stay independent and active, Prevention Matters can find ways to support you. It is a complete and free advice service to help you before personal health or social problems become critical. You can contact Prevention Matters by:

Or you can read more on the Prevention Matters page.

Buckinghamshire County Council Health and Wellbeing website

Our Health and Wellbeing website provides the advice and help you need to stay healthy. You can find information on a wide range of topics including (but not limited to!):

  • Keeping active
  • Quitting smoking
  • Preventing falls
  • Free NHS health checks

Health and Wellbeing website

Doctors and Pharmacists

GPs look after the health of people in their local community and deal with a whole range of health problems. You can locate your nearest GP here.

Also, many Pharmacists now offer free advice and often won’t require an appointment. This could save you a trip to your GP, or help you to make healthy lifestyle changes. You can learn more about what help pharmacists can offer on the NHS choices website.

in-Touch

If you’re having difficulty staying independent and are not receiving any of our services, our in-Touch telephone service may be able to help you. in-Touch can give you advice, information and help you find local voluntary and community services, as well as other social groups and activities. Read more about in-Touch here

Buckinghamshire Falls and Bone Health

Falls and the fear of falling can seriously impact on the quality of life. A fall may not only result in a physical injury but can lead to social isolation, reduced mobility and independence. You may be surprised to hear that one in three people over the age of 65 and one in two of those aged over 80 fall each year in Buckinghamshire.

For all information on Falls and Bone Health in Buckinghamshire and/or to make a self-referral please contact: Telephone: 08442 – 252403 (Locally Charged Telephone Rate) Health and Wellbeing Bucks

Later Life Training – Postural Stability

Stay Steady, Stay Strong: Do you ever feel unsteady? Are you worried about falling? Or do you know an older person who would answer yes? Specialist Strength and Balance Exercise class to help maintain your independence, keep mobile and steady on your feet

Chesham Town Hall Saturdays 9:30 – 10:30 am £5.50 per session. Contact Lucie or Janine Tel: 07951 294178

Buckinghamshire Integrated Falls and Bone Health Service

The Falls Prevention website aims to provide information for all those who are concerned with the issue around falls.

Disabled Living Foundation (DLF):

DLF is a national charity providing impartial advice, information and training on independent living since 1969 and is part of the Shaw Trust. Disabled Living Foundation

Royal Voluntary Service:

The Royal Voluntary Service is a volunteer organisation that enriches the lives of older people and their families across Britain. Royal Voluntary Service

Age UK Handyperson services:

More than 70 local Age UKs operate handyperson services across much of the country. These services offer older people extra help with small practical jobs to make their lives easier and safer around the home.   Age UK

Saga

Saga has published a 32-page guide to preventing falls, in association with the Chartered Society of Physiotherapy (CSP) and Public Health England (PHE). Click here to download a copy of Saga’s ‘Get Up and Go: A Guide to Staying Steady’.

Exercise

Pilates studios and classes in Buckinghamshire: Pilates.co.uk

If you have problems with your health, or if you’ve had them in the past, it can be hard to stay active. Find out more about how we can help you get and stay active. Walking for Health

Saga: 

Get up and Go: a Guide to Staying Steady

Health & Wellbeing Magazine

Age UK:

Staying steady information guide

Falls Prevention

NHS Choices:

Falls Prevention

Strength Exercises

Balance Exercises

Walking for Health

Dance for Fitness

A Guide to Tai Chi

Independent Age:

Factsheet – Health Difficulties: coping with changing needs

Factsheet – Telecare & Telehealth

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