Falls: how to prevent them and what to do if you need help

We all suffer falls occasionally but as we get older we become more likely to fall.

There are many hazards in our homes such as poor lighting or uneven surfaces that may cause us to slip, trip or stumble. Poor eyesight, poor health, alcohol use and problems with walking or maintaining balance can also increase our likelihood of tripping and falling. There may also be medical reasons that can cause falls.

Some people may lose their confidence or hurt themselves if they fall. However, there are many things that we can do to reduce this risk.

It is important to let your GP practice know if you are falling.

• Do not panic.
• Try to stay calm and assess the situation.
• If you are hurt or feel unable to get up follow the Rest
  and Wait Plan.
• Check you are not hurt before you try to get up. If you
  are able, follow the Getting up Plan. 

Rest and wait plan

• Try to call for help. Use your Community Alarm or pull cord alarm if you have one, bang on the wall, call out for help or crawl to your telephone.
• Keep warm. Try to reach for something to cover yourself.
• Keep moving. Try and move your fingers and toes and adjust your position to keep your circulation moving and avoid pressure on one area.
• If you need the toilet while on the floor, use a newspaper or item of clothing to soak up the wet and try to move away from this area.

The getting up plan

Moving around safely

• Always use your walking aid and avoid using your furniture to support yourself.
• Do not use your walking aid to help you stand up. Push down through the arms of the chair or mattress.
• Take a couple of deep breaths, stretch your arms and lift your feet up and down a few times before standing up.
• Do not lean forward too far without holding onto something stable for support.
• Take regular exercise, even if it is only a short walk around the house and complete any exercises given to you by your physiotherapist.
• Take extra care in the dark or on uneven ground.
• Have yearly eye tests. Wear appropriate glasses and keep them clean. Separate glasses for reading and distance are safer than bi-focals and vari-focals as when you look down the reading lens can distort your vision.
• Pause on entering a dark room to let your eyes adjust.
• Take extra care if you have a pet at home

Health factors

• Make sure all medication is clearly marked to avoid taking the wrong dose. Your pharmacist can provide large print labels if you need them.
• Some tablets, such as heart tablets and sleeping tablets can make you feel dizzy or drowsy. Take care and report any side effects to your doctor or pharmacist.
• Keep as active and healthy as possible. Try to maintain a healthy body weight. Being overweight or underweight can affect your health. Eat a balanced diet and drink plenty of fluids. Avoid alcohol.
• Make sure you have plenty of calcium and Vitamin D, which help keep bones strong. You find calcium in milk, cheese, yoghurt and Vitamin D in meat, eggs and oily fish. We get most of our Vitamin D from sunlight. If you are not able to get out and about, speak to your GP who may be able to recommend supplements to ensure that you are getting enough Vitamin D.

Outside areas

• Ensure the path is free from slippery leaves or overhanging branches.
• Consider installing a security light.
• Consider having a strong, well fitting grab rail installed near the door.
• Use a letter cage to catch the post.
• Make sure someone can get in to help you if necessary.
• Avoid going out in the snow, ice and strong winds.

Living room

• Keep the floor clear from rugs and mats, trailing flexes or other obstacles – including too much furniture.
• Higher chairs with armrests are easier to get out of.
• Think about having electric sockets moved higher up the wall.
• Keep the telephone on a low table next to where you usually sit so it can be reached from the floor if you do fall, or carry a cordless telephone in your pocket.
• Avoid having to climb. Ask a neighbour or relative to change a light bulb or curtains.
• Think about having a community alarm.

Kitchen

• Most falls occur in the kitchen. Take extra care.
• Rearrange your kitchen so the most frequently used items are within easy reach.
• Where possible, make sure kitchen shelves and units are between hip and eye level.
• Mop up spills immediately with a long handled mop to avoid bending.
• Avoid carrying hot items across the room. Use work surfaces to slide items along.

Stairs

• Take extra care on the stairs.
• Repair any holes or tears in the carpet and do not leave any objects on the stairs.
• Only go upstairs when it is really necessary.
• Make sure there is at least one handrail fitted to the stairs and consider having a second one fitted.
• Make sure the stairs are well lit and always put the light on.

Bedroom

• Make sure you have a light beside the bed. Consider having a night light.
• Beds should be at a good height with a firm mattress to make it easier to get out. Keep walking aids within reach of the bed.
• Get out of bed slowly. Sit on the edge of the bed for a few minutes before you stand up.
• Ensure your room is warm enough to avoid hypothermia.
• If you have a Community Alarm, remember to put it on when getting up during the night.

Bathroom and toilet

• Use a non-slip mat in the bath.
• Handrails make bathing safer. Make sure any rails you have are securely fixed to the wall.
• If you have difficulty getting on and off the toilet, in or out of the bath, or washing yourself, there are aids and adaptations available that may assist. Contact your Social Work Department for an Occupational Therapy assessment.
• Leave the bathroom door unlocked in case help is needed – consider having a bath whilst someone else is in the house.

Clothing and footwear

• Make sure clothes and nightwear are not too long to avoid tripping.
• Sit down rather than stand when pulling clothes over your head or legs.
• Put footwear on before standing up to fully pull up tights/ stockings.
• Wear supportive shoes with a low, wide-based heel for stability and a man-made sole for grip. Where possible, avoid slip-on shoes.
• Do not walk around the house without wearing shoes and slippers.
• Slippers should only be worn at bedtime and should have a fully enclosed heel.

Falls: How to prevent them and what to do if you need help.

NHS Tayside booklet on falls prevention for patients, public and carers