Falls and Fall Prevention

Falls and fractures are a common and serious health issue faced by older people in England. People aged 65 and older have the highest risk of falling; around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Falling is a cause of distress, pain, injury, loss of confidence, loss of independence and mortality. Falls are the number one reason why older people are taken to hospital emergency departments.

The number of people aged 60 years or over in the United Kingdom (UK) is expected to exceed 20 million by 2030, with the number of people aged 65 years or over being projected to rise by 48.7% in the next 20 years to over 16 million. Furthermore, the number of people aged over 85 years in the UK is predicted to double in the next 20 years and nearly treble in the next 30 years (Age UK 2014, Office for National Statistics) Each year 35% of people aged 65 and over will fall one or more times. Moreover, 45% of those in the 80 years and over age group, who live in the community, fall each year.

How do I prevent a fall?

Health conditions, mobility, medication and footwear can all affect your ability to stay steady on your feet. Health conditions can change and deteriorate gradually so it is important to have regular check ups at your GP surgery to avoid a fall happening.

Stay Active – as we get older our muscle strength and balance decrease which can lead to a fall. It is important to take regular exercise to improve muscle strength and stamina.
Have regular eye tests – poor or failing eyesight can lead to a trip or loss of balance.
Have regular hearing checks – problems with your ears can seriously affect balance and reduced balance can lead to a trip or a fall.
Manage your medication – some medication can make you feel dizzy or faint and prone to losing balance. Check with your GP if this starts to happen.
Look after your bones – bones become fragile with age with many people prone to osteoporosis. Support bone health with Vitamin D and calcium supplements.
Wear the right shoes – wear supportive, well cushioned shoes that are not likely to slip off. Avoid sandals and high heels. Never walk bare feet or in socks or slippers which can increase the chance of slipping and falling.
Avoid alcohol – drinking can lead to loss of coordination and long-term alcohol use can lead to loss of bone density and osteoporosis.
Always keep hydrated – being dehydrated can lower blood pressure which can make us feel faint and prone to falling.
Create a safe environment at home and in your garden to reduce the risk of falling.

How Can an Occupational Therapist Help with Falls Prevention?

Most slips and falls happen in and around the home. An Occupational Therapist can carry out a home visit and assess you and your home environment, identifying risks and hazards and making recommendations for making your home a safer place.

The following are just some suggestions that an OT may make:

Ensure that you have good lighting especially on the stairs.
Ensure the stairs are clutter free with no creases or threadbare carpet.
Recommend hand rails both sides of the stairs to support your balance and mobility whilst travelling up and down.
Ensure you have a night light or torch by your bed in case you need to get up in the night.
Ensure that your clothes i.e. skirts, dresses and nightdresses are not too long.
Make sure your floors are all clear of trailing wires, rucked carpets and lose rugs – if necessary secure your rugs down with double sided Velcro tape.
Consider a non-slip bath mat and rails to support you getting in / out of the bath.
Never stand on a chair to reach an item, use a sturdy step ladder or low step.
Keep your garden paths clear free of moss and ensure your paving stones are level and not posing a trip hazard.
If you have a pet, consider a collar with a bell so you know where they are when you are moving about and do not trip over them.
Consider a personal alarm system so that you can summon help easily if you do fall.
Ensure your heating is adequate and your home is at a consistent temperature.
Make sure your mobility aids are suitable and meeting your needs.
Ensure your furniture is not too low i.e. your bed or your chair.
Make recommendations for suitable equipment and minor adaptations such as level door thresholds and rails along long corridors and in the bathroom.
Recommend telecare solutions for those who are at risk of falls. A fall detector worn around the neck on a pendant will detect a fall and alert a monitoring centre or a carer.

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