Falls Prevention & Your Health

Osteoporosis is a bone condition in which the mesh-like material in our bones becomes thinner and weaker, causing them to become more fragile. This puts us at a greater risk of fracturing them in the event of a fall. Osteoporosis is common in older people and develops as a result of the natural ageing process. However, there are a range of things you can do to help keep your bones as strong as possible!

Tips for reducing this risk:

• Engage in weight bearing exercises. Weight bearing exercises involve supporting your body weight, such as walking, dancing and aerobics, all of which are great options!
• Weight lifting and resistance will also help to build your muscles and keep you strong. This can be done using machines and weights in a gym or it could be as simple as carrying and lifting objects in your daily activities.
• Eating a well-balanced and varied diet will give you the vitamins and minerals that you need to help support your bones.
• Vitamin D helps the body to absorb calcium. We get most of our vitamin D from the sun so try to get out and about when the sun is shining. Always remember to wear sun protection.

Cognitive impairment can cause us to become easily distracted from what we are doing. Cognitive impairment can make us confused, agitated or disorientated with our surroundings. Often this can cause us to panic and become impulsive in our actions; and sudden movements can make us imbalanced. In order to remain stable we are dependent on the coordination between our motor system and our sensory system. This helps us to respond to the environment around us and to control our body movement. If we aren’t aware of our environment then it stops us from being able to recognise the hazards around us, again increasing our risk of tripping over objects.

Tips for reducing this risk:

• Focus on one task at a time, particularly when moving.
• If you’re doing a task with your hands (for example dialling a phone or opening a jar) then sit down whilst doing this to prevent loss of balance.
• Do brain training activities such as crosswords, puzzles, reading, painting, playing an instrument or taking up a new hobby to keep your brain motivated!
• Keep important objects (walking aids, car keys, etc.) in the same places daily so that you don’t forget them or you aren’t rushing around to find them.
• Get a family member or friend to help you with day-to-day activities.
• Reduce clutter around your home if awareness of your surroundings is an issue. This will stop you from tripping over objects or hazards.

Wearing unsuitable or poor fitting footwear can affect our balance and could increase our chances of having a fall. ‘Unsuitable’ shoes are those with a low back, high heel, and frictionless sole. Additionally, shoes that are too big will make it harder to walk, and shoes that are too small will hurt your feet, potentially causing future foot problems. Stiffness in our toes and ankles, swelling and foot pain from bunions, corns, ingrown toenails and claw toes can cause a lot of pain. If our feet are in pain we’re less likely to walk regularly, therefore placing us at a higher risk for a fall.

Tips for reducing this risk:

• Wear well-fitted shoes to help prevent bunions, corns and claw toes.
• Keep your toenails trimmed to prevent painful ingrown toenails.
• Wear shoes with a slip resistant sole, a heel lower than 1-inch, and a high back to support the ankle.
• Ensure your clothes doesn’t trail on the ground. Long clothing can catch on your feet and cause you to trip!
• Try doing ankle exercises to improve strength in your ankles and toes.

Without knowing it, we use our inner ear to help us to maintain our balance. Therefore often time our dizziness can be caused by a problem within our ears. Poor hearing can also make us less aware of our surroundings. This can cause us to trip or slip over things in the environment around us.

Tips for reducing this risk:

• If you are experiencing dizziness or have problems with your hearing then have a chat with your GP. It could be that you have an infection or wax build up within the ear(s). Other temporary causes can be side effects to certain medications, exposure to loud noises and head injury. If your hearing is naturally declining then your GP can refer you to an audiology clinic or specialist ear department for appropriate help.

As we get older our vision often becomes less clear and can stop us from successfully measuring distance and depth. We may also be more sensitive to light changes and glare. All of these changes can contribute to our falls risk. Having clear vision helps us to focus on what is around us and balance ourselves. Impaired vision therefore increases how much we sway when standing which can result in a loss of balance. Steady balance is key to preventing a fall.

Our vision is always changing so it’s easy to wear glasses that are the wrong prescription for us. This can cause our eyesight to become more blurry or cause dizziness (even if the prescription change is minor) which could increase the chance of having a fall.

Tips for reducing this risk:

• Visit your local optician and have an eye test every two years.
• Keep your glasses clean. Dirty glasses can reduce your vision even more.
• If you get up in the middle of the night, make sure that you put your glasses on before getting out of bed.
• Try to eat a healthy and well-balanced diet as this can help to keep your eyes healthy.
• Try to use contrasting colours around the home to help with clarity. For example, white walls and dark furniture can help you to avoid bumping into it.

When we need the toilet, a sense of urgency can often make us panic, causing us to rush. If your balance and mobility isn’t great then increasing your pace can make you more unsteady and can increase your risk of a fall. Incontinence may mean that we need to get up a few times a night to go to the toilet. This is a common time for falls to occur because lighting may be poor, getting up quickly from bed can cause dizziness and we are tired; all of which add to our risk of a fall. Incontinence can also make us less confident and we often worry about daily activities such as leaving the home. Without staying active our mobility and our balance can be affected.

Tips for reducing this risk:

• It’s important to keep hydrated, but try not to drink a lot in the evening so that you don’t have to get up so often in the middle of the night.
• Have a ‘toilet schedule’. Even if you do not feel an urgent need to go to the toilet, go anyway just in case. This will help to reduce the number of times that you need to rush.
• Keep pathways to the toilet clear so that you don’t trip over anything on your way.
• Visit your GP if you are concerned about the frequency and urgency of going to the toilet. Your GP can assess you and offer you appropriate treatment.

Postural hypotension is when your blood pressure drops while changing position; for example when you move from a seated to a standing position. This can cause you to feel dizzy, lightheaded, confused, sick, hot, weak or tired. These are all symptoms than can throw you off balance and increase your risk of falling. It can also cause your vision to blur, increasing your risk of tripping on any objects on the floor.

Tips for reducing this risk:

• If you experience symptoms of postural hypotension regularly, then visit your GP so that they can measure your blood pressure and help to identify reasons for the problem.
• Review which medications you are on with your GP.
• Don’t rush! Move slowly when changing positions and if you feel any of the symptoms mentioned, then wait until you feel ok to carry on with what you are doing. Symptoms will usually pass after a few seconds or minutes.
• When you are doing activities such as getting dressed and washing yourself, try to sit down.
• Try to drink as much water as possible to avoid dehydration as this can make symptoms worse. It’s recommended that men drink ten 200ml glasses of water and women drink eight 200ml glasses of water a day.

Many people experience symptoms that can increase their risk of a fall. Often we overlook the fact that this could be due to the type of medication and the number of medications that we are taking. Some medication or combination of medications can cause feelings of: Dizziness, Drowsiness, Vision problems, Problems with balance and/or movement, Effects that are similar to those of Parkinson’s disease- e.g. uncontrollable shaking, slow movement, painful nerves, muscle stiffness, incontinence or memory impairment. These can all increase our risk of falling.

Tips for reducing this risk:

• If you are on 4 or more medications or are worried about having any of the side effects listed in the risk assessment question on this page, then we recommend that you go and have a medication review with your local GP.
• They will be able to go through your medications with you and check to see whether specific medications, or a combination of medications, could be increasing your risk of falling.
• Going to your appointment with a list of medications that you are currently taking will allow your GP to have an in-depth understanding of how to move forward. This includes both prescriptions and over the counter medication.
• Your GP can then make appropriate changes depending on the outcome of your review.