Falls Prevention
Having a fall can have a major impact on your life, both physically and mentally. It can lead to loneliness and isolation, and can stop you doing things that you once previously enjoyed.
However, having a fall is not an inevitable part of ageing, and there is a large amount of evidence around the ways in which risks can be reduced and kept low.
Keeping well, being active and looking after our mental wellbeing are all important as we age, and will impact much wider than just reducing risks of falls.
Also in this section
Falls Decision Support Tool
This ‘tool’ will signpost you to services that will support you to stay active, steady on your feet and maintain your independence whilst reducing your chance of falling.
It is quick and easy to use, with a maximum of five yes/no questions to answer and should only take a few minutes to complete.
Reducing the risks
All the pieces need to be in place and work well together to lower your chance of falling.
Did you know that there are a number of things that you can do to reduce your risk of having a fall?
Click on the topics in the right hand menu below for information and examples of how you can stay steady and lower your risk.
Medication
Foot care
Footwear
Illness
Strength and Balance
Equipment
Dementia and Cognitive Loss
Nutrition and Hydration
Blood Pressure
Pain
Alcohol
Environment and home safety
Continence
Senses
Medication
Some medications, or combinations of medications, have side effects that can make you feel dizzy, drowsy or lightheaded. This can affect balance and result in a higher risk of falling. The more medication you take the higher the risk.
It is important to take medications as prescribed, sticking to the prescribed dosage and any specific instructions such as when and how to take them like them on an empty stomach or with food.
If you experience any side effects speak to your GP or your local community pharmacist.
Regular medication reviews are important if you are taking prescription medications regularly or taking medication for a long term illness. It is recommended that you have a review once a year with your GP.
For some illnesses and conditions there may be alternatives to prescribed medication, treatments that do not involve taking tablets or medicine.
Foot care
Our feet play an essential part in keeping us moving and maintaining our balance. It is important to keep them healthy so they can continue to keep us active and steady throughout our lives. Problems with your feet can cause pain and alter the way you walk. Some common foot problems that can cause pain and discomfort include bunions, in growing toe nails, overgrown toenails and calluses.
If you aren’t mobile it is still important to look after your feet.
Top Tip: Follow this link for helpful hints on how to look after your feet.
If you cannot manage foot problems yourself at home a Podiatrist can help (a doctor who specialises in ankles, feet and toes). Your GP can refer you can to an NHS podiatrist. Alternatively you can see a Private Podiatrist ( make sure your podiatrist is registered with the Health and Care Professions Council and look for the letters HCPC after their name).
Age Connects Cardiff and the Vale provide a nail cutting service for Cardiff.
Footwear
It is important to wear well fitting shoes and slippers to reduce the risk of a trip or slip.
- Shoes should be the correct size and have laces, buckles or Velcro straps that keep them secure. Avoid slip on shoes.
- Well cushioned shoes offer comfort and support.
- The soles of your shoes should have a good grip.
- Sandals with little support and high heels can increase your risk of falling.
- Walking in bare feet, socks and tights should be avoided. Wear slippers that have a good grip and that fasten and stay on properly.
Top tip: Find out more about how to choose suitable footwear.
Illness
When you are unwell it may mean that you move less which can mean that your muscles get weaker and can increase your risk of falling.
Illness and infections can cause confusion, lethargy and make you feel dizzy. For example, if you have an ear infection, this can affect your balance. Having an infection, such as a bladder infection, can increase your risk of falling as you to need to get up and go to toilet more frequently.
Energy limiting conditions can also increase the risk of falls.
If you are feeling unwell take extra care and make an appointment with your GP.
Strength and Balance
Improving and maintaining your strength and balance can help to reduce the risk of having a fall, and it is never too late to get started! Government physical activity guidelines recommend that strength and balance activity is done at least two days a week. Also, if you do have a fall, improving your strength and balance can make all the difference to your resilience and recovery.
You can find some exercises to do at home by clicking on this link. The Chartered Society of Physiotherapists developed this short animation, highlighting 6 strength and balance exercises, which if done regularly, can help to reduce the risk of falls.
Across Cardiff and Vale there are community based classes which offer exercises and activities which improve strength and balance and general mobility. Many of them are designed specifically for people aged 60 and over.
Equipment
Walking aids such as walking sticks and frames can help to improve mobility and confidence helping us to be more active and independent. If you feel there has been a change to your mobility speak to your GP who will be able to refer you for a physiotherapy assessment.
If you have a walking aid using it correctly is essential. For example, walking aid’s needs to be the correct height, level with your wrist crease when you hold your arm by your side. It is important to check the rubber ends, called ferrules, and replace them if the grip has worn down.
Equipment and adaptations around the house such as hand rails, chair raisers and shower seats can also help to stay steady at home and reduce the risk of falling. If you are struggling to carry out day to day activities speak to your GP who can refer you for an assessment with an Occupational Therapist.
If you live in Cardiff you can contact The Independent Living Service who can help you to access equipment and support to help you to live as independently as possible.
Care and Repair Cardiff and Vale can also help with adaptions to the home to help older people live independently.
Dementia and Cognitive Loss
Cognition refers to the processes that take place in the brain like thinking, learning, perception, understanding and language. Dementia and cognitive loss can increase risk of falling as symptoms can include:
- Problems with mobility, balance and muscle weakness
- Sensory changes
- Difficulty with memory and finding your way around
- Drowsiness, dizziness or lower blood pressure from taking medication
- Finding it difficult to communicate worries, needs or feelings
To try and keep risks as low as possible it is important that people living with dementia remain physically active. A safe environment is also important things like good lighting, signposting and different colours can help. It is also a good idea to have regular medication checks and eye sight tests.
Nutrition and Hydration
Eating a healthy balanced diet with foods that have enough energy, protein and nutrients such as calcium can help to improve your bone and muscle strength. Drinking enough fluids to stay hydrated is just as important as what you eat. A nutritious diet and a good intake of fluid will reduce your risk of muscle loss and frailty which can help to prevent falls.
Top Tip: Stay hydrated. If you don’t drink enough you may become dehydrated which can make you feel light-headed. This will increase your risk of a fall.
If you have a poor appetite, feel weaker or are less able to do your usual activities click here to find out more about eating a nourishing diet and your nutritional risk.
For information on how you can eat well on a budget visit:
Blood Pressure
A common reason for falls is people getting out of bed and standing up too quickly, which means your blood pressure drops quickly, causing light headedness, and a fall can then occur. To avoid this, make sure you get up slowly, when you put your legs over the side of the bed pause before getting up.
If you notice symptoms such as light headedness, dizziness, blurred vision when you stand up or suddenly change position it could mean you have low blood pressure. Get it checked out by your GP.
Pain
Pain can alter the pattern or way we walk, which can increase the risk of falling. Painful feet, for example, will alter how we usually walk affecting balance. Being in pain can also stop us from moving around and being active. When we stop being active this can lead to our muscles becoming weaker increasing the risk of having a fall.
There are different types of pain besides pain that affects our joints, bones and muscles. Pain can affect the way you move and how you react as you may not be as alert to falls risks.
It is important to identify the cause of any pain so it can be treated or managed.
Alcohol
As we age our bodies find it more difficult to process alcohol. This makes us more sensitive to the affects of drinking which can cause an increased risk of falls. Drinking too much alcohol can slow our reactions, affect coordination and make us unsteady on our feet, especially if we are taking certain medications or are living with health conditions.
Not drinking alcohol or reducing the amount we drink can reduce the risk of falling. The recommended guidelines to keep health risks low recommend not to drink more than 14 units in a week (for both men and women). Spread your alcohol consumption across 3 days or more, and don’t drink excessively on any one day.
Environment and home safety
Most falls take place in the home, with trips and slips caused by hazards such as rugs, trailing wires, items stored on the stairs or slippery floors. Make sure you remove as many trip hazards as possible, keep stairs free of clutter, and make sure rugs do not have raised edges.
If you need to go to the toilet at night but don’t want to switch lights on, keep nightlights plugged into the wall sockets to light your way. Rechargeable lighting can be a helpful option to help improve vision at night and reduce your energy bills.
It is important to be aware of your surroundings and to take your time. Putting things out of reach or up high can increase your risk of falling.
If you would like advice about making your home safer by improving lightings or installing aids such as installing grab rails there are services that can help including Care and repair and Cardiff Independent Living Service.
Telecare services use technology and devices that can help you stay safe at home. Personal alarms and monitoring systems let you call for help if you have had a fall.
In Cardiff and The vale of Glamorgan Telecare services are provided by the Local Authority:
Continence
Urinary incontinence, when a person leaks urine (wee) by accident, can contribute to accidental falls in several ways. Incontinence and accidental falls are connected:
- Incontinence episodes may lead to slips on wet floor surfaces.
- Hurrying to use the toilet can lead to slips and trips especially in unfamiliar, cluttered or dark areas.
- Episodes of urinary incontinence are often related to illness, such as urinary tract infections that can cause incontinence, delirium and drowsiness.
- Some medications used to treat incontinence can affect blood pressure which can increase your risk of falling.
- Waking up to urinate at night can result in poor sleep, which is associated with increased fall risk.
- Making frequent bathroom trips at night, through a poorly lit or obstructed pathway, may increase fall risk.
The Health Board’s Bladder and Bowel Service can help you to manage your symptoms and live well with incontinence. If you are a new patient, telephone the HUB on 029 20444501. For reassessments (patients known to the team) contact 029 21841590.
Senses
Our senses allow us to make sense of our surroundings. Poor eyesight and not being able to see trip hazards increases the likelihood of falls. Ensure you have regular sight checks and your glasses prescription is up to date.
You can search for Opticians in Cardiff and Vale here.
If you have problems with your eye health such as an injury, swelling or visual loss you can visit an Optometrist in the community. For more information on when to see an Optometrist visit the Primary Choice pages of the Cardiff and Vale University Health Board website.
Problems with hearing can affect your balance and your awareness of hazards making tripping and falling more likely. The inner ear is responsible for our balance, as well as our hearing. Disorders of the ear can sometimes lead to dizziness and imbalance. If you have noticed a change in your hearing or balance speak to your GP who can refer you to you an Audiologist, a health care professional who specialises in hearing and balance.
In Cardiff and Vale there is a specialised audiology service that will provide balance assessment and rehabilitation for people whose dizziness is caused by their inner ears.
Changes in sensation, for example the sensation in your feet can also increase your risk of falling.
FaME (Falls Management Exercise) Programme
Exercise is strongly associated with reducing falls risks. FaME is an exercise programme which is shown to improve strength, balance and stability, and therefore reduce the risk of falls. It is delivered in Cardiff and the Vale of Glamorgan by specialist qualified exercise instructors in small group classes, and the classes are tailored to the abilities of individuals.
The programme runs once a week for 24 weeks, and individuals progress during the programme to develop their strength, have more confidence and feel steadier on their feet. Generally our FaME programmes are delivered in community venues, and are also a great way to socialise with others in a small group.
