Preventing falls - a Guide for Older People and their Carers

About 135,000 falls occur every year in people over 75 years. One in five of these falls results in fractures that need hospital treatment. If the faller is unable to get up, the faller is at risk of hypothermia, pressure sores and loss of confidence. Half of all these falls are caused by tripping over objects or by falls on steps or stairs.

You can help prevent falls if you can recognize if you - or someone you're caring for - is at risk of a fall and you follow the 15-point action plan in this section. Should you fall, we also include a section on 'what to do if you have a fall'.

find out about preventing falls in older people.

Risks and causes of falls

Action plan to prevent falls

What to do if you have a fall

Further information

Risks and causes of falls

The risk of falling increases as we get older. An 85 year old is five times more likely to have a fall than a 65 year old. Some medical conditions lead to an increased risk of falling, these conditions include-

Poorer balance - The body's balance reactions slow down with age. Conditions like Parkinson's Disease and strokes also affect balance.

Weaker muscles/unstable joints - Osteoarthritis is a very common condition that may make it difficult to move around, leading to a lack of exercise which in turn results in weaker muscles and stiff joints.

Poor eyesight - Eyesight can deteriorate with age, and is more likely to be affected by cataracts and weakening muscles. This increases the likelihood of tripping and falling, especially if combined with poor lighting.

Medication - Tranquillisers, antidepressants, sleeping pills and some heart tablets can lead to dizziness. Always take prescribed medication, but consult your doctor if new medication makes you feel dizzy.

Action plan to prevent falls

Take regular exercise, even if this is only a short walk, to keep muscles strong and joints supple.
Fit easy grip handrails on both sides of the stairs. Avoid/minimise climbing stairs if you don't feel safe climbing them.

Keep stairs and living areas well lit, use 100 Watt bulbs where appropriate. Keep a torch by the bed.

Never leave objects that may be tripped over, on stairs or in walking areas. Avoid flexes and cables crossing walking areas.

Use non-slip rubber mats in the bath/shower. Fit a handrail near the bath/toilet. Avoid small rugs in the bathroom.

Replace worn rugs and carpets. Nail or tape down the edge of rugs to avoid slips and trips.
Minimise bending/climbing. Keep frequently used items on racks or in drawers at an easy level. Have a letter tray and rack for milk deliveries fitted.

If you must climb, use proper steps. Never use chairs or tables, which may be unstable.
Get up from chairs/bed slowly. Blood pressure falls as you get up, and your body may take longer to adjust as you get older.

Avoid poor fitting shoes or slippers, and heels.

Have regular eye tests. It is possible in many areas now to have an eye test in your home.
Avoid clothes that may trip you - like trailing nightdresses.

Don't rush to answer the telephone. Warn friends that it may take you longer to reach the telephone. Have an extension socket fitted upstairs.

If prescribed medication is making you feel dizzy, keep taking it, but consult your GP.
Keep rock salt at hand to put on external paths in cold weather.

What to do if you have a fall

Don't panic - You will probably feel a little shocked and shaken, but try to stay calm.
Assess the situation

if you're hurt or feel unable to get up, follow the Rest and wait plan

if you're unhurt and know you're able to get up, follow the Up and about plan

See your GP - All falls are potentially serious and you should see your GP afterwards

The rest and wait plan

If you're hurt or unable to get up, wait for help -

Try to summon help - Use a pendant alarm if you have one, bang on the wall, call out for help, crawl towards your telephone, (keep the telephone at a low level).

Move to a soft surface - If you've fallen on a hard floor, try to move to a carpeted area.

Keep warm - Try to reach for something to cover yourself with. Try to move out of drafts.

Keep moving - Do not lie in one position for too long, as you may get cold and suffer from pressure sores. Roll from side to side and move arms and legs if possible. If you need to empty your bladder while on the floor, use a newspaper or item of clothing to soak up the wet, and try to move from the wet area.

The up and about plan

Before you attempt to get up, make sure that you're not hurt. The method below is a safe way to get up from a fall but there are others. We strongly recommend that you ask for an assessment from a physiotherapist who can advise you on the most appropriate way to get up.

Roll onto hands and knees - Crawl to a stable piece of furniture - like a bed, stool or chair
With hands on the support, place one foot flat on the floor bending your knee in front of your tummy.

Lean forwards, push on your feet and hands until you bring the other foot to be beside the first.
Turn and sit on the seat. Rest for a while before getting up.

Occupational therapists

Occupational therapists will be able to advise you on how to make your home safer, advise you on the safe way to do things, and the supply of equipment - if necessary.

Physiotherapists

Some physiotherapists specialise in the needs of older people and can assess your ability to get up from a fall without help, advise on the safest method of getting up from a fall and -where appropriate - teach specific exercises and supply mobility aids

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