Most of us will have experienced a fall at some point. For many, having a fall will be nothing more than a bit embarrassing, however, a fall can be startling, upsetting and life changing, especially as we get older.
Although we are more likely to fall as we age, falls are not an inevitable part of getting older. Many falls can be prevented with some simple changes to our way of living and our homes. In some cases, a fall can be a sign that there is a change in our health, but this is often something that can be treated.
What can I do after a fall?
The videos below are from people who have fallen themselves and gives advice about how to get up after a fall, and what to do if you are hurt and cannot get up.
Part 1: How to get off the floor
Getting up from a fall can vary from person to person.
If you do fall the first part of getting up is to remain calm and do not rush. It can take a few minutes to feel pain from any injury that you may have sustained. Therefore, it is important to assess the situation of the fall before you start moving.
If you are injured, please get help.
If you live with someone who has fallen but you’re not sure if they are injured, call 111 for more assistance.
If you live with someone who has fallen and have hit their head, hurt their back, neck, hip – or you are worried they are seriously injured or ill – call 999.
If you live with someone who has fallen, keep them comfortable and warm as you await for help.
Do not try and lift someone else unless you know you are doing because you could make things worse.
For more information, see our instruction leaflet on getting up from a fall.
Part 2: What to do if you can’t get up
It is suggested to have a mobile phone with you at all times that is switched on and charged. You may need a family member to programme an emergency number into your phone. If you are hurt and cannot get up then use your phone to dial 999.
If you are not hurt but you cannot get up, you can also call 111 and get advice from the NHS.
Part 3: Every fall is different
Part 4: How to prevent a fall
Part 5: What to do if someone falls
Top tips if you find someone who has fallen:
- STOP
- Stay Calm
- Assess the Situation
- Check for any injuries
- Make the person comfortable and give them time
What can I do myself to prevent falling?
Changes in lifestyle and modifying your activity is recommended as part of falls prevention. The one person who can help you manage your falls is you!
Exercise to reduce falls risk
Age is no barrier to exercise. At any age, you can see improvement in your strength, balance, stamina and flexibility. It is important to keep your leg muscles as strong as possible to reduce the risk of falling.
NHS Inform have created two resources to provide exercises that could reduced your risk of falling:
- Falls Assistant: a tool which aims to help prevent falls, keep you steady on your feet and help you to stay as independent as possible
- Super 6 Exercises: a printable leaflet with exercises
If you have any concerns about your ability to exercise the please discuss with your GP (doctor) prior to trying any of the mentioned exercise programmes.
Staying active
Try to be active every day and aim to include moderate and vigorous intensity activities in your routine.
- Moderate intensity activities include ballroom dancing and brisk walking.
- Vigorous intensity activities can include climbing stairs or running.
Improving balance and co-ordination can help reduce the risk of falls. Taking part in activities like yoga, tai-chi or the Invigor8 programme could help.
Local activity opportunities
Invigor8 is a programme of exercise classes for the over 65s. It supports people at risk of falls to exercise at a level suited to their ability. The classes are led by highly trained and experienced instructors.
Invigor8 is suitable if you are fearful of falling, feeling unsteady on your feet, have had a previous fall or if you have osteoporosis. Classes are designed to help build and maintain eight core components: balance, strength, flexibility, endurance, how to get down on the floor and back up, floor work, tai-chi and confidence building.
You can self refer to the scheme or be referred by a health or social care professional.
For more information on Invigor8, see the following websites:
Eyesight
Problems with vision can be an important factor in a fall. Poor vision can affect balance and co-ordination as well as the more obvious difficulties of negotiating uneven ground or steps.
Facts:
- Older people with a visual impairment have double the risk of falling
- 80% of people with a visual impairment are over 60
- a 60 year old needs three times as much light as a 20 year old!
Actions:
- Go for regular eye tests and wear glasses of the correct strength
- Improve lighting and de-clutter
- Use bold and bright colours to highlight areas of your home (e.g. steps). A good colour contrast makes things easier to see.
- Clean your glasses regularly, and put them on if you get up in the night.
Hearing
Loss of hearing is common as people age, and is frequently ignored or not treated.
Hearing loss can be caused by inner ear problems which tend to affect balance. People with hearing loss may also have a general lower awareness of their surroundings, or may be distracted by their hearing problem from carrying out tasks such as balance and walking.
Even mild hearing loss may increase the risk of having a fall. It might be worth having a hearing test and investigating hearing problems further.
See the Action on Hearing Loss website for more information.
Feet care
Keeping your feet healthy is an important management strategy to reduce your risk of falling.
Toenail care
- Cut, clip and file toenails safely; keep them at a length which feels comfortable. Trim your nails straight across and smooth the corners with an emery board or nail file. This prevents the nail from growing into the skin.
Skin care
- Wash feet daily using warm water and mild soap but don’t leave them to soak as this destroys the natural oils in your skin and can increase damage. Dry thoroughly especially between the toes.
- Smooth and moisturise dry and rough skin. Avoid use of moisturiser between the toes.
- Check for cracks and breaks in the skin and signs of inflammation. Look for signs of infection or other obvious early problems and seek professional advice.
Checking footwear
- 70% of foot problems are caused by footwear, therefore it is important to ensure you are wearing shoes that fit well and do not cause your feet any pain
- Always get the right size and width. You should be able to wriggle your toes inside the shoes comfortably
- For everyday use, choose a shoe with a fastening strap or lace. This will act like the seat belt in a car and prevent too much movement of the foot in the shoe
- A thick rubber sole is recommended in most cases. This acts as a shock absorber and protects the soles
- Watch out for seams or stitching – these can lead to painful areas on the toes
- Avoid use of ill fitting, soft, sloppy shoes or slippers as these can cause you to slip, trip or fall.
Home environment
There are many hazards around your home which can be removed to help reduce the risk of falls. Use this checklist to see what changes you can make.
Home safety checklist
- Are your hall, stairs and walking areas well lit and kept free of clutter?
- Is there enough room to walk around the furniture in your home and to use a walking aid safely? (if needed)
- Are flooring and rugs in good repair with no curled edges?
- Are electrical cables and telephone cords kept tidy?
- Do you have a light and telephone beside your bed?
- Do you keep a nightlight on for night time trips to the toilet?
- Do you keep bed-covers and dressing gowns off the floor so they don’t present a trip hazard?
- Are your light switches well placed and close to doors?
- Is there a light switch at the top and bottom of your stairs?
- Do you have handrails or banisters at your steps and stairs?
- Do you have a sturdy stepping stool with slip resistant feet, no more than three steps high, for simple household tasks such as changing a light-bulb? Ask a family member or friend to help you with these jobs.
- Do you have a slip resistant mat for use in the bath or shower?
- Do you keep items which are used most often at a suitable height to avoid bending or climbing?
- Are your windows and blinds easily accessible without having to reach or lean too far?
- Do you clean up spills as soon as they happen?
- Are your garden paths and steps level, stable and kept free of moss? Do you have safety rails and barriers where there are changes in garden levels?
Medication
Take medicines at the right time of day and at the dose prescribed. Try setting a repeat reminder on your mobile phone, or if you use telecare you may be able to have a voice prompt added to your unit to remind you to take your medication.
Let your GP or pharmacist know if you ever feel faint, dizzy or drowsy – they may want to change the dose you’re taking or try a different medicine for you.
Check with your pharmacist before taking any ‘over the counter’ medicines or supplements that you can buy without a prescription, as these can also have an effect on other medication you’re taking.
Diet
The most important areas around diet that older people need to be aware of are:
- Calcium and Vitamin D – both are important for healthy teeth and bones
- Osteoporosis – thinning of the bones
- Malnutrition – where your body lacks essential nutrients
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.
Tips for eating well:
- Eat lots of fruit and vegetables
- Base your meals on starchy foods (e.g. pasta, rice, potatoes, bread)
- Cut down on saturated fat and sugar (e.g. cakes, biscuits, fried foods, ice cream)
- Eat less salt – no more than 6 grams a day for adults
- Eat more fish – including a portion of oily fish each week
- Drink plenty of water
- Be more active and try to be a healthy weight
- Don’t skip breakfast.
Reducing the risk of malnutrition
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:
- Try and use one pint of full fat milk a day
- Enrich milk by adding four tablespoons of dried, skimmed milk powder to one pint of full fat milk. Use this in tea, coffee, milky drinks, cereals and puddings
- Spread butter or margarine thickly and add to potatoes and vegetables
- Add cheese to sauces, vegetables, potatoes, pasta and grate over ready meals
- Add cream to soups, stews, porridge, potatoes, fruit and puddings
- Eat little and often. Try to include two to three nourishing snacks a day
- Avoid low fat or diet products
- Make sure you take at least six to eight drinks throughout the day. Nourishing drinks include milky tea, coffee, milkshakes, smoothies, hot chocolate or malted milk drinks.
If you have diabetes
If you have diabetes please consult your family doctor (GP), nurse or dietitian 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 dietitian.
For more guidance, see our information leaflet on Vitamin D supplements.
Osteoporosis
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 does not automatically mean that your bones will break, but it does mean that you have a higher chance of breaking a bone if you have a bump or fall. It is very important that you stay as active as possible to help maintain your bone health.
Broken bones caused by a fall are called ‘fragility fractures’. Some medicines can reduce your risk of breaking more bones. If you have been prescribed medication for osteoporosis by your GP, it’s important that you keep taking your prescription until you’re advised to stop.
The Royal Osteoporosis Society works to improve the diagnosis, prevention and treatment of osteoporosis. Their trained nurses can answer medical queries and give you information about osteoporosis. The helpline is open Monday to Friday 9 am–5 pm. Telephone: 0808 800 0035
Continence
Urinary incontinence is the unintentional passing of urine. It is a common problem and is thought to affect millions of people worldwide.
It is better to go to the toilet regularly rather than waiting until the need is at its highest. Constipation can also irritate the bladder.
Nocturia is where you need to get up several times during the night to go to the toilet. Falls can occur due to stumbling in the dark or through tiredness. Try to not to rush and have adequate lighting e.g. safety lights, touch lamps.
Don’t struggle with incontinence by yourself, here are some useful tips:
- Try to drink as normally as possible. Normal fluid intake is 6-8 cups per day. Cutting down on liquids will make things worse
- Reduce caffeine intake e.g. coffee, tea
- Try to avoid constipation by eating a balanced diet with plenty of fibre
- Contact your GP (family doctor), practice or district nurse to access specialist continence services and clinics.
The NHS Ayrshire and Arran Continence Service helpline is 01292 617073.
Alcohol reduction
It is recommended to consider reducing or stop alcohol consumption if you are falling or at risk of falls. You:
- Should not drink more than 14 units per week
- Have alcohol free days per week
- Spread your drinking over 3 or more days
- Limit the total amount you plan to drink
- Drink slowly, alternate with water, have food along with your drink.
Alcohol can:
- increase unsteadiness and your risk of having a fall
- disturb sleep patterns by increasing toliet visits
- impact on co-ordination and memory, leading to falls and general confusion
- lower your mood
- interfere with prescribed medications, causing some drugs to be exaggerated such as diazepam (Valium) and reducing the effectiveness of some others e.g. tablets to reduce high blood pressure
- cause thinning of the bones when drunk at higher levels.
For over 65s, it is recommended to reduce your daily alcohol units to:
- Women = 1 to 1.5 alcohol units per day (with at least 2 alcohol free days per week)
- Men = 1.5 to 2 alcohol units per day (with at least 2 alcohol free days per week)
Use the NHS Scotland Drinks Calculator to measure your alcohol consumption.
If you feel you need help with your alcohol consumption, please consult Ayrshire Council on Alcohol for further information and advice.
Telehealthcare
Smart Supports allow you to live at home safely and independently while still being able to call for help if needed. These include movement sensors or chair or bed occupancy sensors which link to a central unit and trigger a call to a local operator or family member who can provide help.
Smart Supports provide reassurance and raise confidence of the wearer, particularly if they have had a fall. The following Smart Supports options are available:
- A basic smart support unit comprises of a unit, pendant and smoke detector.
- For people who experience falls during the night a bed occupancy sensor can be linked to a lamp to provide light when the individual gets up. The bed occupancy sensor can also be set to trigger an alert if the person does not return to bed after an agreed time (e.g. 20 minutes).
- If falls are linked to extremes in temperature a temperature extremes sensor may help to prevent individuals from becoming too cold.
- A Buddi system uses satellite navigation technology to pinpoint a wearer’s location, and a mobile phone network to communicate between the Buddi and an operator. It has an inbuilt falls detector and is suitable for someone at risk of falls who also has a degree of cognitive impairment.
- The ‘Just Checking’ system can be used to gather information on a person’s daily activity which is shown simply as a line on a chart. The information gathered can be used along with the views of the individual, family and care providers to minimise risk, identify areas for other Smart Support options and ensure that care is client centred and meets the need of the individual.
Falls screening
Falls screening in Ayrshire is provided by a Falls Assistant Practitioner through the Intermediate Care Service. There is a Falls Assistant Practitioner in North, South and East Ayrshire. A falls screen takes place in your home and helps identify any personal or environmental risks that contribute to slips and trips. The Falls Assistant Practitioner can then refer you to further services as may be appropriate for you.
Contact your local Intermediate Care Service and ask for a falls screen:
- South Ayrshire: 01292 660444
- North Ayrshire: 01294 400616
- East Ayrshire: 01563 507955
Top tips
These top tips provide a summary of the measures you can take to reduce your risk of falls.
- Lower your alcohol intake – Alcohol can increase unsteadiness and the risk of having a fall, as well as interfering with prescribed medication.
- Take medication as prescribed – Always take medication as prescribed by your doctor and if any side effect is troubling you, speak to your doctor or pharmacist, or ask for a review of your medications.
- Keep up your health checks – Ensure you have your eyes tested regularly, your hearing checked if needed and take your annual free flu jag.
- Have a healthy diet – Calcium and vitamin D are important for bone strength. Aim to eat 2-3 portions of food rich in calcium per day, and try to get out in the sunshine for 10-15 minutes per day. Balance this with a healthy diet.
- Stay active – Keep mobile and try to include activities that focus on strength and balance, such as walking, dancing or tai chi.
- Walking aid – If you have a walking aid, make sure you use it and that it is maintained. Your physiotherapist can repair or replace your walking aid if needed.
- Look after your feet – Make sure you wear well fitting shoes around the home and get any foot problems checked.
- Check your home for hazards – Make sure your home is well lit and there are no trailing cables or trip hazards.
- Always take your time getting up to answer the phone or doorbell.
- Carry a mobile phone with you when you’re out, in case you have a fall and need to call for help.
- See what Smart Supports are available – There are many devices that can help people live safely in their own home for longer, which alert carers or family if there is a problem. Ask your local Smart Supports team for details.
- Make a falls plan – After reading the information in the Positive Steps booklet, see what changes you can make to your lifestyle to ensure that you live free of falls.
Useful contact numbers
The contact details below are examples of some services that you may find useful.
- NHS 24: 111
- Emergency service: 999
NHS Ayrshire & Arran Intermediate Care Services:
- South Ayrshire 01292 660444
- North Ayrshire 01294 400616
- East Ayrshire 01563 507955
Age Scotland:
Age Scotland offers information and advice on topics including health, care, money and housing.
Telephone: 0800 12 44 222 (Monday to Friday, 9am to 5pm)