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