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This is an NHS approved site and has been put together by a team of qualified physiotherapists.
However, please note that this website is not intended in any way to replace the advice of your doctor or any other health care professional. Specific advice should be sought in specific situations from a properly qualified health worker.
Home Advice and information
This section contains a wealth of information and useful resources to help you manage your mobility and help prevent falls. If you have an unanswered question or have a useful tip or information to share with others please let us know by emailing us at Digital@nhs24.scot.nhs.uk
If you or someone you know has fallen you’re not alone:
Falls can lead to loss of confidence and independence – whether or not a person has been injured.
In spite of this, falls are not an inevitable part of getting older. You can take action to prevent falls.
We shouldn’t accept falls as a normal part of getting older – falls don’t just happen. Usually, a number of underlying causes or risk factors have played a part.
A risk factor is something that increases a person’s chances of developing a problem, disease or injury.
Risk factors for falls can relate to:
Usually a number of risk factors contribute to a fall. The more personal risk factors we have, the greater our risk of falling. Personal risk factors include:
A fall might be the first sign of a new or worsening health condition. New, and often temporary health conditions that can cause falls include constipation, infection (including a bladder, urinary tract or chest infection), dehydration or sudden confusion (sometimes called delirium).
For this reason it is always sensible to tell your GP or another health professional about a fall.
Falls are not an inevitable part of getting older and not an inevitable part of living with dementia.
People with dementia may also have other health conditions that could increase their risk of falls, for example arthritis, stroke and visual impairment. People with dementia have the right to access the same treatment and support although this may have to be tailored to the individual.
If you or someone you know has dementia, here’s some key things to consider:
Falls are not inevitable and there are lots of practical and simple steps that you can take to reduce your risk of falling. This includes ‘fall-proofing’ your home, taking regular exercise, keeping well and seeking further advice and support when necessary.
“The exercises have helped me to cope with arthritis in my knees. I believe by strengthening my leg muscles I can walk much further and easier than I did before Invigor8. I feel generally stronger and fitter.”
- A participant in the Invigor8 exercise classes in Ayrshire.
There are also things you can do to reduce the harm caused by falls, such as look after your bones and make sure help can be summoned quickly if you do have a fall.
Having a falls risk assessment and making practical day-to-day activity and lifestyle changes can help you identify, assess and reduce your risk of falling; improve stability and maintain or improve independence and wellbeing.
Falls prevention is about enabling you to regain your confidence and live as independent and full a life as possible.
These are common issues but there are simple everyday measures you can take to help you move around safely and prevent a fall.
To help you move around safely and prevent a fall:
If you feel dizzy/lightheaded when you get up from a chair or bed, try moving your legs in a slow marching action before standing up. Remember to take your time to stand up and try not to rush up to answer the phone or doorbell or go to the toilet.
If you do feel dizzy for whatever reason, or if you have ever experienced a blackout or lost consciousness, it is important that you speak to your GP. It may be something simple which can easily be addressed.
There is much you can do yourself or with your carer or family to prevent falls, but sometimes you will need the support of others.
When to get support
Always seek help from your GP or other health professional if you:
Where to get support
Some Community Health Partnerships and local authorities have a specialist falls prevention service. However, in most parts of Scotland services to prevent and manage falls are provided by day hospitals, falls clinics, community care and rehabilitation teams, community physiotherapists and occupational therapists, amongst others. There are also opticians and dentists that will do home visits.
In some places, you will be able to contact some of these services directly yourself, but for others, you may have to ask your GP to refer you. Your GP surgery, district nurse or other health or social care professional will be able to advise you on how best to get support in your area.
When you seek advice and support after a fall or because you have concerns about falling, it is most likely that you will be offered a 'home and person' falls risk assessment.
The purpose of the assessment is to:
The assessment should also include a chat about your bone health and how to keep active. Falls are the leading cause of broken bones in older people and osteoporosis is a condition which makes people more likely to break a bone. Many people are unaware that they may have osteoporosis so it’s helpful to discuss this too.
Following assessment your falls prevention action plan may include:
The plan should be designed to suit your individual needs and way of life. Follow up appointments may also be necessary, to see how you are getting on.
The aim is to reduce your risk of further falls and injuries and help you to restore your independence following a fall.
Keeping active and taking regular exercise is important. Getting older can have an impact on our steadiness. Without regular physical activity, it is difficult to maintain strong bones, strength and balance. Regular exercise helps to strengthen muscles and maintain or improve fitness, balance, stamina and suppleness at any age, as well as reducing joint pain. Regular exercises such as Tai Chi and strength and balance training can improve our stability.
It is therefore important for us as we age to work at improving our balance through exercise.
Physical activity includes walking, dancing, cycling, gardening, housework, exercise or sport – any activity that results in a small increase in your heart rate and breathing. Moderate physical activity will also make you feel warmer but you should still be able to carry out a conversation. If you are not used to being active, you may find that it won’t take very much activity to reach the desired ‘moderate intensity’ level.
Whatever you chose to do, always stay within your own comfort levels. Begin with activities that you know you can do comfortably. Start slowly, and build up gradually over time. If you experience chest pain or feel faint you should stop exercising immediately and contact your doctor.
If you don’t usually take any exercise, some physical activity is better than none. Try not to sit for long periods consider reducing the time you spend watching TV, or take regular walk breaks around the house, garden or street.
There are many ordinary daily activities that you can do to keep active, such as walking, gardening or even doing the housework.
It is more likely you will exercise regularly if you enjoy it. Exercising with a friend can help you both to stick to a plan.
Attending a supervised group gives you a chance to meet people. Exercise classes designed for older people are particularly beneficial as they aim to improve balance and strength, making it easier to get in and out of chairs, on and off buses and up from and down to the floor.
Going out with friends or a walking group to places that you know have good lighting and some seats to rest can increase your confidence and make you feel safe.
If you are already reasonably active, you may still need to ensure your strength, balance and bone health is at its best.
Tai Chi and any form of dancing are great activities to help your bones, muscles and balance.
If you enjoy walking, Paths for All have information on health walks in your area: phone 01259 218888 or visit www.pathsforall.org.uk
If you have certain medical conditions, there may be some exercises or activities that aren’t right for you. Speak to your GP about how you can exercise safely, especially if you have a heart condition, or other medical condition that makes exercise difficult, or if you don’t already exercise regularly.
After a fall, many people become less active and stop going out. This may make matters worse – you can lose confidence and your legs can become weaker. If you have had a fall, it is even more important that you stay active, and do this safely.
Don’t give up on exercising just because you have had a fall or are afraid of falling. If you need help or advice about the best activities for you, speak to a physiotherapist or qualified exercise professional. If you regularly do falls prevention exercises given to you by an exercise professional, falls specialist nurse or physiotherapist keep doing them, unless you are injured or your health has changed.
Leisure centres – your local leisure centre offers a range of exercises, including classes for people of all ages with different interests and abilities. They will have a list of activities and classes to give you ideas. To telephone, look in your phone book under ‘leisure centres’.
There are many things in your life that can affect how you feel and how healthy you are. Drinking alcohol can not only affect balance and coordination but also the health of your bones. A good, nutritious diet is particularly important for maintaining strong and healthy bones. Also how you are feeling, your mood and level of anxiety, will have an impact on your general wellbeing.
Drinking too much alcohol has a damaging effect on bones and can affect your balance both of which will increase your risk of a trip or fall. The effects of alcohol include:
It is best to stay within healthy/safe drinking guidelines. Until recently, women and men had different guidelines, but now this is no longer the case.
This may be too high for older adults as alcohol can:
As you get older, keeping your bones healthy and strong is very important as this can prevent serious injury from a fall.
The most important areas around diet that you need to be aware of, particularly as you get older, are:
You could be malnourished whether you are over or underweight because you aren’t getting the balance of foods in your diet right. For example, you can be a healthy weight but if you eat a limited range of foods your body may lack essential nutrients.
Eating a healthy, varied and balanced diet is a good way to keep you up and about.
Missing a meal can make you feel dizzy or faint (lightheaded), making you more likely to fall. It is important to eat regular meals and make sure you drink enough water throughout the day.
The ‘eatwell plate’ highlights the different types of food that make up our diet. It also shows the amounts of each food that we should eat to have a well-balanced and healthy diet.
It’s a good idea to try to get this balance right every day, but you don’t need to do it at every meal. And you might find it easier to get the balance right over a longer period of time – you could balance your diet out over a week instead of each day. Try to choose options that are lower in salt when you can.
Eating a well-balanced diet rich in calcium and limiting how much alcohol you drink will help to keep your bones strong.
Top calcium foods include yoghurt, milk and cheese.
To help you eat less fat, choose lower fat versions like semi-skimmed milk, low-fat yoghurt and lower fat cheeses. Aim for 2-3 servings every day for adults. A serving is a small matchbox size piece of cheese or one medium low-fat yoghurt or a glass of milk.
Also:
Small amounts of calcium are also found in:
Drinks like tea, coffee, fizzy drinks can hinder calcium absorption.
As well as calcium, we need vitamin D for healthy bones. We get most of our vitamin D from sunlight. Most people in the UK get enough vitamin D by spending 15 minutes in the sun three times a week. Generally, normal levels built up in the summer will be enough to last through the winter. If you can’t get out and about easily, you might be given supplements. Speak to your GP to check that you are getting enough vitamin D.
You may be at risk of malnutrition if you are eating or drinking less than usual, or if you are losing weight without trying. There are some important changes you can make to your diet if you think you may be at risk of malnutrition:
If you have diabetes please consult your family doctor (GP), nurse or dietician before making any of these changes. If you continue to struggle with your appetite or are still losing weight after 4 weeks of following this advice speak to your GP, nurse or dietician.
Looking after your eyes is very important as your eyesight affects your balance and mobility. Good eyesight helps you to move around safely and stay steady on your feet. Older people with a visual impairment have double the risk of falling.
Looking after your feet is important as problems such as calluses, long toenails, poor circulation or loss of feeling can make you unsteady on your feet, as well as causing pain and discomfort. The footwear you choose can also affect your walking and your balance.
If you have painful feet, it may cause you to walk in an awkward way which could cause you to trip and or fall. Having painful feet may also put you off walking as much – being less active as a consequence will cause your muscles to weaken and therefore increase your chances of tripping or falling. If you are worried about your feet, contact your GP, podiatrist or chiropodist.
Make sure you wear shoes or slippers that fit you properly. This will help you move around more safely and comfortably.
The side effects of certain medications, or taking a number of medications can sometimes make you feel faint, drowsy, unsteady on your feet or give you blurred vision.
If you ever feel like this, speak to your GP or pharmacist – they may want to change the dose you are taking or try a different medicine for you. If it seems that your medication is not causing any problems – that’s good, but make sure you do something about it if this changes.
It is also important that you let your GP or pharmacist know if you have stopped taking your prescribed medication, or are frequently forgetting to take it. Remember to:
Even with over the counter medications it is still important that you follow the instructions and check/get advice with the pharmacist how they should be taken and if they can have an effect on anything else you may be taking.
If you think they are making you feel dizzy, drowsy or is causing blurred vision, let your GP or pharmacist know.
It is important that you let your GP or pharmacist know if you ever feel like this as they may want to change the dose or try a different medicine for you.
The environment around us can affect our safety. Over half of all falls happen at home, where we spend much of our time moving around without thinking. But there are lots of simple and practical things you can do to make your home a safer environment to move around in.
Telecare services use technology to support people to live safely and independently in their own homes. Telecare includes falls or motion sensors and personal alarms, which can contact response teams or family members and friends.
If you are worried about falling while you are alone at home, you might like to think about getting a community alarm (sometimes called a personal alarm). 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 wristband that you wear all the time while you are at home. This is linked to your phone. If you have a fall and need some help, you press the button and the staff at the response centre will try to get in touch with you through the telephone. Staff at the centre will then call out the best person to help you – a neighbour, relative or friend, or the emergency services. In some areas there is also a mobile team who will come and help you up from the floor.
Many local councils run community alarm schemes. There is usually a charge for this service. Please contact your council for more information. In most places you will need a telephone line in your house to use the service.
You should tell your GP if you have a fall or start feeling unsteady, even if you feel fine otherwise. There could be many reasons and, equally, many different ways to help you feel confident again. It’s especially important to do this as soon as possible as we know that one fall may be a sign that you are at risk of this happening again.
Let your GP know if you:
Dizziness is often a reason for people falling. It can be caused by:
If you feel dizzy/lightheaded when you get up from a chair or bed, try moving your legs in a slow marching action before standing up. Remember to take your time to stand up and try not to rush up to answer the phone or doorbell or go to the toilet.
If you do feel dizzy/lightheaded for whatever reason, or if you have ever experienced a blackout or lost consciousness, it is important that you speak to your GP as it may be something simple which can be easily addressed.
Your GP will want to check your balance and walking to see if they can be improved. He/she may also check if to see if your blood pressure drops when you stand up. He/she may also talk about healthy bones and whether or not you may have osteoporosis.
With your agreement, your GP can also refer you for a falls risk assessment, which will be carried out by professionals with training and experience.
The purpose of the assessment is to:
If you have problems walking or feel a bit unsteady on your feet, then it might be a good idea to look into getting some form of walking aid. Walking aids will help keep you mobile, reduce your risk and anxiety of falling and give you more confidence when moving around. Ask your GP or speak to a physiotherapist about getting a walking stick or another aid that suits your needs.
Walking aids are most helpful when they have been matched to your needs, so it’s a good idea to get one of your own, rather than use someone else’s. There are a variety of options available – from walking sticks to frames – make sure that you get advice on which of these is right for you.
Walking equipment/aids help:
Common walking aids include:
Once you have a walking aid, it’s important to make sure that it stays in good condition. If it gets worn or you have any other problems make sure you get it fixed right away – your local physiotherapy service should be able to help you.
Further support
Keeping your bones healthy is important, regardless of your age. If your bones are strong, there is less chance of you breaking a bone if you fall.
As we get older, our bones become thinner. Therefore keeping our bones as strong as we can is even more important. Weight-bearing exercise helps keep bones strong.
Osteoporosis is a condition that affects bones. Having osteoporosis means that your bones are more porous than healthy bones and this makes them more fragile.
1 in 2 women and 1 in 5 men over the age of 50 will break a bone because of low bone strength, mainly caused by osteoporosis. Younger people can also be affected by this disease.
Having osteoporosis doesn’t automatically mean that your bones will break, but it does mean that you will have a higher risk of breaking a bone if you have a bump or fall.
What can I do to help?
As well as calcium, we need vitamin D for healthy bones. We get most of our vitamin D from sunlight. Most people in the UK get enough vitamin D by spending 15 minutes in the sun three times a week. Generally, normal levels built up in the summer will be enough to last through the winter. If you can’t get out and about easily, you might be given supplements. Speak to your GP to check that you are getting enough vitamin D.
Limit how much alcohol you drink. If you’re a smoker, try quitting – this also helps look after your bones.
Further support
Having anxiety about falling is a very common problem – we all have worries and fears. Anxiety can make us feel like we don’t have any control over how we feel and that there is nothing that can be done to change our situation. This can leave us feeling low in mood, frustrated and lonely. You may find that you:
Negative thoughts can make things seem worse. For example, anxiety can sometimes lead you to overestimate the risk of falling. Learning to challenge these negative thoughts with more balanced ones can help reduce any worries. It just takes practice.
The more worried you become of falling, the less likely you are to keep active.
Anxiety can make you act in ways that help you feel safer – for example, holding onto things because you think you will fall or not going out. Avoiding or stopping doing things can make life difficult and less enjoyable. This can lead to low mood and depression. We lose a lot of confidence by avoiding walking. This will affect how you feel about yourself and keep fears going.
There are many opportunities available to you to remain active (see Exercise Centre).
Falls can be more common as we get older but falling is not a normal part of ageing so if you have a fall don’t just ignore it. You should let your GP know. You may need a medical check-up to look at why it happened. Ask yourself these questions:
If you are on many different medications make sure you get these reviewed at least once a year. If you have been on sleeping tablets for some time, you might want to see your doctor about options for coming off these. Your GP can also give you advice on how to get a good night’s sleep naturally. It is important that you do not stop taking your medication without speaking to your GP.
There are things you can do to prevent falls happening which should help reduce your fears. You can also make a plan for getting help if you should have a fall. This can help you feel more secure. Your local falls prevention services can offer such information, advice and guidance.
Remember
Physiotherapists work with older adults in interdisciplinary teams and with other agencies in community, hospital and care settings often as an integral part of local falls care pathways.
They have specialist skills in assessment and re-ablement and provide evidence-based exercise, education and advice programmes aimed to prevent falls, improve balance, increase self-confidence, reduce the fear of falling and promote active and healthy lifestyles.
Tell your GP or health professional you had a fall.
Strength and balance exercises help reduce your risk of falling. Here are some important safety factors to remember:
When you’re out and about, here are some simple reminders:
Making simple changes at home, whether it's for you or someone living with you can also reduce the risk of falling.
Here are some simple reminders whilst out in the garden:
There are 3 broad risk factors to be aware of and to look out for as these can increase our risk of falling.
1) Physical factors (if you have any of these, please speak with your GP or other health professional):
2) Lifestyle/behavioural factors:
3) Environmental factors