How to reduce your risk of falling

Falling can be the result of many things, such as:

• reduced activity which can result in poor muscle strength, balance and flexibility
• dehydration, when your body does not have as much water and fluids as it should
• visual problems
• medical problems e.g. low blood pressure, which can result in dizziness on standing
• medication, which can affect your balance and alertness, especially in certain combinations or if linked to alcohol consumption
• continence
• clothing or ill fitting footwear
• hazards at home and in the surrounding environment. For example, loose rugs or uneven paving

1. Staying fit and active - if you want support with this speak to your doctor or nurse.
2. Some medicines, such as pain killers, sleeping and blood pressure tables can increase the risk of falling - if your medicine makes you unsteady, speak to your doctor.
3. If you feel dizzy or light-headed when you stand, ask your doctor or nurse to check your blood pressure when you are lying down and standing.
4. Wearing the correct footwear and looking after your feet, enables you to move around comfortably and safely.
5. Make sure your mobility aids and equipment at home is fitted correctly.
6. A balanced diet can help you to stay healthy and strong.
7. Have your vision checked as it is important to your sense of balance and movement.

Keeping active

Many people feel shaken after having a fall that they reduce their activity. They think this will keep them safe. This can make matters worse. If you have a fall it is even more important to stay active:

• Try to get involved in regular physical activity. This can maintain and improve balance, flexibility, confidence and independence. It can also lift your mood.
• There are specific exercises that are shown to be beneficial in preventing falls. These include exercises that will improve your strength and balance. You could join a class that focuses on improving strength and balance.
• If you prefer to exercise at home, you can get further advice on appropriate exercises from Age UK ‘Staying Steady’ information guide, or you could speak to your GP Practice.
• If you are frightened of going out again, following a fall, try to go out with a friend or neighbour until you have rebuilt your confidence.
• You can self refer to the Rotherham IAPT (Improving Access to Psychological Therapies) service for support with anxiety following a fall.
• Any exercise is good for you. Walking, gardening and swimming are all good ways to keep fit and healthy. Even a small amount of activity can have positive effects.
• Build extra activities into your daily routine, for example get off the bus a stop earlier than normal.
• You may enjoy exercising at home with friends, or join an exercise class. It can also be fun to exercise to music.
• If you are not so active, chair-based exercises can also be beneficial.

Healthy diet and hydration

A balanced nutritious diet can help you to continue to be healthy and strong which will help reduce your risk of a fall.

• Try to eat a well-balanced diet including at least 5 portions of fruit and vegetables a day.
• Ensure that you drink plenty of fluids. Aim to drink approximately 6-8 glasses a day (for example, water, fruit juice, tea).
• Only have alcohol in moderation and be particularly careful if you are on certain medication. If you are unsure about drinking alcohol and taking your medication, speak to your pharmacist or GP Practice.

Vision

Your vision is important to your sense of balance and movement. Sight loss can occur very gradually so you may not always be aware  of changes in your vision. Here are some useful things to be aware of:

• It is important that you make the most of your free eye test and get your eyes tested at least every two years.
• We all need more lighting in the house, as we get older. Try to have bright and even lighting throughout the house, and avoid moving from light to dark areas, as it will take your eyes a while to adjust.
• Contrast is very important in helping you to see things clearly. Marking the edges of steps with non- slip white paint will make them more visible and reduce the risk of tripping.
• Some people who wear bifocal or varifocal lenses may be better off with one pair of glasses for reading and one pair for walking. Other people may become disorientated by having several pairs of glasses (or may only ever be able to find one pair).
• Try to remember to clean your glasses regularly and to put them on if you need to get up in the night.

Medical conditions

There are a number of medical conditions (for example, Parkinson’s, Dementia, Stroke), which may cause you to fall. If you feel that your falls may be linked to these, please seek advice from your GP practice.

Blood pressure

Your blood pressure can sometimes drop when you stand, and your body may take a while to adjust. You may get dizzy when standing up from a chair or your bed. If this occurs you may need to have a lying and standing blood pressure check at your GP practice.

• Try to rise slowly, moving your legs before standing
• Take care when bending and stretching

Arthritis

Sometimes people get arthritis in their neck, which can cause dizziness.

• If you think you may be suffering from this condition, please speak to your GP practice for advice.

Osteoporosis

Osteoporosis means that you have got thin bones. This means a minor bump or fall may result in a broken bone.

• You can keep your bones healthy by eating a diet rich in calcium and vitamin D. For example, milk, nuts, dried fruits and breakfast cereals. Also, through regular weight-bearing exercise, such as dancing and walking.
• If you are a smoker, try to give up or at least cut down. Smoking has a toxic effect on the bones. Not smoking will benefit bone health and general fitness. If you are a smoker and would like to give up contact Get Healthy Rotherham.
• For further information on healthy bones you can contact the  Royal Osteoporosis Society, or ask your GP practice.

Medication

Some medications can make you feel unsteady on your feet.

If you are taking more than four types of medication in a day you should have your medication reviewed once a year by your GP.

During this review you should have a chance to discuss any problems you are having with your medicines. Don’t forget to mention any over the counter medications you are taking.

Continence

Lots of people fall because of rushing  to the toilet.

Try to have your last drink at least an hour before you go to bed, to reduce your risk of having to get up in the night. However, do not reduce the amount of fluid you take as this could lead to you becoming dehydrated.

Do not be embarrassed, if you are experiencing problems with continence; speak to your GP practice.

Appropriate clothing, footwear and foot care

Wearing the correct clothing and footwear and looking after your feet, enables you to move around more comfortably and safely.

Do

• wear sturdy and supportive shoes
• take care of your feet. More information is available from AgeUK 'Fitter feet'.

Don't

• wear slippers which are loose and do not support your feet as these could cause a fall
• wear loose fitting and trailing clothes (especially night clothes and dressing gowns) as these can cause you to trip and fall

Home equipment and mobility aids

Ensure that your mobility aids (for example, walking sticks) and your equipment at home (for example, grab rails) are fitted correctly. This can help to keep you steady on your feet.

• Try to ensure your mobility aids are correctly measured and fitted.
• Ensure that your walking stick is at the correct height. To check this, stand straight (with support if needed) and check that the handle of the stick is at wrist height.
• Get the rubber (ferrule) on the bottom of your walking stick replaced regularly.

Most of the suggestions are common sense but it is worth considering them and taking action to correct any hazards, as soon as possible.

• Keeping an eye out for things that can cause you to slip or trip can help make your home and the surrounding areas, a safer place to be.
• If you have tripped over once, it could happen again, to you or to someone else. Remove the hazard to prevent this happening.
• A cold, damp home can lead to stiffness of the joints, which reduces mobility. Try to keep your home warm and comfortable to avoid this.

There are a number of services listed in the ‘Sources of Help’ section that can help you to make the suggested adjustments to your home and surrounding area.

In the kitchen

• If you spill something on the floor clean it up immediately. It is all too easy to slip on a spill, which you were intending to wipe up later!
• Ensure that you can reach items that are regularly used without climbing or bending. If you are having difficulties get someone to re-arrange the items so that they are easier to reach.
• If you must climb, use proper steps.
• Never use chairs, stools or tables to climb, which may be dangerous.
• If you have a table and chair in your kitchen it is advisable to use this rather than carrying hot food/ drinks through into a lounge, especially if you use a walking aid. However, if you do need to carry objects, certain aids such as trolleys or things that fit to a Zimmer frame may be provided by Social Services, ask for an assessment  through your GP practice.
• Remove any loose rugs and ensure that carpets/floor coverings are in good repair, and securely fixed. Age UK may be able to help you with this.

In the bathroom

• Raising your arms when leaning over the basin to wash your hair, could make you feel faint. Try washing your hair in the shower or bath instead, or ask someone to help you.
• If you find it difficult to get on and off the toilet, or in and out of your shower or bath, contact Social Services. They will be able to advise you and may provide some aids to assist you.
• A non-slip mat in the bath and a well-placed grab-rail can help you to keep your balance when you are getting in/out of the bath.
• Always leave the bathroom door unlocked, in case of an emergency. If possible, arrange for someone to be in the house when you have a bath. A personal screech alarm, mobile phone or Rothercare alarm system can also be useful.

Hall and staircase

• Ensure that you have good lighting throughout your house, particularly on the stairs.
• Handrails fitted to your stairs can make them easier and safer to climb. Social services can help you with this.
• Avoid leaving things on the stairs that you could trip over. 

In the bedroom

• Check whether your bed is the right height for you. When sitting on the edge, the soles of your feet should  touch the floor and you should be able to stand up easily.
• It is easy to trip up when you first get out of bed. Beware of loose dressing gown cords, sheets and bed covers trailing on the floor.
• Make sure that you can switch on the bedside lamp easily if you wake up in the night. A torch may also be helpful if you need to move around at night without disturbing other people or have a night light fitted.
• Move your telephone to a position where it is easy to access. Consider getting a cordless phone to prevent trailing wires.

Don't panic! You will probably feel a little shocked and shaken but try to keep calm.

Assess the situation.

If you are hurt or feel unable to get up follow the Rest and Wait plan.

If you are hurt and unable to get up wait for help and follow these guidelines.

Try to summon help by:

• Using the Rothercare pendant alarm, if you have one.
• Banging on the wall with your hand or walking stick.
• Shouting for help  Or:
• Crawl towards the telephone, or pull it towards you (if safe to do so) and use it to call for help.

Move to a soft surface:

• If you have fallen onto a hard surface, try to move towards a carpeted area.
• If you have fallen near the bed, pull the bed clothes off and try to move yourself on top of them
• If you have fallen near a chair or settee, pull the cushions off to put under your head, neck, legs etc.

Keep warm:

• Try to reach for something to cover yourself, i.e. bed clothes, knee blankets, towels, etc.
• Try to move out of draughts.
• Do not move too close to fires or radiators - you may burn yourself.

Keep moving

• Do not lie in one position for too long, you may get cold or get pressure sores.
• Roll from side to side and move arms and legs if possible.

Before you attempt to get up, make sure that you are not hurt. If you feel that you are able to get up, the following method is one safe way to get up from a fall, but there are others.

After a fall, it is always advisable to speak to your GP Practice.

1. Roll onto hands and knees and crawl to a stable piece of furniture such as a bed, stool or chair.
2. With hands on the support place one foot flat on the floor, bending your knee in front of your tummy.
3. Lean forwards, then push on your feet and hands until you bring the other foot to be beside the first.
4. Turn and sit on the seat. Rest for a while before getting up.

Age UK

For further information and advice visit the Age UK website and type in ‘Staying Steady’ in the search box
www.ageuk.org.uk
Telephone: 0800 169 6565

The Royal Osteoporosis Society

Supporting people with Osteoporosis and maximising prevention of falls and fractures www.theros.org.uk
Telephone: 0808 8000035

Podiatry

For footwear / footcare advice
Telephone: 01709 423200

Rotherham Adult Care Services

Telephone: 01709 822 330 

Community Occupational Therapy

To refer to occupational therapy for equipment concerns and housing.
Telephone: 01709 822330

Handyperson Service

The council run this service via Yorkshire Housing.  
Rotherham Council website
Yorkshire Housing website
Telephone: 0114 256 4270
Refer through Assessment Direct

Rothercare

Telephone 01709 371897  
Refer through Assessment Direct

Age UK Rotherham

For information and advice 
Telephone: 01709 835214
Age UK Rotherham website

Community Transport Door2Door 

Provides a range of safe, reliable, flexible, accessible transport services for people who have mobility difficulties and for community groups. 
Telephone: 01709 517100
www.door2door.org.uk

Home Visiting Optician 

To discuss who your local optician is, contact the Rotherham Health Advice Centre on Telephone: 01709 423030

Visual impairment team 

For assistance with your vision
Telephone: 01709 336415 

Single point of access 

Assessment direct for advice and referral  
Telephone: 01709 822330 
Rotherham Council - Single point of access website

Get Healthy Rotherham 

Free service to the people of Rotherham to help stop smoking, reduce alcohol consumption, get more active, lose weight and improve overall health. Service commissioned by RMBC and provided by Parkwood healthcare and its partner organisations.  
Telephone: 01709 718720. 
www.gethealthyrotherham.co.uk

South Yorkshire Inclusive Living 

The Independent Living Unit Centre provides impartial advice about equipment and practical aspects of daily living for disabled people, carers and professionals. 
Telephone: 01302 592400