In the run up to publication of my new book Carers and Caring; the One Stop Guide; how to care for older relatives and friends I am sharing an A to Z some of the practical solutions learned from research and experience. If you think any problems have been missed you can email me and tell me, and I’ll make sure they are covered in the next edition and online on my website at www.juneandrews.net. 

Falls prevention

In older people, a fall is one of the commoner reasons for being admitted to hospital, or coming to the attention of social services. Older people are more likely to fall down to the floor if they stumble. When they were younger reaction times would have been faster, and muscles stronger to respond to imbalance - so they could catch themselves from falling even if they tripped or slipped. Exercise and good food, good lighting in the house, and just being careful when moving around can make a difference. If the person is wearing the correct spectacles, that can help.

People ask me the secret of my old age. Well the most important one is I always hold the side rail when I am going up and down my stairs. I’ve seen too many old people end up in hospital and they never go home. (Dyliss, age 95)

What else can carers do to prevent falls at home?

Removing clutter and frayed carpets and getting rid of scatter rugs is a good start. If there must be rugs, attach them to the floor so that they cannot slip using double-sided carpet tape or gripper tape. If the rug is over fitted carpet, you can use rug pins to secure it to the underlying carpet.

Mop up spillages on hard floors as soon as possible. Apply a non-skid treatment to the floor. It might not be practical to replace the flooring, but it’s possible to make the existing floor safer. There are products specifically for wood floors. The transition from one type of floor type to another is a risky threshold, for example from the hall carpet to the kitchen tiles. People with neurological conditions or visual impairment misperceive the line or threshold as a step and may stumble. An example might be where the hall carpet ends and the bathroom floor starts. Thinking it is a step the person puts their foot down wrong and does not have a fast enough reaction time to recover, so falls to the floor.

No matter what the floors are like, well-fitting shoes are important to prevent falls. It is a bad idea to walk about in socks. Floppy slippers are even worse.

Ask for a medication review. Some medicines make a fall more likely.

Carers can ask for a medication review to see if any medicines are being taken that would increase the fall risk. Some sedatives and antidepressants have that effect. Any drugs that affect your brain, your blood pressure or your blood sugar can cause dizziness. Give the doctor details of any previous falls or near-misses. It is worth keeping a diary of those. The doctor will ask the patient about any joint pain, shortness of breath or numbness in the feet and legs when they walk.

After a fall people sometimes lose confidence and take less exercise, which is a bad idea because decreasing exercise can increase the risk of a fall. You want to do things that will improve the person’s balance, flexibility, muscle strength and gait. Walking is a very good exercise for this, and it helps improve mental health too. As a carer you may find it useful to recruit a buddy who will take the person out for a walk regularly. That gives you some respite while making them less likely to fall down.

There is much more about falls prevention in  Carers and Caring: The One-Stop Guide: How to care for older relatives and friends - with tips for managing finances and accessing the right support  available from all good bookshops in May 2022

 Three hints:

1.     An exercise programme improves strength and balance

2.     Review medicines and glasses

3.     Safety-check the home