10 Exercises To Prevent Falls | Fall Prevention Exercises

Fall Prevention Exercises

Follow along with me (Mike - Physiotherapist) for these 10 exercises to prevent falls. In this video, we go through strength and balance exercises, and I also show you some progressions of each exercise for continued progress.

For more on falls prevention, head to morelifehealth.com/falls-prevention

Falls Prevention Exercises:

1. Exercise Begins - Exercise 1 - Knee Extensions: 2:45

2. Exercise 2 - Sit-To-Stands: 5:29

3. Exercise 3 - Calf Raises: 9:40

4. Exercise 4 - Partial Squats: 11:33

5. Exercise 5 - Knee Flexions: 13:40

6. Exercise 6 - Hip Extensions: 15:30

7. Exercise 7: Hip Abductions: 17:00

8. Exercise 8: Static Balance: 19:30

9. Exercise 9: Dynamic Balance - Heel - Toe Walks: 22:35

10. Exercise 10: Dynamic Balance - Figure 8 Walks: 26:33

Give these exercises a go and let me know how you went below the video.

Remember consistency and progression with exercise is key!

Stay moving! and I’ll see you soon!

- Mike

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 3

BE PREPARED - WHAT TO DO IF YOU FALL

In Parts 1 and 2, we covered all required to decrease your falls risk to a large extent.

This next part is essential for everyone and could be the most important section of this article, so please take your time going through the content. All of it!

I say it’s most important because there is always a chance anyone could fall, which means YOU or someone you know!

The outcomes of a fall when older are usually much more severe, with an increased risk of serious injury. Additionally, getting up off the floor usually isn’t so simple if the physical capabilities required are not there, potentially leading to further issues.

Furthermore, those who may be around to assist you and do so incorrectly may also put themselves at risk of injury or falling, ending up in the same predicament.

So it’s essential to know how to be prepared for a fall if one was to happen, know what to do if you fall, how to get up off the floor safely, and how to help someone who has fallen.

In this part, we are going to cover all of this.

CONTENTS OF PART 3:

• WHAT TO DO IF YOU FALL

• HOW TO REDUCE HARM AND SUMMON HELP IF YOU FALL

• BE PREPARED: CREATING A FALLS EMERGENCY PLAN

• WHAT TO DO IF YOU FALL: HOW TO GET UP SAFELY AFTER A FALL

• VIDEO - HOW TO GET UP SAFELY IF YOU HAVE FALLEN

• HOW TO ASSIST SOMEONE WHO HAS FALLEN

• WHY YOU SHOULD TELL YOUR DOCTOR AFTER A FALL

WHAT TO DO IF YOU FALL

Below is a flow chart on what to do if you fall and find yourself on the ground.

I have made it so you can print this to have a copy you can refer to.

Click on the diagram below, download and print it, and familiarise yourself with it.

SHARE THIS SECTION with anyone who could benefit from it. It may save a life!

Steps to Take Following a Fall - Click to download and print

As you can see from the diagram, many scenarios can occur following a fall.

The best possible outcome of falling is not having any injuries and getting up safely. In this scenario, you should still tell your doctor just to make sure there is no injury you may have missed.

It's also important in all cases to understand why you had your fall, which your doctor will help uncover.

Take note of the red section on the right in the diagram above. This is a situation following a fall in which you are on the ground, injured or not, unable to get up, with no way to summon help.

This is where many problems following a fall arise, and it's a situation WE MUST AVOID BY HAVING APPROPRIATE MEASURES IN PLACE.

HOW TO REDUCE HARM AND SUMMON HELP IF YOU FALL

This step aims to ensure that if a fall occurs, you can get help as quickly as possible to minimise any secondary consequences.

We will go through some questions to ensure you're covered for most situations if you fall.

CAN YOU GET UP OFF THE FLOOR?

If you were to fall in your home (assuming no injuries), do you feel you could safely get back up off the floor?

You want to ensure you have the physical capabilities to get up off the floor if you were to have a fall. The best way to do this is through exercise and a healthy diet to improve your strength, balance and fitness.

We will cover how to get up off the floor safely below.

For various reasons, some of you reading this may have difficulty getting up off the floor, or if you were injured, you want to stay where you are until help arrives - to avoid further injury.

In these situations, it is VERY IMPORTANT to be prepared and able to summon help effectively.

IDENTIFYING SITUATIONS THAT COULD BE PUTTING YOU AT RISK

Are there walks or activities you undertake where it might be challenging to get up from the ground if you fall? 

(An example could be: walking on your own through an open field, a sports oval or a walking track. In these places, there is nothing to hold onto).

If your answer was yes - 

If you lack confidence in your physical capabilities to get up and you were to have a fall, in such a situation, the best thing you can do is find an alternate route to take to avoid this.

If you cannot recover in situations like this, you may be in a hazardous situation.

If this is a route that cannot be avoided, many actions can be taken to minimise the dangers, e.g.:

• Do everything in this guide (all three parts).

• Take your walking aid with you if you have one.

• Tell a friend or family member where you are going.

• Take your mobile phone with you and keep it handy.

In summary, if one of your activities or walking routes could put you in danger of falling, be prepared or, better still, change your activity (if possible) with a safer option. 

HOW TO SUMMON HELP IF YOU FALL

If you were to fall and injure yourself, would you be able to get help in all situations?

Think of all areas of your house and the tasks you undertake, and determine how you would get help if you fell.

Here are ways to summon help in different situations:

a) In The House (Particularly the Bathroom): 

• Someone you live with (spouse, family member or roommate, neighbours, carers).

• Telephone (cordless or mobile are best) - always kept charged and with you.

• Pendant alarm.

c) Outside 

• Be sure there are people around; get to know your neighbours.

• Mobile phone kept with you (pocket, bag or walking aid).

SUMMARY - WAYS TO SUMMON HELP:

• People: Attract the attention of those around you (family, neighbours, friends etc.)

• Landline Phone: Throughout your house in close reach, or always keep a cordless phone with you.

• Mobile Phone: kept charged and with you, especially when outside.

• A Pendant Alarm.

Note: Make sure phones are always within reach; cordless or mobile phones are best in the house or outside.

To safeguard yourself further, have a check-in system with a neighbour, friend or family member where you can check up with each other daily at a specific time.

BEING PREPARED: Creating A Falls Emergency Plan

At this stage, we've ensured there is a way to summon help if you fall.

This section will determine who to call if you fall and ways to quickly contact them.

WHO TO CALL

1. KNOW YOUR FRIENDS, FAMILY MEMBERS OR NEIGHBOUR'S NUMBERS

The first step is to determine and know who you would call if you were to fall.

Right now, think of three people you would call if you were to have a fall.

You can put your answers in the action plan.

KEEP YOUR NUMBERS IN EASY ACCESS

1) If you have a landline phone, store the numbers of who you will call on the phone and know how to access the numbers quickly. 

2) Keep a printout of your emergency contacts on or near each house phone.

3) Store emergency contact numbers on your mobile phone and know how to access and call them. If you don't know how to use your phone, take the time to do so.

2. KNOW YOUR EMERGENCY NUMBERS

I'm sure you know your local emergency numbers, but here are several, just to be certain!

• Australia = 000

• New Zealand = 111

• The United States & Canada = 911

• The United Kingdom = 999

• From Any Mobile Phone - 112 (Anywhere in the World)

3. CONSIDER OTHER TECHNOLOGICAL DEVICES

As previously mentioned, using your mobile phone or a pendant alarm are ways to call for help if fallen. Another way to quickly and easily summon help and stay safe is to use Smart Watches.

Apple Watch

Smartwatches, like the popular Apple Watch, track different components of your health and fitness. The features include step tracking, heart rate & oxygen saturation monitoring, sleep monitoring and much more. 

Furthermore, the Apple Watch has inbuilt fall detection.

The Apple Watch fall detection is a life-saving feature that can help you if you fall. Using sensors, it can detect when you've fallen and automatically call for help to your nominated contact numbers if it detects that you're unresponsive. 

Once enabled, the Apple Watch will continuously monitor your movement data to detect if you have fallen. If a fall is detected, the apple watch will vibrate and display an alert. You can choose to dismiss the alert or call emergency services.

View fullsize

Apple Watch - Fall Detection Screen

If you are unable to dismiss the alert or call emergency services, the apple watch will automatically call your emergency contacts and send them your location. The apple watch will also display your medical id so emergency responders can quickly get information about your medical conditions.

You can set up your medical ID in the health app of your iPhone. For further details on how to set up your medical ID on your Apple device, click here.

View fullsize

Apple Medical ID

Fall detection is on the watch automatically for people over 65 years old. If you're under 65 years old and want to turn on fall detection, you can do so in the settings app on your Apple Watch.

If you have an apple watch, click here for details on setting up the Apple Watch fall detection.

Another great feature of the apple watch is the voice control, where you can speak to your watch and call someone, e.g., "Hey Siri, call my daughter!" This feature could come in handy if you fall and want to call a family member or friend quickly. Click here for a link on how to use voice command.

If you're interested in purchasing an Apple Watch, click here to view them or head to your local Apple store. But note that the "Series 3" Apple watch does NOT have fall detection capabilities.

There are other smartwatches on the market with fall detection software.

WHAT TO DO IF YOU FALL - HOW TO GET UP SAFELY AFTER A FALL

If you are on the ground after having a fall, how you react can cause more injuries than the fall itself. You want to make sure you know how to handle this situation!

The first step: DO NOT PANIC!

Your first instinct may be to get up as quickly as possible, especially if your fall is in public.

Avoid this instinct. STOP!... Take a deep breath…. Slow down! Relax.

It may also be the instinct of people around you to help you up immediately. Do not allow this.

Take another deep breath and assess your situation by asking these questions…

1. AM I HURT?

IF YES…

If you feel you could be hurt, other than minor cuts, scratches or bruises, DO NOT GET UP. 

If there are people close by, call them for help or use your telephone, mobile phone or pendant alarm to summon help, as discussed in the previous sections. 

Getting up from the ground when you are hurt (even with assistance) can cause further injury.

Ensure those who have come to your assistance have called for trained professionals (e.g. ambulance) and do not try to get you up.

The professionals are trained to deal with situations just like this.

WAIT FOR THE TRAINED PROFESSIONALS TO ARRIVE. 

Wait for the ambulance - or in a nursing home, community setting, or similar - for the doctor, nurse or physiotherapist to assess you. Once you have summoned help, keep warm and comfortable the best you can.

[Continue on to step 2b]

IF NO…

If you do NOT have any injuries, ask yourself :

2) CAN I GET UP?

IF YES…  Continue to 2A

IF NO… Continue to 2B

2A) I CAN GET UP: HOW TO SAFELY GET UP FROM THE FLOOR AFTER A FALL!

STEP 1:

1. Lying on your back. Relax, take another deep breath in and out.

2. Roll onto your side and tuck your elbow under.

3. Push into straight arms.

1. Lying on your back

2. Roll onto your side & tuck elbow under

3. Push into straight arms

STEP 2:

1. On straight arms, push your buttocks up and come onto your hands and knees into a crawl position.

2. In this position, you can crawl to furniture close by to assist you in getting up.

Push your buttocks up into crawl position.

STEP 3:

1. Crawl to furniture close by.

2. Use your hands to pull yourself up.

3. Slowly begin to rise, using your strongest leg first, one leg at a time,

4. Then your other leg.

Crawl to furniture close by and pull up into standing.

STEP 4:

1. Stand up.

2. Slowly twist around and sit on the chair. 

3. Relax, settle and tell a friend or family member (and your doctor) that you have fallen.

Stand up and twist around into seated position.

VIDEO: HOW TO GET UP OFF THE FLOOR WHEN YOU HAVE FALLEN

How to get up off the floor after a fall

2B) I CAN'T GET UP: WHAT TO DO IF YOU CAN'T GET UP

In a situation where you find you are unable to get up off the floor, ask yourself the following questions: 

Can I Attract Attention?

The first thing to do is see if there may be anyone close by who may be able to come to your help.

• Call out to someone near to assist you.

• If you have your phone or pendant alarm on you, use it to get help.

• If nobody is within close proximity and you don’t have your phone or pendant alarm on you, make loud noises in whatever way you can (e.g., if you use a walking stick, bang it on an object within reach), or call out as loud as you can to get the attention of those close by.

Attract the attention of someone for help.

CAN I GET COMFORTABLE?

If your calls for help go unanswered, it’s now time to make yourself comfortable (and warm) the best you can, as you may be in this position for some time until help arrives.

Use a nearby cushion, blanket, or a rolled-up piece of clothing and place it under your head as a pillow.

Can I Keep Warm?

You also want to keep yourself warm as best as you can.

• Cover yourself with anything nearby - clothing, a blanket or a rug if possible.

Use items close by to get comfortable/warm.

 Can I Keep Moving?

• Change positions regularly to avoid pressure on certain areas and pressure sores (your skin breaking down).

• Move all your joints to prevent stiffness and help with circulation.

• If your bladder is to "let go," roll away from any wet areas.

• Continue to keep making noise and yelling for help from time to time as someone may hear your calls.

• Wait patiently and calm until help arrives. Help will arrive eventually. You will be ok!

Keep your body moving.

HOW TO ASSIST SOMEONE WHO HAS FALLEN

Here are some general guidelines that you can use to assist someone who has fallen get back on their feet.

Note before: NEVER attempt to pick the person up. This could lead to further injury to the person who has fallen, or yourself getting injured or being pulled to the floor with the person.

Your job is only to help guide them in getting up. It’s essential you allow the fallen person to do the work. Never at any moment lift the person’s weight.

Never try to get a person up if they are injured - call emergency services. 

If the person is a resident in care, tell the staff immediately. 

1. The first step is to relax and stay calm when a friend or loved one has fallen. Do not try and get the person up straight away. You can place a pillow or something soft under their head while you assess the situation.

2. Determine if the person is in pain. Ask them. If they have pain, determine where it is and the severity.  Examine them for visible injuries like bleeding, bruises, broken bones or sprains. 

3. If they are injured, call emergency services. While you wait, keep them comfortable and warm.

4. If they don’t have any pain or injuries, get them to move their arms and legs gently. If they still don’t report any pain and think they can get up, you will now guide them gently and slowly in getting up. 

   If they can’t perform any of the below steps at any time, get stuck, experience pain or become too tired - stop!

5. Gently prompt the person to roll onto their side into a side-lying position. 

6. Now get two chairs which will be used to help get the person into a sitting position. Place one chair near their head and one chair near their feet.

7. Prompt the person to push up from the side-lying position onto their hand and forearm and then into a half-sitting position.

8. Now prompt the person to keep pushing up until they are in a crawl position, on all fours, facing the chair. If the person gets knee pain, you can place a cushion, towel or something soft under their knees to make this step more comfortable.

9. Direct the person to use the chair in front of them to help them get into a kneeling position on both knees. Only gently guide their movements.

10. Once on both knees, ask the person to bring one leg forward so they kneel on one leg with the other foot firmly on the floor. They should be in a kneeling lunge position with the chair in front of them and their hands on the chair, using it for support.

11. Now prompt them to push up with their arm and legs, using the chair in front of them to assist.

12. Once they are up, help guide them to sit on the chair behind them. 

13. Examine again for injuries. Falls can be a scary experience and they will usually be in a heightened state. Encourage them to relax until they are feeling calmer before they try standing up and walking around. 

14. Check the person can safely stand and walk before they are walking on their own.

15. Notify the person’s doctor of the fall and keep an eye out for any pain or signs of injury which may occur later.

SHOULD I TELL MY DOCTOR AFTER A FALL?

It is natural to want to downplay a fall after it has happened. It's common to think that a fall is an embarrassing indicator of decline or that it may now signal the need to rely on others for assistance. THIS IS NOT TRUE!

When you tell your doctor, they will check for any injuries you may have missed following the fall and assess your situation for the possible causes, which will help prevent future falls.

Yes, some changes may need to be made to ensure you prevent falls as much as possible. But all changes and measures taken by your doctor and other health professionals will be directed towards maintaining and improving your situation as best as possible for your ongoing independence.

Not telling your doctor may limit your independence in the long run as you may not get the appropriate support and interventions you require.

Don't just get up and shake it off… TELL YOUR DOCTOR OR OTHER HEALTH PROFESSIONAL ABOUT IT.

FINAL WORDS

And there we have it.

We have now covered everything required to decrease your risk of falling to a large extent and also prepare you if you were to fall.

If any new information comes up about falls, I will continue to update these pages so your falls prevention information is always up to date.

As you have seen in this guide, the thought of falling is scary, but many things can be done to prevent them. It does not have to affect your life. Do what needs to be done, and live your life as best you can.

For life is meant to be lived!

If you have any questions about falls, join the More Life Health Facebook Community. CLICK HERE to join.

For any updates and to ensure you are doing all you can to prevent falls, sign up to the More Life Health mailing list below. When you do, you'll be sent a free 4-week eBook to help you improve your health and fitness.

AND ONE MORE THING BEFORE YOU GO: MAKE SURE TO SHARE THIS FALLS PREVENTION SECTION.

Everyone over 60 should read this guide and be knowledgeable about falls. We all know falls are a huge problem.

Please share this article and the More Life Health website if you know anyone who would benefit from reading it.

It's now time to get out there and do everything that makes you happy.

Keep Active! Keep Happy! Keep Smiling!

- Mike

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 2

10 STEPS TO PREVENT FALLS FOR GOOD

In Part 1 of this Falls Prevention Guide we covered that falls are not just a normal part of ageing. We looked at how a falls cycle can develop and the risk factors associated with falling.

When we understand the factors that increase the risk of falling, we can eliminate or minimise them as much as possible, thus preventing falls.

This is what we will be doing in this section, Part 2. Taking the appropriate steps to prevent falls.

What we will be covering in Part 2:

• STEP 1: Stop What’s Putting You At Risk - Take Care and Ask For Help

• STEP 2: How To Exercise To Prevent Falls - The Best Exercise For Falls Prevention

• STEP 3: Improve Your Vision And Hearing To Prevent Falls

• STEP 4: The Best Shoes to Prevent Falls and How To Take Care Of Your Feet

• STEP 5: Simple Changes To Make In And Around Your Home To Prevent Falls

• STEP 6: Be Aware of Health Conditions and Medications Putting You At Risk of Falling

• STEP 7: Decrease Your Falls Risk With Good Nutrition

• STEP 8: Get A Good Night’s Sleep Naturally, Every Night

• STEP 9: Slow Down and Be Mindful To Prevent Falls

• STEP 10: Walking Aids & Assistive Devices - How They Can Help and How They May Put Your at Risk Of Falling

Before we start, if you feel you’re at risk of falling, maybe you’ve even had some near misses or have fallen. Do not keep this to yourself! Let your doctor know so you can determine why this is happening and can undertake what’s required to prevent further issues.

Furthermore, although I outline these 10 steps to decrease falls that you can follow, you should not and do not have to go it alone. Many services are available to help, which can be organised through your doctor.

STEP 1:STOP WHAT'S PUTTING YOU AT RISK - Take Care and Ask For help!

The first step in preventing falls is re-thinking how you do those tasks or habits that could put you at risk.

All of us are guilty of doing things we shouldn't.

Earlier in life, certain tasks you do, which could have little risk, aren't usually an issue. However, when physical abilities change over time, there is less room for error.

The tasks that could put you at risk of a fall change for each person and their capabilities.

Some examples could be using a ladder or a chair to perform specific tasks, such as changing a light bulb. We all know this can be dangerous. Or it could be as simple as not using a walking aid when you know you should be.

You may also not be aware you are putting yourself at risk.

Some habits may seem harmless but are a common cause of falling, e.g., not putting on seeing glasses, especially at night, when needing to go to the bathroom or reading something while walking, such as a magazine, mobile phone or tablet.

After many years of carrying out these tasks or habits, changing them can be difficult.

Moreover, being independent and self-sufficient throughout life, it isn't easy to rely on someone to now do jobs for you. We all want to know and show that we are still capable.

Sometimes you may know you should ask for help or want to ask for help, but the act of asking can be difficult. For many of us, asking isn't easy, and when we need to, it can be uncomfortable. You may feel that your requests could be silly, and you don't want to burden anyone or take up their time.

But there comes a time when you must do what's best for you and need to just swallow your pride…. If you need help with something, ask!

It takes little time for someone to change a light bulb for you, get some items from the top cupboard, or trim a tree branch every so often.

You don't want to fall doing something risky, and NO ONE wants something bad to happen to you. No one wants you to have a fall!

If you need help and want to ask, know it's ok. It isn't a loss of your independence, and you aren’t any less a person for not being able to do something and getting help.

You aren't a burden on anyone, and even if you are a slight burden on someone, WHO CARES!

You deserve the support for being there for others throughout your life, so put your feet up and enjoy watching someone help you for once.

DON'T BE AFRAID TO ASK FOR HELP!

OTHER OPTIONS - WHEN YOU DON'T HAVE HELP

If you live in a big city and have no one to ask for help or still can't shake the feeling you'll be a burden if you ask, you can speak to your doctor about what services are available to help you.

You can also get help through certain websites.

An example website is Airtasker (In Australia or UK). On these websites, you can pay reasonable rates to have someone do jobs for you.

You can put up absolutely any job you want to be done, such as painting your house, trimming a tree branch, or hanging a painting. Whatever!

Once you put your job up, people will give their offer, and you can then choose a suitable person.

There are different websites for different countries, so if you want a little help, search for a similar site in your country.

IT’S UP TO YOU TO CHANGE

Firstly, be aware of certain things you do that could put you at risk of falling.

If you know you are increasing your risk of falling by doing certain tasks or engaging in risky behaviours, make a conscious effort to stop or change these habits. One unexpected fall can make a considerable change to your life.

Take, for example, the glasses situation above. You may think it's not much of an issue not wearing your glasses at night. But it only takes one slip or trip from not seeing what's in front of you to cause a fall.

Start wearing your glasses at night and put them in easy-to-see and reach places like the top of your bedside table, so you remember to wear them.

Another example is reaching for items in hard-to-reach places like the top of your cupboard.

You may think standing on a chair is fine, although you've noticed your balance and coordination isn't as good as it once was. One moment of lapsed concentration, and you could fall off the chair. 

Put items currently in hard-to-reach places in easy-access cupboards (or get a friend or family member to place them there for you) or obtain a reach stick or step stool with a handle to be safe.

Think about tasks you are doing that could put you at risk and change them.

We will cover more of this in-depth in STEP 5: MAKING YOUR HOUSE FALLS PROOF.

RISK-TAKING & FALLS SUMMARY

• Eliminate the need to undertake risky behaviours and change habits to ensure you are safe.

• If you wear glasses, wear them, especially at night, and watch where you are going (and how you are moving).

• Improve your balance by taking steps to reverse the age-related decrease in your physical abilities.

• Don't be afraid to ask for help.

STEP 2: How To Exercise To Prevent Falls - The Best Exercise For Falls Prevention

Now that you're avoiding those things you do that could be putting yourself at risk, the next step…. and THE MOST IMPORTANT STEP, is to improve your physical abilities. 

The best way to do this is by increasing your overall activity levels and doing specific exercises to help prevent falls.

Not only will you decrease your falls risk by moving better, but you will also gain many other added benefits, including improved health and general well-being, looking and feeling younger and improved confidence.

It's never too late, or you are never too old to get active!

REMEMBER THIS: GETTING OLDER IS INEVITABLE; BECOMING FRAIL ISN'T!

As we get older, we must consider and accept factors out of our control. Changes in our body (physiological) do and will occur over time. We are never going to be like our much younger selves. We must accept this!

However, the main reason we see changes in our physical abilities as we get older is not because of the ageing process but because we do less as we age.

Common belief has it that "ageing" is the reason for these changes, but it's NOT!

Our life habits start involving less and less activity over time. As the years go on, we find ourselves sitting more and moving less. We find ourselves doing what's most comfortable and easiest.

With less movement and exercise, we start seeing a decline in physical abilities. 

As time goes on, the tasks you have always done become more difficult. It's also quite common to be worried about falling and getting injured, leading to further avoidance of activity. 

The decline in activity causes a decline in physical abilities over time!

The good news is: physical abilities can be retrained at ANY age!

This means that you can improve your physical abilities no matter your current capabilities or how old you are.

You just need to believe this and start getting active more so! And you don’t need to go it alone; a Physiotherapist can help!

If you start making a few changes, increasing your activity levels and exercise within your capabilities and progress over time, you WILL improve. You WILL get stronger, fitter and balance better!

You will begin seeing and noticing these changes.

Life will feel much more effortless!

Start exercising and start making improvements today!

When you improve your physical abilities, you want to focus on all aspects of physical fitness to help prevent falls.

The decline in physical abilities increasing the risk of falling and fall-related injuries, due to lack of activity and exercise, is illustrated in the diagram below.

View fullsize

Physical changes (risk factors) that can lead to a fall and injury.

HOW TO IMPROVE YOUR PHYSICAL CONDITION

[Note: Always speak to your doctor before starting any exercise program or coming to any conclusions about your health. I recommend you see a Physiotherapist for an assessment to determine your falls risk, areas to be worked on and for an individualised exercise program].

When you undertake physical activity, you can improve and maintain all of these aspects of physical fitness shown in the diagram above.

Anything caused by lack of use can be re-trained and improved. 

You can improve your physical abilities and therefore decrease your falls risk.

So let's get started.

STEP 1) GET MOVING

You may have heard me say that one of the first and most important steps we should take to improve our health and life is to increase the amount of physical activity we are doing.

The same goes for preventing falls. The first and most crucial step in decreasing our chances of having a fall - is to just get moving!

We must get off the couch and move our bodies more often.

MOVEMENT IS HEALTH! MOVEMENT IS MEDICINE.

Find a physical activity that you enjoy doing or would like to do! And begin doing more of it!

You do need to do some extra specific exercises each week to improve your balance, strength, coordination, flexibility, cardiovascular fitness and posture (which we will cover below). Eventually, you'll start enjoying these too. But for now, focus on just increasing your activity levels each week.

By doing enjoyable activities, you'll get better results than any exercise program you don't enjoy doing. When it's enjoyable, you'll keep it up! 

You'll get the results without the stress of doing something that feels like a chore and stick to it.

Consistency is the key, and enjoyable activities bring consistency.

Find an activity that excites you and get moving!

Some ideas: Walking in nature, swimming, playing with the grandkids more often, trying a new activity - Tai Chi, dancing, lawn bowls, bocce, ten pin bowling, tennis, aqua aerobics, golf, tennis, yoga, cycling. The ideas are limitless. 

Find the inner child inside you! Get outdoors and enjoy what mother nature has to offer. 

If you're stuck on choosing activities, I recommend walking every day for at least 10 minutes to start.

Have fun on your walk. Do different types of walks. Attempt different terrains. Walk up stairs, down stairs, walk on grass or in the shallows and sand of your local beach. Go on safe bush walks. Walk faster. Slower.

These different terrains train your body in different ways without you knowing it. 

You are training your heart which will make you fitter; you are training different muscles in your body, which will make you stronger (even the little ones that help with balance); you are ensuring your joints don't stiffen up. You are also training your body to respond to different terrains. All abilities, when improved, will decrease your falls risk.

You are also doing wonders for your stress levels and mind; over time, you will improve your confidence. 

Obviously, don't get carried away and do too much too soon and don't try anything out of your capabilities (no risky behaviours, remember). Always start small, but also challenge yourself a little and increase how much you walk or do the activity over time. Give time for your body to adapt to the exercise you are doing.

Take breaks. Don't wear yourself out or push yourself too hard. Ask a friend or family member to come along for safety and to have some company. 

Take your walking aid if you need to. Be smart, be safe AND most importantly, enjoy it!

Always think of ways to incorporate more activity into your life and keep moving!

STEP 2) GET SPECIFIC, STAY CONSISTENT AND ALWAYS CHALLENGE YOURSELF

Once you've begun increasing your physical activity levels by doing activities you enjoy, it's important to incorporate specific exercises into your life each week. This will further decrease your falls risk and improve your physical abilities.

Your program should include a wide array of exercises to improve your balance, strengthen your whole body (with particular focus on your legs), improve your posture, flexibility, cardiovascular fitness, body awareness, and reaction time. These exercises will also keep your bones strong!

Once you begin incorporating specific exercises into your weekly routine, the next step is to make gradual progressions (continually challenging yourself), so you will continue to improve.

Ways to progress your exercises include increasing the number of repetitions, increasing the weights you are using, walking longer distances or doing more challenging exercises.

If you are new to exercise, the best place to start is with my 4-week exercise eBook, which covers all you need to get started. For a FREE copy, join the More Life Health Mailing list (click to Join); by signing up, you’ll have many other exercise videos, articles and more.

For exercises specifically for falls prevention, click HERE.

You will also find beginner exercise videos on this page HERE.

I also cover exercises for seniors in videos on the More Life Health YouTube Channel, so be sure you subscribe to the channel. Also, join the Facebook Support Community if you have any questions and to help you on your journey.

Let's start working on each aspect of your physical fitness to help prevent falls.

THE BEST EXERCISEs FOR FALLS PREVENTION

BALANCE EXERCISES TO PREVENT FALLS

Decreased balance, or becoming unsteady on your feet, makes it more challenging to carry on with your activities of daily life, making it much harder to remain upright without falling.

A loss of balance is one of the main reasons people fall over. 

HOW OFTEN TO DO BALANCE EXERCISES TO HELP PREVENT FALLS

Improving your balance is essential to decreasing your falls risk. So it is imperative to perform specific exercises at least three times a week, ideally each day, to prevent falls.

Only five minutes each day of dedicated and focused specific balance exercises will do wonders in helping you prevent falls. 

To improve your balance,  CLICK HERE for all the balance resources you need.

Also, make sure to check out my in-depth article THE STEADY SENIOR - THE COMPLETE GUIDE TO GREAT BALANCE OVER 60 (CLICK TO READ), which will give you everything you need to test and help you improve your balance.

And CLICK HERE for THE 10 BEST BALANCE EXERCISES FOR SENIORS.

STRENGTH EXERCISES TO PREVENT FALLS

Loss of muscle strength, specifically in the legs, is another major factor causing one to fall.

To decrease your falls risk, you MUST increase your leg (and core) strength which will also make your day-to-day tasks much easier. We use our legs in almost every task we do.

HOW OFTEN TO DO STRENGTH EXERCISES TO HELP PREVENT FALLS

If doing strength exercises is new to you, you will start seeing a difference by completing them at least twice weekly. Progress to three times per week and then every day over time. 

If using weights, resistance bands or other types of strength equipment, it’s always better to keep a day in between to allow your body to recover.

To improve your strength, CLICK HERE for all the strength resources you need.

Also, check out my in-depth article THE STRONG SENIOR: THE COMPLETE GUIDE TO GETTING STRONG AND STAYING STRONG OVER 60 (CLICK TO READ) which will help you get and stay stronger.

And CLICK HERE for the 10 BEST LEG EXERCISES FOR SENIORS.

IMPROVING FLEXIBILITY - STRETCHES TO PREVENT FALLS

Decreased flexibility makes movement more difficult, changing the natural movement pattern, which can increase falls risk.

To decrease your falls risk, you also want to improve your flexibility. 

HOW OFTEN TO STRETCH TO HELP PREVENT FALLS

A simple 10-minute gentle stretch routine will do wonders to help you improve your flexibility and help you to feel better and will go a long way to help you prevent falls.

You will find 10-minute stretch routines on this page HERE - STRETCHES FOR SENIORS which also includes many other videos for stretches to help you prevent falls.

Also, check out my in-depth article THE SUPPLE SENIOR - REGAINING FLEXIBILITY AFTER 60 - A STEP BY STEP GUIDE (CLICK TO READ) to help improve your flexibility.

CARDIOVASCULAR FITNESS AND FALLS PREVENTION

With decreased fitness comes breathlessness and faster muscle fatigue. When you are more tired from the activity, you are doing and your muscles fatigue more quickly, this increases your risk of falling due to your inability to handle the demands that the task requires.

To improve your cardiovascular fitness, start slowly and progressively increase your activity levels AND begin doing the More Life Health exercise videos.

HOW MUCH CARDIO TO HELP PREVENT FALLS

To improve cardiovascular fitness, you want to exercise at least three times per week at an intensity that gets the heart rate up.

A simple way to know the intensity of the exercise you are undertaking you can use a Rating of Perceived Exertion (RPE) Scale.

To learn more about the RPE Scale, I cover this in the exercise section of my article: BETTER BREATHING: IMPROVING THE HEALTH OF YOUR LUNGS OVER 60 (CLICK TO READ).

A simple way to improve your fitness is regular brisk walks.

For more on walking and doing it safely, check out my article: ALL ABOUT WALKING: HOW TO WALK MORE WITHOUT PAIN!

TO DOWNLOAD and PRINT an RPE scale to use, you can do this HERE.

POSTURE EXERCISES TO PREVENT FALLS

Over a lifetime of poor postural habits and a lack of proper activity, changes in posture occur (such as rounded shoulders, forward head, etc.).

This change in posture changes your centre of mass, making it much harder to maintain balance.

To improve your posture, CLICK HERE FOR POSTURE EXERCISES and more to help you improve your posture, which can help you prevent falls.

Aim to incorporate these exercises into your exercise routines at least three times per week to see improvements.

OTHER FACTORS OF PHYSICAL FITNESS TO IMPROVE

REACTION TIME EXERCISES AND FALLS PREVENTION

When younger, if something unexpected happened, e.g., you were to step on uneven ground, you were bumped accidentally, or something like a cat or dog would get between your feet - you could react much more quickly. Your body would unconsciously react and undertake the required movements to respond to these unexpected situations.

If we do not continue to move sufficiently as we get older, the messages sent from our senses to our brain to evoke a response - become much slower and hence a slower reaction time. This means a higher chance of falling due to the inability to react, as required, to external situations.

PROPRIOCEPTION AND FALLS PREVENTION

Proprioception is the ability to sense or be aware of where our arms and legs are in space. Take, for example, lifting your foot to clear an obstacle on the floor but thinking your foot was much higher than what it actually was. This can cause a trip hazard.

Over time, this awareness can decrease, making it more challenging to know where our arms and legs are in regard to our environment; this can increase the risk of having a fall.

Your reaction time and proprioception will improve as you stay consistent with the exercises.

BEING OVER/UNDER WEIGHT AND FALLS PREVENTION

When we do less activity and consume excess calories, we'll put on weight (usually fat).

On the other hand, and less commonly, some people may lose weight from a lack of activity and calories. In an already frail person, this can cause many issues.

Being overweight or underweight can put you at a higher risk of falling. When overweight, movement may be more difficult, fatigue levels increase, and balance may decrease.

When underweight, there is usually a loss of strength and muscle mass, leading to a higher falls risk. There is also a higher chance of a fracture during a fall.

To maintain as close to optimal weight as possible, exercise and nutrition is essential. Stay consistent with the exercises and speak to your doctor or a nutritionist to get you started on a healthy diet to help.

BRITTLE BONES AND FALLS

This is not so much a contributor to falls but more a reason why injuries are more severe following a fall.

Healthy and strong bones decrease the chances of fracture following a fall.

For more on improving bone density, check out my three-part article on healthy bones, THE COMPLETE GUIDE TO STRONG BONES OVER 60 (PART 1).

HOW MUCH EXERCISE TO PREVENT FALLS

After reading this section, you may be a little overwhelmed at all these different components of fitness and what’s recommended to improve each component to decrease your risk of falls.

Keep it simple so you don’t get overwhelmed. It will all start making sense as you stay consistent and dedicate time each week to completing exercise.

I recommend completing exercises at least 3-4 times a week and aim to do at least 20-30 minutes on these days. 

Always start slow and gradually increase the amount you are doing. Always give your body adequate rest between sessions.

And stay consistent. This is not a sprint! Treat movement as medicine for your body. Something you should be doing each week, without fail!

You can do it!

PHYSICAL EXERCISE AND FALLS SUMMARY

• Being active and doing exercises is the most important step you can take to decrease your risk of falls.

• Increasing your weekly physical activity is the first step to improving your physical capabilities.

• The second step to decreasing your falls risk is doing specific exercises.

• The third step is staying consistent and slowly progressing your exercise over time.

• For exercises specifically for falls prevention, you will find them on this page HERE.

• To make it easier for you to keep exercising, join the More Life Health Support Community and the More Life Health mailing list for a FREE 4-week exercise ebook to help get you started and regular workouts, health tips and more sent to your inbox.

• For generalised exercise videos that cover all components of fitness, head to the Exercise section of the More Life Health website, which offers an array of exercises to get you started and keep you going.

• I also cover exercises for seniors in YouTube videos on the Facebook page. So make sure you subscribe to both.

• Following these workouts and increasing your physical activity will decrease your falls risk. Plus, give you many more added benefits that come with exercise.

STEP 3: IMPROVE YOUR VISION AND HEARING TO PREVENT FALLS

The next step in preventing falls is to ensure your vision and hearing are the best they can be.

I'm sure it is no surprise that low vision increases falls risk. A little more surprising, however, is that hearing loss can increase falls risk also.

Both vision and hearing decline as we age. However, the good news is that there are ways to improve your sight and hearing which will decrease your falls risk.

VISION LOSS AND FALLS IN SENIORS

There are many causes of low vision as we age; the good news is, in most cases, the causes are treatable. They can be fixed!

A significant cause of vision-related falls is cataracts which, after surgery, can improve vision and decrease falls risk.

Another cause of vision-related falls is wearing bifocal and multifocal/progressive glasses (glasses with different focal lengths in the same pair). Falls due to this issue are even seen in people who have worn these glasses for a long time.

However, this does NOT mean you need to immediately obtain single-vision glasses and throw away your multifocal ones!

Although the data is clear on this issue, the solution is not so straightforward and is dependent on several factors, e.g., your general health and mobility; if you have fallen in the last year; how often and where you use your glasses, particularly outside the home and if you have any problems with steps or stairs [1]. Based on these factors, you and your optometrist may decide that having an additional pair of single-vision glasses for use outside the home and/or on stairs may reduce your falls risk [2].

Bifocals, multifocal and reading glasses can impair the ability to see the distance between objects (aka depth perception) and the ability to distinguish two similarly coloured objects between each other or their environment (aka our contrast sensitivity).

When depth perception decreases, it is more difficult to know how far away items are. This makes it hard to navigate surroundings and increases the likelihood of bumping into objects, such as furniture or walls.

Additionally, depth perception allows us to determine how fast an object moves toward us. Think about how important this is when crossing a road or driving a car.

Decreased contrast sensitivity, on the other hand, makes it difficult to distinguish between objects. For example - trying to see a dark object in a dimly lit room or when stepping down from a curb/pavement when the pavement is the same, i.e., the contrast is poor between the curb and the street.

Or walking down a whole flight of the same coloured steps - with a decreased ability to differentiate the contrast of the steps, the stairs may start blurring together.

These three common tasks become difficult with a decline in contrast sensitivity.

FALLS HAZARD: With poor contrast sensitivity, stairs like this become hard to differentiate.

SAFER STAIRS: Easier to differentiate, and with grip to help avoid slips.

MORE TIPS FOR DECREASING FALLS RISK & VISION

Get a yearly check-up by an optometrist to make sure there you don’t have any underlying eye issues.

As said earlier, the majority of low vision issues are treatable. For more on healthy eyes, make sure to read my article: HOW TO CARE FOR YOUR EYES AFTER 60.

Keep in mind that when you receive new glasses or a change in your lens prescription, your risk of falls increases temporarily.

Objects may now appear smaller and further away than they are, or it could be the opposite effect and objects now look bigger and closer than they are. This magnification can change the way you walk and can make it difficult on stairs.

If you have been given a new pair of glasses, or have new lenses, be aware that it may take some time to get used to them. It’s a good idea to wear them in a familiar place first, i.e., your home, before going into unfamiliar territory. Be patient and allow your eyes to adapt.

If you wear bifocal or multifocal glasses and spend a lot of time in outdoor activities, or in unfamiliar settings or have difficulty with steps/stairs it’s a good idea to speak to your optometrist about supplying a pair of single-vision glasses [3]. This is an effective way to help prevent falls.

To further optimise your vision with the help of an optometrist, there are certain alterations you can make around the house to help you see hazards and decrease your falls risk. We will cover this further in step 5 (Making Your House and Yard Falls Proof).

VISION LOSS AND FALLS SUMMARY

• The majority of the causes of age-related low vision are treatable.

• Aim to see an optometrist at least yearly.

• Bifocal, multifocal and reading glasses increase falls risk.

• Single vision lenses are an effective way to help prevent falls outdoors, on steps or stairs and in unfamiliar environments.

• New glasses take a while to get used to. Wear your new glasses in familiar places first.

• Ensure adequate lighting in low contrast areas such as stairs.

HEARING LOSS AND FALLS IN SENIORS

Many Health Professionals dismiss poor hearing for playing a part in falls, and 95% of the material for preventing falls neglects hearing loss as a point of focus.

However, hearing loss can play a role in putting you at risk of a fall.

In a 2012 study, researchers determined that even a small loss in hearing (from no hearing loss to mild hearing loss) can TRIPLE the risk of having an accidental fall. This risk increases with more significant hearing loss, making hearing loss a risk factor that must not be ignored.

When hearing is lost, a whole lot more energy is used up dealing with the added stress hearing loss places on someone. Fatigue sets in much sooner, making it more challenging to maintain balance and the adequate strength required to respond if needed.

Furthermore, with decreased hearing, not having the full ability to stay aware also increases the risk of falling.

HOW TO DECREASE FALLS RISK FROM HEARING LOSS

Improving your hearing can help you prevent falls.

The first step is to get your hearing checked regularly (every two years) by an audiologist.

If diagnosed with hearing loss, hearing aids most likely work to prevent falls in addition to other benefits, e.g., improved communication, health and quality of life [4, 5].

If you have hearing aids, make sure you wear them and make sure you regularly clean and service them. If you have difficulties doing this, get a friend or family member to help you.

HEARING LOSS & FALLS SUMMARY

• Even a slight loss in hearing can dramatically increase the risk of falls.

• Hearing loss places extra physical and mental stress on you and decreases your ability to respond to your environment.

• Wearing hearing aids can improve balance and decrease falls risk.

• Make sure to regularly clean and service hearing aids

STEP 4: The Best Shoes to Prevent Falls and How To Take Care Of Your Feet

Do you ever take the time to look after your feet?

Or, have you ever stopped to think if your shoes could be putting you at risk of having a fall?

It’s a good idea to understand how the shoes you are wearing (and the health of your feet) could put you at risk of falling and how to provide your feet with some care to help prevent falls.

SHOES AND FALLS RISK IN SENIORS

The quality of your shoes and particular shoes can play a big part in increasing falls risk. 

The characteristics of a shoe which could be putting you are risk of falling are:

WORN, LOOSE OR BACKLESS SHOES/SLIPPERS

Worn or shoes stretched out of shape become a slip and trip hazard. When they become like this, you should replace them.

If your shoes are too big for your feet, or you spend a lot of time in your slippers or backless shoes, these shoes can slip off your feet, becoming a trip hazard and increasing your risk of falls.

THONGS (AKA FLIP FLOPS OR JANDALS)

In Australia, we call footwear like the below picture thongs.

In other parts of the world, they are called flip flops (USA) or jandals (NZ). And I am sure they have different names in different parts of the world.

If you're anything like me and love wearing thongs (the type that goes on your feet) during summer, you must know that these can be difficult to keep on your feet at times and can trip you up.

Safer alternatives are sandals with a velcro back strap, or buckle, which will allow you to move around freely and keep them on your feet.

Flip Flops (thongs) - a trip hazard

Safer alternative to flip flops (with fasteners)

SHOES WITH SOFT OR WORN SOLES

Shoes with worn or soft soles can cause slips, especially in wet weather. 

If the soles of your shoes are worn thin or soft, get them re-soled or purchase a new pair.

HIGH HEELS OR PLATFORM SHOES

When wearing high-heeled shoes, there is less contact with the shoe to the ground. This makes you less stable and puts you at a higher risk of falling.

Some women find it hard to let go of wearing high-heeled shoes, but these shoes are not suitable for your feet, and by wearing safer shoes, you can decrease your falls risk.

Worn soles can cause slips

A falls risk, for obvious reasons

Replacing potentially unsafe shoes with safer shoes will go a long way in keeping yourself from falling.

When purchasing a new pair of shoes, it's a good idea to buy a pair of shoes that protect you from having a fall. So let's now look at what makes up a safe shoe to help you prevent falls.

View fullsize

What Makes a Safe Shoe

• Firm heel cup - to improve stability while walking.

• Laces, buckles or Velcro fastening - Hold the shoes to your feet, avoiding any tripping hazards. Velcro or clips are best for those with decreased hand or finger dexterity.

• Firm but thin soles will give your brain great feedback when walking as it allows your feet to 'read' the underlying surface.

• Textured sole/tread to prevent slipping.

• Correct length to allow normal foot function.

• Low and wide heel to increase contact with the ground.

• Bevelled heel to prevent slipping.

• Wide toe box - If you suffer from bunions or pain in the ball of your feet, a wider toe box (the section where your toes sit) can give your toes the room they need. This will provide greater comfort and can decrease falls risk.

Now I know these shoes won't always be as pleasant on the eye as other shoes, but they'll go a long way to keeping you on your feet.

OTHER FOOT-RELATED FACTORS THAT CAN CONTRIBUTE TO A FALL

Besides your footwear, other factors related to your feet could put you at risk of falling.

BARE FEET AND SOCKS 

Bare feet and wearing socks make you more prone to slipping than with shoes on. 

As we age, the grips on our feet can decrease.  

If you’re at risk of falling, wear footwear with appropriate tread to help prevent slips

If you want to wear socks, grab some non-skid socks, which will help stop you from slipping. 

ENSURE APPROPRIATE FOOTWEAR  

Get into the habit of wearing appropriate and safe footwear for the type of activity you are doing. 

CERTAIN FOOT CONDITIONS 

Pain, decreased sensation, claw toes, bunions and ingrown toenails can increase your risk of falling by changing your gait and affecting your balance. 

If you have any of the above issues, see your Doctor or Podiatrist, who can help eliminate and manage these foot conditions. A podiatrist can also fit you with appropriate shoes.

SIMPLE FOOT CARE ROUTINE FOR SENIORS

In addition to ensuring proper footwear and taking care of any conditions of your feet, you can improve the health of your feet to decrease your falls risk by undertaking simple foot care each week.

Here are some ways to help take care of your feet.

• Inspect your feet and nails every week.

• Cut your toenails regularly, or book in with a Podiatrist who can do this for you. (If you have a nail condition, a Podiatrist may be required to cut your nails).

• Wash your feet using a mild soap daily.

• Always dry your feet thoroughly after showering or sweating to prevent infection.

• Apply a good quality moisturiser to keep the skin on your feet healthy and prevent any dry, itchy or cracked feet.

• Wear appropriately fitted shoes with the features of a safe shoe (see diagram above).

• Wear good quality, breathable socks.

• Book and attend regular Podiatrist visits, if required.

SHOES, FOOT CARE AND FALLS PREVENTION SUMMARY

• Particular shoes can put you at risk of falling.

• To decrease your risk of falling, wear shoes that can reduce your risk and keep your feet healthy.

• Walking without shoes, wearing socks without grip, and conditions of the feet can increase your risk of having a fall.

• Following a simple foot care routine, like the one above, can decrease your risk of falling and keep your feet healthy and looking good.

• Regular appointments with a Podiatrist can help keep your feet in good condition, and they can advise on appropriate footwear for you.

STEP 5: Simple Changes To Make In and Around Your Home to Prevent Falls

PREVENTING FALLS IN THE HOUSE AND YARD

It's now time we focus on making the environment you spend most of your time safer.

We will now identify hazards in and around your house that could put you at risk of falling.

We will then get into ways to eliminate the risk, decreasing your chances of having a fall.

Some of these tasks listed below will be too difficult to undertake on your own, so help will be required. Additionally, your doctor may be able to organise an Occupational Therapist to assess your home and help make the appropriate changes to decrease your falls risk, so speak to your doctor about this.

FALLS HAZARDS IN THE HOME

Before we go into specific risk factors common around homes and backyards, I want you to remember an acronym to help you be aware of environmental risk factors that could put you at risk of a fall.

That is, F.L.A.T.S.

FEET – Your feet could be putting you at risk of a fall. Wear appropriate footwear (see step 4) to ensure you don't fall. 

If you like to wear socks, make sure they are non-slip socks and know that wearing no shoes on certain surfaces could increase your risk.

LIGHTS – Take extra care in low light areas and remember to put on your glasses, especially at night. (see step 3).

ACTIVITIES (RISKY ACTIVITIES) – Rather than performing behaviours that could be risky – ask for help (see step 1).

 Specific assistive devices can help you with certain tasks while decreasing fall risk. (Step 9).

TRIPS – Remove clutter and keep your house clear of trip hazards such as toys, rugs and cords. 

If you have one or more pets, always be aware of their whereabouts (discussed below).

SLIPS - Consider using non-slip products to remove risk in slippery areas. Mop up any spills quickly (the main areas of concern are your bathroom and kitchen).

We'll now get into the specific fixes you can make around the house to decrease your falls risk.

PREVENTING FALLS IN THE HOUSE

KEEP WALKWAYS TIDY AND FREE FROM TRIP/SLIP HAZARDS

• Check that all carpets or rugs are fixed firmly to the floor so they won’t become a trip hazard. Don’t use throw rugs or small area rugs as they are a known trip hazard.

• Remove or fasten loose electrical and telephone cords. Keep them away from walking paths. Use cable covers to cover loose cables that cannot be removed or secured (see next section).

• Remove clutter -Always tidy up toys, paper, books, clothes, shoes etc., keeping them out of walking paths.

• Your animal could be a potential trip hazard. Always keep a lookout for your pets and stay aware of their whereabouts when walking.

• Put non-slip strips on tile and wooden floors. These can be bought at your local hardware store.

• Arrange your furniture, especially low coffee tables and other items, so they are not a potential trip hazard.

• Keep off newly washed floors. Allow them to dry.

• Wipe up spills as soon as they occur.

• If there is broken glass, clean it up immediately.

ELIMINATE THE NEED TO UNDERTAKE RISKY ACTIVITIES/TASKS

• Keep those items you often use in easy-to-reach places or cupboards.

• Use a “reach stick” to get items in hard-to-reach places.

• Never stand on a chair, table or step ladder to get those items in hard-to-reach areas.

• If you need to use a stool to step on, make sure it is sturdy with a handrail (see next section).

• If you need to perform a task that could be putting you at risk of a fall, ensure you have someone to assist for safety reasons. Remember: it’s ok to ask for help (see step 1).

• Ensure that your couch or your chairs are not bucket-style, making it difficult for you to get in and out. Your couch and chairs should be the right height for you to easily get in and out of.

• As mentioned earlier, one of the most common places to fall is next to the bed when needing to move around at night (usually having to go to the bathroom in the middle of the night). Have light switches/lamps, telephone, your seeing glasses and mobility aid (if required) close to your bed to decrease your risk of falling in this situation.

ENSURE YOU CAN SEE WELL AT ALL TIMES

• Avoid walking in the dark. Ensure there is adequate lighting in all places throughout your house and backyard.

• Use night lights and consider motion-sensor lights.

• Remember to wear your glasses at all times, especially at night. Put them on if you wake after sleeping and need to get out of bed.

• Remember to use the lights and ensure the switches are in easy-to-reach places.

• If lighting is poor, take extra care.

• Do your best to avoid walking in the dark.

WEAR APPROPRIATE FOOTWEAR

• See previous step (step 4) above.

PREVENTING FALLS IN THE BATHROOM (& KITCHEN)

ELIMINATE SLIP HAZARDS

• Wipe up spills quickly.

• Place non-slip mats in areas that are commonly wet. Consider using a non-slip mat or strips in the shower.

• If using rugs on tiles, consider non-slip underlay or non-slip rugs.

• Use FIRMLY FIXED grab rails on the inside of your shower, bath and near toilets. DO NOT use suction cup grab rails; these can be dangerous. Over time they may be unable to withstand the force placed upon them and become unstuck.

• Keep the thermostat of your water heater set at 50 degrees Celsius (120 Fahrenheit) or lower to avoid scalding your skin and a frenzied reaction to the heat.

• Place a night light in your bathroom.

• If you have difficulty getting off the toilet, use a toilet seat riser to make it easier to get on and off.

PREVENTING FALLS ON STAIRWAYS

MAKING CHANGES TO YOUR STAIRWAYS TO PREVENT FALLS

• Place handrails on at least one side of the stairs, preferably both sides. Handrails should extend the whole length of the staircase and beyond the first and last steps.

• Ensure handrails on the stairs are tightly fastened.

• Ensure stairs are free of clutter or trip hazards at all times.

• Ensure adequate lighting in stairways. Improve the lighting on your stairs.

• If you have difficulty distinguishing your steps from one another, even with good lighting, place brightly coloured tape on the steps for improved contrast.

• Hold the handrails when going up and down stairs.

• When carrying objects while moving up and down stairs, hold on to the object with one hand and use the handrail with the other.

• Don’t let what you are carrying block your view.

• Improve your leg strength and muscular endurance if you have difficulty walking stairs.

PREVENTING FALLS IN YOUR YARD

Falls occur more frequently outdoors than indoors (1).

Being outdoors is something everyone should be enjoying; however, the outdoors presents potential hazards.

There are trip hazards, possible slip hazards, different terrains, uneven footpaths, gravel, and possible holes (some hidden from view). There are curbs to step up, cars, bikes, streets to cross, different-sized steps, and kids on scooters or balls being kicked about. These are some of the many potential fall hazards!

It's always important to be alert when outside and take extra care.

HOW TO PREVENT FALLS IN THE YARD

ELIMINATE SLIP HAZARDS

Keep garden areas and backyard free from moss; it is slippery. 

If certain areas of your yard are known to get wet and slippery (for example, your pool area), consider non-slip sealers for the tiles or place non-slip strips or mats around the pool area.

ELIMINATE TRIP HAZARDS

Look out for and eliminate any loose pavements, pots, toys or other trip hazards (such as exposed tree roots or backyard items).

TAKE CARE WHEN ON STAIRS

Examine your outdoor stairs and decide if any of the tips for altering indoor stairs (mentioned above) are required to prevent falls.

USE THE RIGHT ASSISTIVE DEVICES

Sometimes a walking aid may not be required when indoors, but when outside, due to the inconsistencies and unfamiliarity, one may be required.

Take a walker or walking stick (if required) to increase your confidence, help with balance, improve your walking and decrease your falls risk when outside.

WEAR APPROPRIATE FOOTWEAR WHEN OUTSIDE

See previous step (step 4) above.

STEP 6: Be Aware of Health Conditions and Medications that put you at risk of falls

HEALTH CONDITIONS AND FALLS PREVENTION

The next step in preventing falls is knowing how specific health ailments, medical conditions, and medications can put you at risk of falling.

By being informed and understanding the risks, you can take preventive measures to ensure you prevent falling the best you can.

HEALTH AILMENTS & MEDICAL CONDITIONS

Certain medical conditions can increase falls risk.

These medical conditions include Parkinson's disease, dementia, arthritis, osteoporosis, diabetes (impacting the sensation in feet), postural hypotension (drop in blood pressure when standing resulting in dizziness and/or fainting unexpectedly), foot problems, incontinence, vision and hearing loss.

Additionally, if you feel under the weather with a cold or flu (or other viruses) or are in pain, you are at a higher risk of falling.

In this section, I will be covering the most common:

• COLDS & FLU AND FALLS

• INFECTION AND FALLS

• PAIN AND FALLS

• DIZZINESS/VERTIGO/LIGHTHEADEDNESS/POSTURAL HYPOTENSION AND FALLS

• INCONTINENCE & FREQUENT URINATION, AND FALLS

• MEDICATIONS AND FALLS

COLD & FLU AND FALLS

When we get sick or are feeling under the weather, we are usually much weaker, our balance may be off, our muscles ache, and we may also experience dizziness.

This makes it not surprising that the incidence of falling is increased when sick with a cold or the flu.

When we are sick, our body is sending warning signals, letting us know it's not well and needs rest and recuperation to get back to good health.

It's the most crucial time to give our body the care it requires to ensure we get back to good health as soon as possible.

By this, I mean eating well, staying hydrated, getting sunlight, staying stress-free and resting up!

Besides small amounts of gentle walking and stretching, which will make you feel better; everything else can wait!

When you have a cold or flu, this isn't the time to be pushing yourself to continue with all the exercise and physical activity you've been doing or get into some heavy chores. Save this for when feeling better.

Understand that your falls risk increases when sick with the cold and flu.

Take caution, be patient, rest up and once feeling better, you can get back into your usual activities like you were once doing when not feeling under the weather.

INFECTION AND FALLS

Another health ailment that can hit unexpectedly and put us at risk of falling is infections.

The effect an infection can have on us as we get older usually comes as quite a surprise.

We think a minor infection, although important to get treated, is not such a big deal. We can just go to the doctor and take some antibiotics, which will take care of it.

However, among other symptoms, infections can lower blood pressure and cause dizziness and lightheadedness, all of which increase the risk of a fall.

This goes for ALL people. Although infections increase as we age and in those with dementia, these symptoms also occur in people under 65 [1].

The most common type of infection that leads to a fall is a urinary tract infection (UTI) [1]. This infection is most common in women, and susceptibility increases with age.

If you're feeling under the weather, it's always best to see your doctor and get checked for any infection. Know that if you do have an infection, you're at a higher risk of having a fall, so take extra care until the infection has subsided.

Healthy habits, exercising and eating well decrease the chances of infection. Keeping your pelvic floor muscles strong will also aid in helping to reduce recurrent UTI infections.

PAIN AND FALLS

Being in pain also increases your risk of having a fall. Pain can either be short-term from a recent injury or surgery (aka acute pain). 

Or pain can also be long-term. Pain that has been with us for some time (aka chronic pain). Common chronic conditions that can cause pain over the long term could be osteoarthritis or osteoporosis.

When we are in pain, our bodies don't work like they are supposed to, and our bodies compensate in certain ways to avoid aggravating the painful areas.

ACUTE PAIN

When dealing with an acute episode of pain, it is another instance of your body trying to protect the area. What's required is resting the area, utilising any pain-management techniques and providing adequate nutrition to allow the body's tissues to heal.

As per your doctor, analgesia may be required, at times, to manage pain. If taking medication for pain, know that certain analgesia medications, especially the stronger ones, may have side effects which put you at an even higher risk of falling.

Speak to your doctor about this and, if taking medications, have greater awareness and take extra care during this time.

CHRONIC PAIN

On the other hand, for chronic pain or pain that has been with you for some time, REST is not the answer and a different holistic approach is required to get your pain under control. It can be done! Don't believe anyone who says you have to just put up with the pain; there is always something that can be done to help you with your pain symptoms.

For more about pain and to help you overcome it, read the four-part pain series here. 

PAIN IS NOT AN INEVITABLE PART OF AGING. YOU DO NOT HAVE TO BE IN PAIN

By getting your pain under control, your chances of having a fall will decrease.

DIZZINESS, VERTIGO & LIGHTHEADEDNESs AND FALLS

Vertigo is a type of dizziness, which is the feeling that your head or the room is spinning, or lightheadedness, which is the feeling that you are about to faint. Vertigo has a rotational element. Lightheadedness has no rotational element.

As we age, our body systems lose effectiveness. This leads to disrupted sensation, balance and visual inputs to our Vestibular System (system of the inner ear). This system is responsible for helping us stay standing.

When this system is not working as it should, dizziness or vertigo can develop and the risk of falling increases.

Although many different medical conditions can cause dizziness, the leading cause is disorders of the inner ear, with Benign Paroxysmal Positional Vertigo (BPPV) being the most common cause. The good news is this condition is treatable [2].

Additionally, the effects of anxiety and depression and making changes in your life (e.g., taking new medications or wearing new glasses) may lead to dizziness, and further increase falls risk [3].

As mentioned earlier, this is not normal, and the underlying cause of the dizziness must be found and eliminated. Speak to your doctor, so the underlying issues are determined and treated.

By working with your doctor, or other specialists, to help treat dizziness, your risk of falling will decrease.

POSTURAL HYPOTENSION AND FALLS

Postural hypotension is caused by a drop in blood pressure when moving from lying down or sitting to standing. Due to this drop in blood pressure, dizziness or even fainting can occur, putting one at risk of falling.

If you have experienced these symptoms before, see your doctor immediately to get to the cause of this low blood pressure.

Always take your time when standing from a seated or a lying position. Never rush straight into walking.

Stand up. Take a few deep breaths, and assess how you feel before slowly walking.

For any cases of dizziness, you may require a mobility aid for safety when getting about.

INCONTINENCE AND FREQUENT URINATION

Problems with bowel and bladder control can impact the ability to stay active, healthy and independent.

Urinary incontinence (or when the bladder lets go) is a falls risk, and the following factors can cause this:

INCREASED RUSH COMBINED WITH DECREASED PHYSICAL ABILITIES

With decreased physical abilities such as poor balance, poor vision (especially at night), decreased lower limb strength and/or poor walking ability, reaching the toilet in time when needed may be challenging. Reduced physical abilities combined with the need to rush to the bathroom is a fall waiting to happen.

Additionally, with age, hand and finger function may decrease. This makes tasks, such as removing clothing for the toilet, more difficult; increasing the need to rush to get to the bathroom in time and the high possibility of making risky moves in this frantic movement.

On the other hand, you don't want to get caught in the cycle of doing less activity and being less social to avoid an embarrassing situation. Doing this leads to further loss of physical abilities and additional problems.

MEDICATIONS FOR INCONTINENCE

Some medications used to treat incontinence can cause postural hypotension, a factor that can cause a fall. 

NEEDING TO GO TO THE TOILET AT NIGHT

Waking at night to go to the toilet puts you at higher risk due to the darkness, and it can also result in inadequate sleep, which is also associated with increased fall risk.

STRATEGIES TO REDUCE FALLS RISK FROM INCONTINENCE, FREQUENT URINATION & FALLS

• Familiarise yourself with the strategies above and start actioning them.

• Strengthen your pelvic floor muscles.

• If incontinence is becoming an issue for you, speak to a doctor, continence advisor or specialist.

• Improve your physical abilities (walking, strength and balance).

• Improve your hand and finger function.

• Do not avoid life. Keep socialising and continue with your normal daily activities.

• Wear clothes that are easy to remove or get undone.

• Use pads to avoid any embarrassing situations.

• Keep the pathway to the toilet obstacle-free and leave a nightlight in the bedroom/bathroom at night.

• If you wear spectacles, make sure you put them on at night when waking to go to the bathroom.

• Take your time when going from lying/sitting to standing. Take deep breaths, and get your balance before moving.

For more on the pelvic floor, including pelvic floor dysfunction, managing incontinence, and pelvic floor strengthening exercises, read THE OVER 60s GUIDE TO THE PELVIC FLOOR & HOW TO STRENGTHEN THE PELVIC FLOOR.

MEDICATION AND FALLS

Another area regarding falls risk that needs to be covered is the medications taken.

There are two factors regarding medications and falls risk that require caution.

The first and the most risk factor is too high an initial dose when starting a new medication. When this is the case, the side effects could impair your physical abilities and give other unwanted symptoms increasing your risk of falling.

The second is the number of medications you take. Even taking just one medication may increase your risk of falling. This risk increases with each medication you take, and taking more than four medications raises your risk significantly [4].

REDUCING FALLS RISK & MEDICATIONS

The risks of falls can easily be minimised by being very careful when starting a new medication and taking extra care until you see what effect the medication will have on you.

If you take four or more medications or any medications for sleeping issues, depression or anxiety, speak to your doctor. Discuss having your medication reviewed and gradually reduced/discontinued to non–pharmacological alternatives if this is possible.

Natural/non-pharmacological alternatives to medications for sleeping issues, depression and anxiety include:

• Getting more exercise/physical activity (step 3).

• Getting your sleep habits in order (step 8).

• More time spent on relaxation and mindfulness. Find what works for you to help you relax (step 9).

• Getting support and reassurance – speak to family members and friends more often.

HEALTH AILMENTS, MEDICATION AND FALLS RISK SUMMARY

• Specific health ailments and medical conditions, both acute and chronic, can put you at risk of falling.

• Proper caution should be taken when unwell, and strategies to minimise the effects of each health ailment or medical condition should be undertaken.

• Your doctor should discover the root cause of your health ailments so they can be treated sufficiently and your falls risk decreased.

• More than one medication and certain medications can increase your falls risk.

• If you take four or more medications or any medications for sleeping issues, depression or anxiety, speak to your doctor. Discuss having your medication reviewed and gradually reduced/discontinued to non–pharmacological alternatives if this is possible.

STEP 7: DECREASE YOUR FALLS RISK WITH GOOD NUTRITION

(Your SIMPLE GUIDE TO NUTRITION, CALCIUM, VITAMIN D, ALCOHOL AND THE EFFECT OF NUTRITION on FALLS)

It's important now we discuss nutrition and how we eat can improve our health and can also play a role in preventing falls.

We know that what we eat is very important for general health. But these same effects that good nutrition has on our health also decrease our chances of having a fall.

Healthy eating keeps our muscles strong, our minds alert and also gives our bones the nutrients they need to stay strong.  

When we increase our physical activity and exercise, our metabolic demands increase. What this means is we should ensure we are getting adequate nutrition.

We want the nutrients required to keep us healthy and the energy to fuel our body, undertake daily activities and help make us stronger and healthier versions of ourselves.

Nutrition is a large and complex topic. Learning what's required to improve your life can take some time, but when you do and put what you have learnt into action, you will see the results. 

I have written some simple-to-read articles on nutrition over the years and given guidelines to help you keep healthy and help decrease falls.

NUTRITION & PREVENTING FALLS

To get started with a basic understanding of nutrition, make sure to read my article: 

• A VERY QUICK INTRODUCTION TO NUTRITION FOR SENIORS: LEARNING THE BASICS.

Once done, also make sure to read my other articles:

• HEALTHY EATING FOR SENIORS: HOW TO BEGIN EATING HEALTHY - THE FIRST STEP [PART 1]

• HEALTHY EATING FOR SENIORS: HOW TO BEGIN EATING HEALTHY - THE FIRST STEP [PART 2]

And check out the Nutrition/Healthy Eating section on the More Life Health website.

There are also some vitamins and minerals (micronutrients) that aid in keeping your bones strong and can help with falls prevention.

CALCIUM AND FALLS PREVENTION

One of those is calcium.

Calcium is important in preventing falls, keeping your muscles strong, helping you move more efficiently and maintaining your bone strength.

For more on calcium, make sure to read my article on this important mineral here - CALCIUM IN OLDER ADULTS: HOW MUCH CALCIUM SHOULD YOU GET?

Another essential nutrient in preventing falls and keeping us strong and balancing well is vitamin D.

VITAMIN D AND FALLS PREVENTION

We make vitamin D when our skin is exposed to the sun. As we age, we tend to spend less time in the sun, especially in the winter months, making vitamin D deficiencies prevalent in seniors.

Vitamin D is essential for bone strength, muscle function, and preventing falls.

It assists in preventing falls by improving postural balance, improving movement and aiding in propelling and helping with navigation abilities during walking [1].

Aim to get 20 minutes of direct sunlight daily, avoiding the hottest part of the day. Make sure not to overdo it and burn your skin.

By getting a healthy amount of sun, you will keep your vitamin D levels topped up, helping to keep your muscles and bones strong, improve your balance and decrease your falls risk.

Some foods do also contain vitamin D in small amounts. These foods include oily fish (tuna, salmon, herring and mackerel), egg yolks, liver and some fortified products. If you live in a part of the world where it is difficult to get sun during winter, do your best to consume more foods containing vitamin D.

A common question I am often asked is: Should I supplement with Vitamin D plus calcium?

It has been shown that Vitamin D plus calcium supplements reduce fracture incidence, including hip fracture, following a fall [1]. I recommend getting your vitamins and minerals from real food, but supplements can help if your diet lacks these minerals.

Suppose you feel your diet may lack good nutrition and/or you may not be getting adequate vitamins and minerals (including vitamin D and calcium). In that case, I recommend you see a qualified nutritionist or your doctor for assistance.

I also cover more about calcium and magnesium and their role in stronger bones in PART 2 - THE COMPLETE GUIDE TO STRONG BONES OVER 60.

ALCOHOL AND FALLS PREVENTION

Finally, regarding what we put into our bodies and falls, I want to add some information on alcohol and its effect on falling.

Most of us enjoy a drink or two (maybe more), and it would be common sense to think that increased alcohol would put us at risk of falling.

And this is true!

However, there is evidence that light alcohol consumption may decrease your risk of falling.

I’ll explain the reasons why this could be:

Light alcohol consumption can increase confidence, help relieve stress, lift mood and is usually done in the company of others. All these factors have been shown to DECREASE falls risk.

Increased confidence in doing tasks usually equates to improved performance; thus, falls risk will decrease.

So there is little reason why you have to stop enjoying a few drinks to prevent falls.

Overconsumption of alcohol, however, will put you at an increased risk of falling. Excess alcohol consumption disturbs balance and affects judgement, and when under the influence, you may put yourself in risky situations that could lead to a fall.

These are the times that we need to take caution. 

Excess consumption of alcohol is not conducive to good health or your fall risk. It’s best to limit your alcohol consumption, but if you enjoy drinking socially, there may be times you overdo it, so extra caution is required. 

If you feel your drinking is out of control and something you’d like to get help with, you should speak to a Doctor or a qualified Professional.

But know that light alcohol consumption is ok and will not put you at higher risk of falls. 

Enjoy yourself. Enjoy Life!

 NUTRITION AND FALLS SUMMARY

• What we eat is essential for good health, preventing falls and decreasing the risks of serious injury if you fall.

• Eat a diet with adequate calories comprised of sufficient protein, carbohydrates and fats and high in vitamins and minerals. For more on nutrition, CLICK HERE.

• Most of the population is not getting enough calcium and vitamin D, nutrients vital for health and bone strength.

• Aim to get 20 minutes of sun exposure avoiding the hottest part of the day for adequate vitamin D.

• Vitamin D and calcium supplementation have been shown to reduce fracture incidence.

• Light alcohol consumption has been shown to not increase falls risk.

• Heavy alcohol consumption can impair judgement and balance and increase the likelihood of risky behaviours, which could lead to a fall.

STEP 8: GET A GOOD NIGHT'S SLEEP NATURALLY, EVERY NIGHT

It's well known that when we are not getting enough sleep, we are not performing at our best. We are usually weaker, less alert, fatigued, and our mood is down. 

Furthermore, lack of sleep can increase your risk of falling [1, 2].

By making sleep a priority and getting a good night's sleep each and every night, you are decreasing your falls risk, and your general health and wellbeing will also improve.

Getting a good night's sleep each and every night is one of the best things you can do to improve your health and will go a long way in decreasing your falls risk.

For tips on how to get a good night's sleep, read my article - SLEEP IS GREAT MEDICINE: HOW TO GET A GOOD NIGHT'S SLEEP OVER 60.

SLEEP AND FALLS IN SENIORS SUMMARY

• There is no change in the amount of sleep needed as we get older. The amount of sleep required remains the same for all ages.

• You can take many steps to improve your sleep naturally (i.e., enhancing your sleep environment, getting active, getting the right light, getting social, eating healthy, and reducing stress).

• Speak to your doctor if you are having difficulty sleeping. If you are currently taking sleeping medications, let your doctor know you'd like to try a natural alternative.

STEP 9: SLOW DOWN AND BE MINDFUL TO PREVENT FALLS

Are there times when you are continually making silly mistakes or doing clumsy things? Maybe it's bumping into things, stubbing your toe or hurting yourself somehow? Dropping items or frequently losing something? Or leaving behind items at certain places?

Do you find yourself overthinking things? Do you find that your head can be kind of chaotic at times?

Perhaps you can't stop worrying?

If you're stressed with a busy mind, if you are not present, your mind is elsewhere. This is when mistakes or accidents usually happen. This is the time when you are most likely to have a fall.

Furthermore, stress directly affects balance. When you are stressed, balance and other physical abilities may not be as good as they could be. Something I see commonly in my patients.

With decreased physical capabilities - your falls risk will increase!

Additionally, people experience dizzy symptoms during periods of stress.

With a stressed, chaotic mind, life is just much harder.

If your mind is busy, you'll get many benefits from practising mindfulness daily or taking time out of your day to calm the mind.

When we are calmer, there is less stress, our physical capabilities improve, our balance is better, we are healthier, and everything feels easier.

Calm the mind, and you WILL become more aware of your body and what's around you. YOU WILL DECREASE YOUR FALLS RISK.

DECREASING STRESS AND RELAXATION THROUGH MEDITATION

It is important to improve your health and decrease your falls risk, that you are doing what you can to reduce stress.

Meditation is one of the best ways to decrease stress, calm the mind, and be more present.

Meditation doesn't have to be a very disciplined, monk-like practice.

Think of meditation as spending a set amount of time, with intention, on doing something good for yourself to help reduce stress. That's it! It's that simple.

I have previously written an article on meditation, including a simple meditation technique.

If you're interested in a simple meditation technique, you can use to decrease stress, calm your mind, get healthier and reduce your fall risk, CLICK HERE - DECREASING STRESS AND RELAXATION MADE EASY. 

MINDFULNESS AND FALLS PREVENTION SUMMARY

• Stress and rushing can increase falls risk.

• Mindfulness/meditation can help decrease stress, make you more alert, aware, mindful, and present, improve physical capabilities, and reduce your risk of falls.

• Don't neglect the mind-body connection.

STEP 10: Walking Aids & Assistive Devices - How they help and how they may put you at risk of falling

We should always strive to be in our best physical condition and health by being active as much as possible and exercising, regardless of age.

Sometimes, however, for various reasons, there may come a time when a little assistance is required to help keep you steady, active and living your life safe from falling.

That assistance might be the use of a walking aid. I have covered mobility aids, including the different types, how to use one and how to fit them correctly - CLICK HERE FOR YOUR QUICK GUIDE TO WALKING AIDS.

Furthermore, incorrect use of a mobility aid or not using one when you need one is also a common cause of falls.

There are some steps you can follow to ensure you are using your mobility aid correctly and will decrease your chances of having a fall.

Here are some tips to follow when using a 4-wheeled walker to prevent any issues:

• Ensure your walking aid is suitable for your abilities. Don't think any walking aid will be fine. You require the one most suited to you.

• Ensure the walking aid is fit to you correctly.

• When getting used to your walking aid, have someone with you until you can walk safely on your own. This will help build confidence.

• Ensure you wear appropriate footwear always when using your walking aid

• Clothing – ensure clothes cannot come entwined with the wheels.

• Tripping – Not only tripping over the walking aid itself but also clutter and hazards in the house.

• Repair walking aids regularly. Have it serviced once a year; it's inexpensive and a simple tip. Chat to your local mobility needs store to have this organised.

• Replace worn wheels, tips or glide skis. It's always good to have extra parts in case something fails. The most common issues are worn wheels, skis or handle grips, frayed brake cords, and brakes that are not working.

• Tie down or remove any items sticking out of the walking aid that could get caught on objects when walking, e.g., items in your basket or brake cords that stick out.

• Ensure you are walking with your walking aid correctly. When sitting down, get as close to chairs or furniture as possible before letting go of your walker.

• If you're leaning over too much when using your walker, practice upright walking (rather than adjusting the height) and take more rest until you can walk longer with an upright posture. This will prevent or decrease any back pain you may be experiencing when walking.

• When sitting on a walker, ensure the brakes are in a locked position. Place the walker against a wall for added stability.

• When opening the walker after storing it, ensure it is locked in place (open) before using it.

OTHER ASSISTIVE DEVICES

There are other assistive devices on the market designed to help prevent falls. These items can go a long way in helping you prevent falls.

I have also covered 10 ITEMS THAT CAN HELP YOU PREVENT FALLS - make sure to check them out (COMING SOON).

WALKING AIDS, ASSISTIVE DEVICES AND FALLS SUMMARY

• There may come a time that a walking aid is required for YOU to keep you moving well and prevent falls. Don't feel shame or embarrassment if this is the case.

• Always see a Health Professional to have a walking aid prescribed and fitted.

• Not all mobility aids serve the same purpose. Never borrow someone's walking aid unless you're sure it's the right one required for you after checking with a Health Professional.

• Ensure your walking aid is fitted correctly and that you use it correctly and safely.

THE FINAL STEP

And there we have the 10 steps to decrease your falls risk... by a lot!

By implementing these 10 steps above and working on overcoming your fear of falling, you will have done all that you can to ensure you do not have a fall.

Finally, there is one last part we must cover! There is always that chance that you may still fall even if you do absolutely everything possible. 

Continue onto the next part, Part 3, where we cover (in detail) how to sufficiently prepare yourself for a fall, what to do if you fall to avoid injury, how to get up off the floor and how to help someone off the floor safely.

PART 3 - BE PREPARED - WHAT TO DO IF YOU FALL

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

THE ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS - PART 1

THE GUIDE TO PREVENTING FALLS FOR OLDER ADULTS

As a Physiotherapist specialising in seniors' health, I have witnessed firsthand the harsh reality of falls.

Throughout my career, I have often been called upon as a first responder in aged care centres after someone has fallen, to assess for injuries, direct the appropriate response and help as needed.

I have also rehabilitated many patients following a fall-related injury, helping them improve their physical condition so they can return to independent functioning in their daily lives.

Furthermore, I have been heavily involved in falls prevention. This included implementing falls prevention plans and exercise programs in various settings while assessing thousands of patients' mobility, physical condition and falls risk.

Due to my expertise and experience, I have spoken numerous times at many nursing homes and community centres across Australia about how best to prevent falls.

With falls being a huge problem facing everyone over the age of 65, I felt it was important to write this guide about preventing falls and do my bit to further decrease this problem.

Before we get started and dive deep into how to prevent falls however, the first thing you must know is……. falls are NOT a normal or inevitable part of ageing! 

I'll repeat... FALLS ARE NOT A NORMAL OR INEVITABLE PART OF AGEING!

Yes, falls ARE a huge problem facing older adults, but many things can be done to prevent them!

This doesn't mean avoiding everything you enjoy, everything fun, to ensure you don't fall…. NO!

Preventing falls simply means being aware and doing what's required to significantly reduce your risk of falling so you can go on living the life you want to.

Rather than ignoring this problem and putting it to the back of your mind in hopes that it won't happen to you or, in some cases, again, it's time to tackle this issue head-on, for good!

Once done, you can enjoy life as you wish in your golden years, without fear!

Now let’s get started preventing falls.

- Mike

[Note: To get the most out of this guide, make sure you spend the time to read it in its entirety. Once you have done this, you can skip through to any section by heading to the Falls Prevention main page and clicking on the appropriate links.

Also, please share this guide with anyone you feel would benefit from it, and make sure you sign up to the mailing list for a free exercise ebook, regular exercise videos for seniors, and more].

PART 1: THE IMPORTANCE OF FALLS PREVENTION

INTRODUCTION - HOW TO PREVENT FALLS

I like to think of preventing falls the same way we avoid a possible fire in our home or workplace.

We all have some risk of a fire occurring, especially when we cook, use electricity, iron, use the heater or get the fireplace going. 

But what do we do to avoid a fire? We decrease our risk, and we decrease it A LOT!

Fire safety usually looks something like this:

STEP 1: We educate ourselves about the dangers of fire to ensure we remain aware.

STEP 2: We become aware of the risk factors of fire and eliminate them best we can, to prevent any fire from happening.

We prepare ourselves by undertaking proper fire safety. This includes keeping our house up to date with appropriate fire standards, e.g., installing smoke detectors, putting fire extinguishers or fire blankets around the place, familiarising ourselves with fire exits and knowing the emergency phone numbers.

We don't give up here; we take precautions to maintain fire safety to guard ourselves against a fire and put our minds at ease. This may include removing dry leaves from guttering during hot, dry periods, having the fire extinguishers checked as required or changing the battery on smoke alarms.

STEP 3: We still know there is always the chance of being caught in a fire even when we eliminate the risk. We make sure we know what to do if a fire breaks out. For example: get down low and GO, GO, GO! and call emergency!

We cover everything to decrease our risk of a fire happening and what to do to keep ourselves safe if one were to occur. We have done all we can.

We trust our plan. We trust our equipment. We trust ourselves and the fire service. We trust everything will be ok.

We don't sit around in a fireproof suit with a hose, waiting for a fire, all ready to go.

WE GO ON LIVING AND ENJOYING OUR LIVES WITHOUT WORRY!

This guide will take a similar approach to the fire prevention plan above to prevent falls. Carry on to the next section for the falls prevention plan.

THE FALLS PREVENTION PLAN

In PART 1 of this guide, we will go through the consequences of falls to ensure you remain aware and learn everything that could put you at risk of falling.

In PART 2: We will go through what changes to make and how to make these necessary changes to decrease your fall risk as much as possible. You will also work on becoming as healthy and in good physical condition as possible to help you prevent falls. 

As it’s impossible to completely eliminate all risk of falling, there is always the chance that even if you have done everything you possibly could, you still fall. So we want to be prepared for this situation.

In PART 3, we cover how you can be prepared and what to do if you fall to handle the situation safely and effectively.

Once you have completed all parts of this guide, you will have peace of mind and confidence, knowing you have done everything possible to prevent falls, and be prepared.

Furthermore, you will get many added health benefits when you undertake what's set out in this guide. You will improve your physical abilities, you will be stronger, moving better, balancing better, you will be sleeping better, you will have decreased stress, you will feel better and much more!

WHY YOU SHOULD BEGIN PREVENTING FALLS TODAY

A FALL CAN HAPPEN TO ANYONE!

There was once a time I was walking through the dining room in a Residential Home, lost in thought about all the jobs I needed to get done before the day was out.

While rushing around the place deep in thought, I had failed to notice one of the cleaners had just mopped the floor.

I was also wearing shoes I shouldn't have been. The grips on the soles of my shoes were worn down. "I'll be right!" I thought to myself a few weeks earlier when I noticed the soles wearing thin. I liked these shoes, so I wasn't ready to replace them just yet.

It was lunchtime, and the room was packed with residents eating their lunch.

As I was walking through the room, suddenly I slipped. The next minute, I was down on the floor, on one knee in front of everyone.

I remember hearing one of the ladies shriek in fear, worried I'd been hurt and seeing other ladies jump when they saw it. 

There was silence. Everyone was looking at me.

"Aren't you the guy that's meant to stop us from falling?" a man named Merv chimed in laughing, while I'm still down on one knee.

"I'm just stretching, Merv," I replied, jokingly, with a smirk on my face while faking a stretch. 

Merv was right; I had fallen. The Physiotherapist, an expert on falls prevention, much younger than everyone else in the room, had fallen for all to see.

AND, this fall could have easily been prevented!

AND..... I knew my shoes were putting me at risk. It was not like these shoes were stopping me from replacing them or the slippery floor made me rush over it.

I just never thought it would happen to me.

A few of the ladies asked me if I was ok. I was fine, luckily. Not a scratch. 

I got back up and got on with what I was doing. 

Whoa, close call! That could have been much worse.

Luckily, I was young with good physical capabilities. If not, this could well have been a different story.

Most of us assume that an incident won't occur to us. We usually think, "that just happens to other people". 

But, A FALL CAN HAPPEN TO ANYONE!

This story is to highlight the importance of falls prevention. Take falls prevention seriously, because you could fall too!

THE FACTS ABOUT FALLS

Roughly 30-50% of people over the age of 65 are at risk of falling; this risk increases to the higher end (50%) as we continue to age [1].

Once over 65 and having already fallen, this risk increases again [1].

Our falls risk increases for many reasons as we get older (covered below). Combine this with bones becoming weaker, our muscle mass decreasing and usually less fat covering our bones, the chances of a falls-related injury are increased and injuries sustained are usually more severe.

The most common injuries are fractures, with hip fractures being the most serious and occurring more commonly in women [2].

Furthermore, our recovery time following an injury increases as we get older, taking longer to get us back to where we once were.

Now, don't be too alarmed. The primary physical injuries - broken bones, cuts and knocks to the head occur in only a small percentage of falls. Most falls result in only minor cuts and bruises, if that.

But they can also be frightening and an unwanted fall cycle can be triggered, affecting life in other ways [See Diagram below].

View fullsize

From the above diagram, a fear of falling can develop after a fall.

Due to this fear of falling, physical activity is usually undertaken less (or in some cases avoided), leading to decreased physical abilities. Consequently, the risk of falling is further increased.

The cycle continues, and it becomes increasingly difficult to undertake the activities required for daily living.

As you can see, falls have both physical and mental effects. They can cause injury and disrupt quality of life in a big way.

You may have also read or heard the very scary statistics or some horror stories about falls and associated fractures, which can compound this fear of falling. I won't go into these statistics. A simple search will find them.

Yes, these statistics can be frightening, and we must do all that is possible to ensure we prevent falls, which is 100% possible. However, there is no need to get caught up in these statistics surrounding falls. 

In my career as a Physiotherapist, I have helped rehabilitate hundreds, after a fall, and it is very rare someone does not make a full recovery. Those that don't are usually much older and/or frail and tend to have limited cognitive abilities.

Worrying about the dangers of falls is impractical for preventing them. 

Any fears causing you to avoid movement or certain activities are holding you back from living life and making progress in preventing falls. These fears usually require more than just an understanding to overcome. However, they are possible to be overcome and you can make big progress.

Overcoming the fear of falls is complex, I have written an article covering it a little, and how to overcome it here: OVERCOMING THE FEAR OF FALLING

You can get to the bottom of why you are falling and improve these areas of your life causing your falls. These improvements will help prevent any more falls.

You want to be doing everything to ensure you're not avoiding any movement or activities in your life, but of course, taking precautions if/and where necessary.

It starts by changing your focus from avoiding falls to doing what's required each day, getting yourself in the best physical and mental shape to prevent falls and eliminating or minimising the factors putting you at risk (discussed next section).

This Falls Prevention article aims to help you to continue living your life the way YOU want to and doing what's required to prevent falls. This is the key to a good falls prevention plan and the key to overcoming falls.

From this point onward, we will stop focusing on the scary what-ifs of a fall. Instead, we will focus on the things within your power that CAN be changed to prevent falls, which we will cover in this article, and we will start putting these into action.

To do this, let’s now take a look at what could put you at risk of falling.

What’s Putting You at Risk of Falling - Risk Factors For Falls

To prevent falls, it's important to be aware of the different factors that could be putting you at risk of falling [1, 2, 3, 4].

Once identified, every risk should be eliminated or minimised, one by one. We will discuss all the risk factors in greater depth in the upcoming sections.

Factors that could be putting you at risk of falling are:

Physical Changes

• Decreased physical abilities (e.g., decreased vision, decreased balance, strength, proprioception and gait issues)

• Chronic health conditions (e.g., vertigo, arthritis, dementia, diabetes, incontinence, stroke)

Behaviours

• Risk-taking behaviours out of one’s capabilities

• Lack of awareness of one’s own risk of falls - cognitive decline

• Fear of falling leading to avoidance behaviours

Habits

• Lack of activity/exercise

• Poor sleep patterns

• Inadequate nutrition

• Alcohol abuse

• General lifelong habits which now pose a risk

The Environment Around You

• Hazards around the home (indoors and outside)

• Other indoor and outdoor risk factors

  • These hazards above include trip and slip hazards, uneven surfaces, poor lighting or glare and no handrails on stairs or grabrails in bathroom

Medications

• Certain types of medication (and quantity of medication) pose a fall risk

Clothing/Equipment

• Loose-fitting, long or baggy clothing

• Footwear -  worn, incorrectly fitted or not appropriate for the foot (e.g., heels)

• Wrong or incorrectly fitted mobility aid

• Not using mobility aid or other assistive equipment prescribed by Physiotherapist/Occupational Therapist

In the next chapters, we will look at eliminating or minimising these risk factors, so your falls risk decreases by a large extent.

Here is a diagram that sums up the risk factors of falling. Have a read and see if any could be putting you at risk of a fall.

View fullsize

Falls Risk Factors

Now we have identified the risk factors that could be putting you at risk of falling. It’s now time to start working on eliminating the risk factors to prevent falls.

We will cover all you can do to prevent falls, including exercise and more in the next section, PART 2: 10 STEPS TO PREVENT FALLS FOR GOOD

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.

PREVENTING FALLS - OVERCOMING THE FEAR OF FALLING

RETURN TO FALLS PREVENTION HOME

HOW TO OVERCOME THE FEAR OF FALLING

IDENTIFYING A FEAR OF FALLING

Do you lack confidence doing activities you once did with ease in fear you may have a fall?

Or have there been times when you have limited or avoided certain activities you once did effortlessly due to fear?

These activities could include anything; crossing the road, going outside or maybe going to the shopping centre makes you feel a little uneasy.

If you answered yes to the above questions, you have a fear of falling.

However, you're far from being alone.

In a study on the prevalence of fear of falling in older adults, 90.5% of the subjects reported a fear of falling in at least one activity.

A fear of falling is common among older adults, especially if physical capabilities start to decline (i.e., weaker legs or increasing unsteadiness when walking) or after a fall.

WHY A FEAR OF FALLING CAN DEVELOP

There are many reasons why the fear of falling can develop.

It could be you are feeling not as steady on your feet as you once were. Maybe you are feeling weaker doing certain activities. Perhaps you've heard stories of friends having a fall and don't want the same happening to you. Or, maybe you've had a fall and, understandably, don't want it to happen again.

Falls can be a scary ordeal, especially when older and the body isn't as strong, steady, mobile and reliable as it once was.

Fear is healthy and normal. Everybody experiences fear.

Fear is our mind's way of alerting us to the dangers present and it can protect us from entering dangerous situations.

However, if the fear is uncontrollable, something that you think about a lot and is negatively impacting your life, this fear must be dealt with.

You want to be able to keep up your physical activity and your life. 

When you start limiting activities and avoiding life due to your fears, your physical abilities decrease and your chance of falling increases.

When you start managing and overcoming this fear, you can improve your physical abilities and continue to do those things you love.

Your falls risk decreases. You can live the life you want to.

HOW DOES THE FEAR OF FALLING CAUSE MORE FALLS

You may think that worrying about something will make you more cautious and decrease your risk of falling, but this is untrue.

The fear of falling will make you overthink every move and you may begin avoiding the activities that keep you moving well.

When you do less activity over time, your body becomes weaker and your balance worsens.

When physical abilities deteriorate, daily life becomes more difficult. This makes it more challenging to do the physical activity that will get you strong and decrease your risk of falls.

Confidence is lost and it's common to become overly cautious, regardless of what the physical abilities actually are.

A negative falls cycle develops (see below). Remember this fall cycle discussed in PART 1 of the ULTIMATE GUIDE TO FALLS PREVENTION FOR SENIORS.

View fullsize

Activities in life are avoided and balance/stability issues increase; again, further increasing falls risk.

This downward spiral also impacts mood and well-being; thus decreasing social interactions. It's a vicious cycle that needs to end.

BE CONFIDENT AND GO ON LIVING LIFE

Overcoming the fear of falling isn't as easy as just snapping out of it and getting on with life.

Your mind is sending out warning signals out of your voluntary control. This fear is real and must be overcome like any other fear.

And it can be.

Firstly, by reading all the steps in the Falls Prevention guide (and implementing all strategies), your confidence will increase, and your fears surrounding falling will begin decreasing.

But more may need to be done.

You may know that you are capable of undertaking your daily activities and understand your fears are irrational.

But fear is an emotion, and when big emotions grip us, we can become powerless. We always automatically revert to what's safest and what's comfortable.

To be free of the fear, you start by changing your thoughts surrounding it; this is done by listening to and feeling your worries about falling, then reframing them.

Once you have reframed your worries, you now focus on the new reframed thoughts, especially when your fears arise. And gradually do more and more activities that help build your confidence.

A TASK TO HELP OVERCOME THE FEAR OF FALLING

The goal of this task is to decrease your fears surrounding falls. By doing this, you will reduce your falls risk.

You will become less sensitive to your fears until they do not have control over you. By letting go of these fears, you will remain cautious (healthy), just not overly cautious (unhealthy), which leads to a decreased quality of life and increases fall risk.

After completing this step, you will be more confident and can get on living life.

Take your time during this step; it will be worth it. Now let's begin.

Write down EVERY fear or thought you have about falling in EVERY situation and reframe them into something positive.

Example 1) If I fall, I may injure myself.

REFRAME: I have spoken to my doctor, and he says it's ok for me to walk. I have done everything to decrease my falls risk as set out in this guide. I am doing my exercises. I am eating well and moving well; I will walk within my capabilities and take a rest if I feel tired. I will live my life. I will be ok!

Example 2) If I fall, I will look stupid in front of people.

REFRAME: I will not fall. I am walking to the best of my abilities. I have done everything possible to prevent falls. 

However, if something unexpected happens and I do fall, people do not care about how I look and would be more concerned if I am ok.

I can deal with it. I will live my life.

Example 3) If I fall, I may not be able to get up.

REFRAME: I am now always prepared if I do fall. I am also doing everything to improve my physical abilities. If I do fall, I know help will be on the way.

Example 4) If I ride my bicycle, I may fall.

REFRAME: The last time I fell off my bicycle was right before I started to pedal. Now, before I start pedalling, I make sure that I am balanced and that no clothing, straps, etc., can get caught in the pedals or gears. In addition, I have done strengthening and balance exercises, thereby decreasing my falls risk. I will continue to enjoy riding my bicycle!

Now it's your turn. Think of ALL the reasons why you fear falling. Go through them one by one, answering the question "I am afraid of falling because?"... Then reframe the fear.

Continue for as many fears as you have surrounding this!

This process of reframing, repeating these new reframes, and taking small steps to do what you fear is known as desensitisation. Over time you will be desensitised to the fear.

This is one of many techniques to help you overcome the fear of falling

Remember, you will also need to continue to do the activities required that you want to be doing. Take your time with this and gradually increase your confidence. If you need extra guidance, get help from a professional (e.g., Physiotherapist).

With a slow and controlled approach, you'll start making significant progress. 

It won't be long until you're on your way to overcoming your fears and back to doing more of what you most love to do.

IF YOU'VE FALLEN BEFORE

If you've previously fallen and the fear is constantly on your mind and is impacting your life, I recommend you speak to a psychologist or a counsellor.

A fall can be just like any traumatic event. The sooner you come to peace with the past event that once happened to you, the better your life will be.

As said earlier, educate yourself on falls, eliminate the risk factors for falls, put safety measures in place and improve your physical abilities.

Read everything within this guide and implement the strategies. Then continually challenge yourself by doing the things you fear, gradually, and your confidence will begin to increase. Your fear of falling will start to dissipate.

To speed up the process, work with a Physiotherapist, Psychologist or other suitable Allied Health Provider.

FEAR OF FALLING SUMMARY

• A fear of falling is common in seniors.

• A fear of falling can put you at a higher risk of falling.

• By implementing a falls prevention plan and doing what's required to help decrease your falls risk, you can increase your confidence surrounding a fear of falling.

• Many psychological techniques can help you overcome the fear of falling - one technique is desensitization.

• If your fear of falls persists or you want help with overcoming your fear of falling, speak to your doctor or a psychologist or counsellor.

• A physiotherapist can help you improve your physical capabilities, and will help guide and assist you through the process to getting stronger and balancing better, which will help build your confidence.

SOURCES

TO VIEW ALL SOURCES USED IN THIS ARTICLE AND FOR ADDITIONAL RESOURCES, CLICK HERE.