Falls Prevention Guide

f you meet some of the criteria below, you could be at risk of having a fall.

• I’ve had a fall, but not been to see anyone about it. 
• I haven’t reviewed my medication with my GP practice within the past 12 months. 
• I often need to get up to go to the toilet during the night. 
• I don’t think I’m as active as I should be (I do less than five sessions a week of 30 minutes moderate activity). 
• I sometimes feel light-headed, dizzy or weak when I stand up or walk. 
• I struggle to keep on top of basic tasks around the home. 
• I haven’t had my eyes tested in the last year. 
• I wear bifocals or varifocals. 
• I’ve got quite a lot of clutter in my home. 
• I don’t think I drink enough fluids every day (3 pints / 1.6 litres for women and 3.5 pints / 2 litres for men). 
• I struggle to take proper care of my feet. 
• My slippers have probably seen better days. 
• I have a long-term condition, such as diabetes, arthritis, dementia, heart disease or Parkinson’s. 
• I turn off all unnecessary lighting, to help save my electricity costs. 
• I think I drink more alcohol than the recommended limit (14 units a week for men and women). 
• I often catch my feet on things which could trip me up, such as the dog or furniture. 
• I’m not always that warm in my home. 
• I worry about feeling unsteady or tripping over when I leave the house. I don’t go out as much as I should, or I’d like to.

• It’s always best to plan ahead and prepare yourself and your home, just in case you do have a fall.  It will help give you and your family peace of mind, knowing that you’re fully prepared. 

• Make sure you look after yourself by being more active, eating well and staying hydrated. Use our checklists to make your home and garden as fall proof as possible. These small changes can help you lower your chance of having a fall. Find out more on how to reduce your risk of falling section and staying safe in your home. 

• If you have a mobile or cordless phone, try to remember to carry it around the house with you. Ensure it's charged and switched on. Save the numbers for family, friends and neighbours into all your phones, especially those who live nearby and can help if you need them to 

• Place cushions, blankets and a bottle of water around your home. Keep them at floor level, so if you fall, you can easily reach them to stay warm, comfortable and hydrated. Wherever you decide to place them, make sure it doesn’t become an additional trip hazard! 

• If you don’t already have a lifeline alarm consider getting one. All you’ll need to do is push the button and help will be on its way to you. 

• If you can and you feel safe to do so, try practising getting up from the floor. If you do have a fall, you know what to do and how to do it safely. 

As we get older, our muscle strength and balance reduce. This can lead to a fall.  

There are different exercises you can do, which are designed to improve muscle strength, balance, posture and co-ordination, to help you reduce the risk of having a fall. 

Take a look at some simple exercises you can try. There are a great range of other exercises you can try, including those available on the NHS website,[external link] which help with your strength [external link] and balance[external link].

It’s important to keep an eye on your appetite and try to ensure you eat well.  It's always better to eat something little and often if you are unable to manage three main meals.  The food you eat will give you more energy, which you need to keep up your strength and reduce your chance of falling. 

Alongside eating well, you should also be drinking plenty of fluids.  If you don’t drink enough, it’s likely that you’ll start to feel light-headed, which will increase your risk of a fall.  It sounds like a lot but try to drink about six to eight glasses of water a day. 

As you age, your bones naturally become weaker and more brittle. This makes it more likely you will suffer a fracture if you fall. 

It’s important to try and keep your bones healthy and strong by;

• eating calcium-rich foods (including milk, cheese, curly kale, okra and sardines)
• getting enough vitamin D from sunlight (particularly between April and September)
• doing some weight-bearing exercises. 

It is estimated that approximately 3 to 6 million people aged over 60 in the UK, have a urinary incontinence problem.

This means you’re more likely to need to rush to the toilet, especially at night. 

This can increase your risk of having a fall, so it’s worth talking to your GP. There may be exercises or medication you can try to help improve your incontinence. 

Some medications can make you feel faint or dizzy and affect your balance.

Let your GP know if you experience any side effects after taking your medication. They can check the dose or look at alternative options. 

As you get older, you may notice that your eyesight changes and you have more problems with your vision. It may be harder to gauge depth perception or see the edge of steps and kerbs. 

This can affect your balance and co-ordination and will increase your risk of falling. It's important to get your eyes checked every year or at least every two years.  Don’t forget your optician is also checking for conditions like glaucoma, cataracts and macular degeneration. 
 
It’s also likely that your hearing will deteriorate as you get older. This can also impact on your balance.  If you think you have a problem with your hearing, talk to your GP. It may be something which is easily treated, such as a build-up of ear wax, an ear infection or you may need a hearing aid.

As you get older, your body doesn’t process alcohol in the same way it did when you were younger. This means you’re more likely to experience unsteadiness when you drink, which increases your risk of falling.

As you get older you’ll probably notice that your feet have changed shape. You may have lost some feeling and flexibility. It is important to buy and wear correctly fitted shoes - not your favourite pair from 20 years ago! 

• Your shoes should be long enough. Your toes don’t touch the end (round or square toed styles offer more room). They should provide sufficient support around the middle part of your foot. 

• The soles should be thin enough so you can feel the ground beneath your feet but cushioned for shock absorption with a good tread. 

• Try to avoid slip on shoes and go for ones with fastenings, such as laces, as they’ll give you extra support. If you’re buying heeled shoes, try to make sure the heels are low and broad, as this will give you extra stability. 

Remember: Don’t buy shoes in the morning, as they’re likely to feel tighter in the afternoon, after your feet have swollen a bit. 

We know you get used to your comfortable, old slippers and it can be hard to throw them away. If they have holes in their soles, they’re too loose or frayed, it’s time to buy a new pair.  Your slippers should fasten, so they stay on properly, and have a good grip. 

Remember: Don’t walk on hard, slippery floors in just your socks or tights, that’s what your new slippers are for! 

If you have sore, tingling or swollen feet, which is making it harder for you to safely get around, make an appointment to see your GP, as they might be able to help. 

Make sure you regularly trim your toe tails (only cut straight across) and keep your feet moisturised to help prevent painful cracking.  If you have hard skin, try using a pumice stone. 

Remember: If looking after your own feet is difficult, don’t just ignore them, make an appointment to see a chiropodist or podiatrist instead. 

Make sure your clothes don’t have any loose hems or hanging tie cords, which you could accidently trip over.  It only takes a few moments to securely fasten your belt or tie your dressing gown cord. 

Try doing something regularly and stick to it. It could be going for a daily walk or stretching during ad breaks or waiting for the kettle to boil.

Start small and build up slowly.

It will be easier to stick to an activity if you enjoy it.

Try a new activity such as dancing or riding a bike. You can search online for exercises to do at home. 

Get out and about. You could go to the shops or to a park.

Set yourself goals and rewards. You could go for a long walk then treat yourself to your favourite tv show.

Do you have friends or family who want to be more active? Or who want to help you become more active? Meet up and do things together. Challenge yourselves to see who can do the most steps a day etc

Join a local club and try things such as dancing or rambling.

See local clubs and societies in Darlington

It’s easy to get into the habit of not lifting your feet as high as you need to when you walk, but this will increase your chance of catching your feet and tripping.  There are exercises available, to help improve your posture, strength and balance. 

You can do these two or three times a week. Or every day, if you’d prefer. You will help improve your balance and co-ordination, which can reduce your chance of having a fall. 
 
Please only attempt these exercises if you feel safe to do so and make sure what you're holding onto, is nice and steady. 

1)  Heel raises 

Stand up tall and hold on to the back of something sturdy with both hands, such as a chair or the kitchen sink.  Lift your heels off the floor and take your weight on your big toes.  Hold the position for 3 seconds, then lower back down to the floor with control.  Repeat the move 10 times. 

2)  Toe raises 

Stand up tall and continue holding your support with both hands.  Raise your toes off the floor and take your weight on your heels (try not to stick your bottom out!).  Hold for 3 seconds, then lower back down to the floor with control.  Repeat the move 10 times. 

3)  Sit to stand 

Sit tall towards the front of your chair, with your feet slightly back (so they’re not directly under your knees).  Lean forward slightly and stand up, using your hands on the chair if you need to.  Step back carefully until your legs touch the chair, then slowly lower yourself back into a seated position.  Repeat the move 10 times. 

4)  Heel toe stand 

Stand up tall and hold on to the back of your sturdy chair or kitchen sink again, but this time with only one hand.  Put one foot directly in front of the other, so they’re in a straight line, with a small gap between your feet.  Looking ahead, take your hand off the support and balance for 10 seconds.  Move your front foot back and place it hip width apart from your other foot.  Repeat the move for another 10 seconds, this time with the other foot in front. 

5)  Heel toe walking 

Stand up tall again, this time with one hand placed on your kitchen counter.  Look ahead and then walk 10 steps forward, placing one foot directly in front of the other, so they form a straight line.  Try to maintain a steady walking action, if you can.  Place your feet hip width apart, before turning around and repeating the steps back in the opposite direction. 

6)  One leg stand 

Stand close to your support and hold on to it with one hand.  Slightly lift one foot off the floor, so you’re now balanced on one leg.  Make sure you keep your standing knee soft and your posture upright.  Hold the position for 10 seconds, before lowering your foot and repeating on the other leg. 

There are a great range of other exercises you can try, including those available on the NHS website [external link], which help with your strength [external link] and balance[external link]. 

If you are finding things difficult, ask for help from friends, family or neighbours. They may not realise you need extra help, or may be embarrassed to offer. Most people are more than happy to give a helping hand.

It may be something like moving a heavy item in the garden or if you struggle with day to day tasks such as cleaning.

If you’re struggling to reach things in your cupboards or cabinets move things around. Make often used items easier to reach. 

Ensure any spills are mopped up straight away to prevent wet, slippery floors. 

Use a non-slip mat in the bath or shower and consider installing grab rails in the bathroom for additional safety. 

Keep your paths free of moss, leaves and snow / ice in the winter.  Repair any cracks or uneven spots.

Make sure your doors, garage and garden are well lit. This will help you safely get around at night and in the winter. 

If you have steps into your home or garden, consider installing safety rails to help you feel more confident going in and out.

Make sure your light bulbs are giving off enough light so you can get around safely. 

Don’t walk around your home in the dark, especially if you’re getting up at night to go to the toilet. Turn your bedside light on, keep a landing light on or even consider using a torch, if that’s easier 

If you have free standing lamps, make sure the wires are safely tucked away so you don’t trip over them. 

If you don’t already have them, consider installing two-way switches on your stairs and landings. You can even have a smoke alarm wired in at the same time, for extra fire safety in the home. 

Make sure any clutter, especially in the hall, landing and doorways, is safely cleared away. it could be a trip hazard. 

Ensure all rugs have a non-slip mat underneath them and replace them if they’re worn or frayed. 

If you have frayed or loose carpets, consider replacing them or asking someone to securely tack them down for you. You will be less likely to trip. 

Keep all cables and wires tidied away.  You could consider buying a cable tidy box, to help organise and store jumbled wires, especially near the television, radio or computer. 

Don’t keep any items on your stairs. Ensure everything is tidied away and correctly stored. 

If you have a pet, they can easily get under your feet, especially if you’re carrying something and don’t notice them. Why not buy them a bright collar or a bell, so you know exactly where they are. 

When you’re walking, make sure you take your time and don’t rush. It can help to scan the immediate area for any trip hazards, such as uneven or cracked pavements. 
 
Don’t worry if you think you’re slow and holding others up, they can always walk around you, and your safety is more important.

Be careful of raised or lipped doorways, when entering or leaving shops, as they’re easy to miss and trip over. 

Don’t forget to give your eyes time to adjust to darker conditions inside, especially if it’s a bright day outside.

Be aware of any changes to the pavement or kerb, especially near pedestrian crossings, as they can often have subtle gradient differences

Using conventional shopping bags can obscure your view of the pavement and where you’re walking, so why not consider swapping to a rucksack instead? They’re great for carrying shopping and are better for your back. 

Or consider getting a shopping trolley. Some even have seats so you can rest when you need to.

If you’re getting the bus, keep your bus pass or money handy. This will save you looking in your bag and rushing. You will be ready to safely board the bus when it arrives. 
 
Don’t be afraid to ask the bus driver to wait until you’re seated before they drive away. It’s easy to lose your balance when the bus is moving.  Also, don’t leave your seat to get off the bus, until it has come to a complete stop. Ring the bell or ask the driver to stop.

Don’t be embarrassed to use a walking aid, such as a walking stick, if it helps you feel steadier and more confident. 

If you’re using a walking stick, make sure it’s the right length for you. The top of the handle should be level with your wrist crease, when your arm is down by your side. It should have a new rubber end on the bottom. 
 
If a walking stick isn’t quite meeting your needs, consider a walking or wheeled frame instead. These will give you even greater stability.