Help to prevent falls

Introduction

Falls are a common problem, but you can reduce your risk of falling by keeping active.

Eating well, keeping fit and looking after your bones is important.

Exercises to strengthen your muscles and to improve your coordination and balance are one of the more effective ways to reduce the risk of falling. There are many groups and classes available at local leisure centres and day centres that offer balance and strength training, or an exercise programme can be followed at home following the advice of a professional.

You will benefit most from an exercise programme specifically designed to meet your needs. Remember, that reducing your physical activity can actually make you more at risk of falling.

Get the best out of your Eyesight

Your vision plays an important part in your sense of balance and movement.

It is a good idea to have your eyes checked every two years. Eye tests are free if you are aged 60 or over. Be aware that reading glasses and bifocals can make objects appear closer than they really are, which can cause you to trip or lose your balance whilst over-reaching for objects.

Make sure your glasses are clean and well fitting. If you go from light to dark, or the other way round, stop and give your eyes time to adjust before moving.

… And your Hearing

Ears and hearing are closely involved with balance. Ear infections can upset your balance as can a build-up of wax in the ear canals.

Medications: Use them properly to work for you

Some medications can have side effects which make you feel faint or unsteady. This includes non-prescription and over-the-counter medications and supplements.

If you take more than four kinds of medication, ask your doctor or pharmacist to check them regularly. Do not mix alcohol with medications as this can cause dizziness and lack of balance.

Once you reach 60 years of age, prescription medicines are free of charge.

Some pharmacists will collect your prescriptions from the surgery and some will deliver to your home. If you have difficulty remembering to take your medicine it may help to use a memory-aid container – some have a reminder alarm or recorded message. Ask your pharmacist, or contact the Disabled Living Foundation on 0845 1309177.

Safe Home Environment

Look at your home to eliminate trip hazards and risk:

• Good lighting is important – use the highest wattage light bulbs your light fitting allows. Make sure your stairs are well lit. If you need to get up in the night, switch on a light or use plug-in nightlights to illuminate your route from the bedroom to the toilet.
• Stairs – get into the habit of using a hand rail and consider having a second rail fitted. Try to avoid carrying items, such as hot drinks, up and down the stairs.
• Keep the floor clear of trailing wires, loose mats, fraying carpets or anything else you may trip on.
• If you have a cat / dog, consider a bell on the collar so you know where he/she is.
• A non-slip mat in the bath and a handrail can help to prevent falls.
• A stool or chair in the bathroom is useful so you can sit on a chair to dry yourself.
• Don’t lock the bathroom door in case you need help.
• Stand up slowly after lying down or sitting. Take care when bending down and make sure you are steady before walking. Be especially careful when you are ill and weaker, for example with sickness and diarrhoea.
• Raising your arms and tipping your head backwards, for example reaching into high cupboards can make some people feel light-headed and dizzy. If this happens, think about storing frequently used items in areas that avoid you having to stretch or stoop.
• Keep warm – cold muscles work less well. Make sure that you don’t turn off the heating to save money.
• Don’t rush – the phone can wait. Use the ‘last number’ service (1471 on most phones) to return the call in your own time. You could also consider a cordless or mobile phone or extra telephone extensions around the house.
• Fitting a key safe can enable permitted friends, relatives or carers to access your house if you are unable to answer the door.

Looking after your Feet

Never ignore minor foot problems – symptoms such as pain, soreness and redness should be checked out as they may lead to more serious problems and reduced mobility and balance.

It is important to consider suitable shoes that fit well. If your soles or heels are painful when you walk, cushioned insoles can help.

Shoes with Velcro straps may be easier to put on and to adjust when feet are swollen. Avoid loose, worn or backless slippers and shoes with heels.

Clothing such as long night dresses can also increase your risk of tripping.

Avoid walking on slippery floors in socks or tights. A long-handled shoe horn may help you put on your shoes.

Anxiety about Falling

As the result of a fall you may be anxious, or you may just be worried about falling. It is important to remember that there are ways to get your confidence back. Talk to your doctor, district nurse or therapist to help you work out a plan to improve your balance, strength and confidence. The purpose of falls prevention is to enable you to live as independent and enjoyable a life as possible.

Fainting, Blackouts and Unexplained Falls

If you have experienced a fall as a result of dizziness, fainting or blackout, or cannot remember why you fell, this could be caused by a medical condition which causes low blood pressure, a slow, or even fast heart beat.

Movements such as getting up and turning your head could lead to dizziness and blackouts. If this occurs please contact your GP.

Community Alarms and Monitors

Many of the problems after a fall, such a pneumonia and hypothermia, are due to the person lying on the floor for long periods. Community alarms allow you to call for help even if you can’t reach a telephone. You contact a 24-hour response centre by pressing a button on a pendant or wrist band, the staff at the centre will contact someone who can help you.

If you are worried about a confused friend or relative falling on the stairs or wandering into danger, a motion proximity sensor can let you know if they move into an area of risk.

Bed and chair monitors work by sensing changes in pressure when an occupant moves, triggering an alert. Contact your local social services for advice.

Mobility Aids

A mobility aid could help you if you are unsteady on your feet or have difficulty getting about.

Walking sticks, walking frames

It is important that your walking stick is the correct length – level with your wrist crease when your arm is held by your side. A walking stick should have a rubber ferrule which prevents it from slipping – they can wear out quickly, but replacements can be bought from large chemists.

Walking frames give more support and are more stable. Always get advice from your physiotherapist on which walking aid is most suitable for you and how to use it.

Wheelchairs

Wheelchairs can be accessed via the Red Cross on a short-term basis. Your local Shopmobility scheme may loan electric wheelchairs around town centre / shopping centres.

What to do if you Fall

1. Calm down and compose yourself
2. Check your body. If you are not badly injured, think about getting up: don’t move if you are in pain. Try to attract attention by banging on the floor or wall; use your personal alarm or call 999 if you can.
3. If you can’t get help and are not hurt, try to get up.
4. If you’re hurt or can’t get up, keep yourself warm. Cover yourself with a coat or anything you can find. Keep moving as much as you can and try to move to a softer, carpeted and warmer area.

Eating for Health

Eating healthily is important for maintaining muscle strength and strong bones, for energy and to prevent illness. It is better to eat smaller, more frequent meals to maintain blood sugar levels.

Ensure your diet contains ample quantities of calcium and Vitamin D.

Most of our calcium comes from milk or foods containing milk (dairy foods). Aim to eat 3 portions of calcium a day.

If your appetite is poor and you are losing weight, contact your GP.

What is a portion?

• 1/3 pint (200ml) milk
• 1 small pot (125g) yoghurt
• 1 1/2 oz (45g) hard cheese
• 2 tbsp (80g) cottage cheese

Fluids

Water, fruit juices or tea are necessary to ensure the functioning of all the body’s organs. Not drinking enough may result in reduced blood pressure and falls.

Osteoporosis – Bone Strength

Osteoporosis is a lack of bone density which causes bones to become fragile and liable to break easily. The health of your bones can make a big difference to the effect a fall will have on you.

You can keep your bones healthy by eating a diet rich in calcium and Vitamin D, and taking regular weight-bearing exercise. It is never too late to give up smoking and limit the amount of alcohol you drink.

Taking regular, weight-bearing exercise, for example brisk walking outdoors is particularly good as it increases the opportunity for exposure to the sun which helps in the production of Vitamin D.

The main source of Vitamin D is the action of sunlight on the skin.

To increase Vitamin D try to go outside for half an hour each day between April and September.

Supplements to Increase Bone Strength

Elderly people who are frail or house-bound may not get enough calcium or Vitamin D. To reduce the risk of fragile bones, GP’s can prescribe supplements – these must be taken for about a year before the benefits can be seen and should be continued long-term.

If you have previously broken a bone, your GP may prescribe bone protection medication e.g. Bisphosphonates

This medication slows down the cells that break down bone, enabling the bone-building cells to work more effectively and increase bone strength.

If you have been prescribed Bisphosphonates:

• Take tablet whole
• Take with a full glass of water
• Sit up for 30 minutes after taking medication

Once you are prescribed a bone protection medication it is vital you continue to take it unless your GP or consultant says otherwise. If your supply of bone protection medication runs out please contact your GP.

Useful Contacts

ELMBRIDGE

SPELTHORNE

RUNNYMEDE

Produced by the Fractured Neck of Femur Working Group (with kind permission of Royal Berkshire NHS Trust)