Keeping Me Well - Cardiff and Vale University Hospital

Fall Prevention

Reducing the risk of having a fall 

Reducing the risks of falls is a bit like a jigsaw. A number of pieces need to be in place and work well together in order to keep risks low.

Click on a jigsaw piece below for more information about how these factors can increase or decrease the risk of falls.


Many medications can increase the risk of falls. Medication that act on the brain, the heart and circulation and those that lower blood sugar, are well known for side effects that increase the risk of falling. Common side effects of these medication include dizziness, drowsiness or feeling lightheaded. The more medication you take, the greater the chance that one or a combination of them will make a fall more likely to happen. It is important that people have regular reviews of their medication. If you have concerns about your medication, speak with a pharmacist or doctor.

Foot Care Jigsaw piece

Foot care

Toenails need to be clipped, and feet looked after so you can walk properly and comfortably.

Age Connects Cardiff and the Vale provide a nail cutting service for Cardiff and Vale residents. For an appointment or to find out more call 029 2233 1113

Footwear jigsaw piece


It is important to wear well fitting, closed back shoes and slippers in order to reduce the risk of a trip or slip due to your footwear.


Having an infection such as a bladder infection can increase risks due to causing you to need to get up and go to toilet more frequently, and also be generally weaker due to illness.

Generally, having ill health can mean moving less as it can be uncomfortable or we have little energy. Moving less can lead to muscle wastage, which increases falls risk

Strength jigsaw
Balance jigsaw piece

Strength and Balance

Improving and maintaining your strength and balance can greatly 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 strength and balance exercise programmes 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.


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.

Alternatively, if you live in Cardiff you can contact The Independent Living Service.

Care and Repair Cardiff and Vale can also help with adaptions to the home to help older people live independently. 

Cognition jigsaw piece


Dementia and cognitive loss causes falls, as some symptoms of dementia can make people more at risk:

  • problems with mobility, balance and muscle weakness
  • difficulty with memory and finding your way around
  • taking medication that make you drowsy, dizzy or lower blood pressure
  • finding it difficult to communicate worried, needs or feelings

Try to keep risks as low as possible by remaining physically active; creating a safe environment using good lighting, signposting and different colours; 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 fluid to stay hydrated is just as important as what you eat, as is keeping your levels of alcohol consumption If you eat a nutritious diet and have an adequate intake of fluid, you will reduce your risk of muscle loss and frailty which can help to prevent falls. 

If you have a poor appetite, feel weaker or are less able to do your usual activities find out more about eating a nourishing diet and your nutritional risk.

blood pressure piece

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.

Pain jigsaw piece


Pain can alter the pattern or way we walk, known as our gait, 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 bodies deconditioning which means muscles become smaller, we lose strength and become weaker. All of these things can increase the risk of falling. It is important to identify the cause of any pain and treat it.


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 reactions, affect coordination and make us unsteady on our feet, especially if we are taking certain medications. Not drinking alcohol or reducing the amount we drink can reduce the risk of falling.

Environment jigsaw piece


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.

If you would like some advice about making your home safer, for example through installing grab rails, contact…

Continence jigsaw piece


Urinary incontinence can contribute to accidental falls in several ways. Incontinence and accidental falls are connected:

  • Incontinence episodes may lead to slips on wet floor surfaces.
  • Urge incontinence may increase fall risk when a person hurries to the toilet, especially in unfamiliar, cluttered or dark areas.
  • Episodes of urinary incontinence may be transitory and often related to acute illness, such as urinary tract infections that can cause incontinence, delirium, drowsiness, and hypotension.
  • Medications used to treat incontinence, such as anticholinergics or alpha-blockers, can cause postural hypotension.
  • 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 is available to supporting individuals and their families to improve their symptoms, utilising a holistic assessment to provide options on treatment and interventions. They can provide education on behavioural and lifestyle changes that can promote bladder and bowel health.

If you are a new patient, telephone the HUB on 029 20444501. For reassessments (patients known to the team) contact 029 21841590.

Senses jigsaw piece


Poor eyesight and hearing loss affects balance and not being able to see trip hazards increases likelihood of falls.

Ensure you have regular sight checks and your glasses prescription is up to date.

Keeping Me Well - Cardiff and Vale University Hospital

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