Falls

Anyone can have a fall, but older people are more vulnerable than others.

Information written and reviewed by Certified Doctors.

Contents

Introduction

Anyone can have a fall, but older people are more vulnerable than others. This is mainly because long-term health conditions increase the chances of a fall.

Falls are a common but often overlooked cause of injury and sometimes death. Around 1 in 3 adults over 65 who live at home will have at least one fall a year, and about half of these will have more frequent falls.

Most falls do not result in serious injury, but there is a risk of problems such as broken bones.

Falls can also have an adverse psychological impact on elderly people. For example, after having a fall some people can lose confidence, become withdrawn and may feel as if they have lost their independence.

What should I do if I have a fall?

If you have a fall, it is important to keep calm.

If you are not hurt and you feel strong enough to get up, do not get up quickly. Roll onto your hands and knees and look for a stable piece of furniture, such as a chair or bed. Hold on to the furniture with both hands to support yourself and when you feel ready, slowly get up. Sit down and rest for a while before carrying on with your daily activities.

If you are hurt or unable to get up, try to get someone’s attention by calling out for help, banging on the wall or floor or crawl to a telephone and dial for an ambulance.

Try to reach something warm to put over you, particularly your legs and feet, such as a blanket or a dressing gown. Stay as comfortable as possible and try to change your position at least once every half an hour or so.

If you are living with or caring for an elderly person, see accidents and first aid for information and advice about what to do after an accident.

What causes a fall?

The natural ageing process means older people have an increased risk of having a fall. In the UK, injuries caused by falls are the most common cause of death in people over the age of 75. There are three main reasons why older people are more likely to have a fall. These are:

  • chronic health conditions, such as heart disease, dementia and low blood pressure (hypotension), which can cause dizziness and a brief loss of consciousness
  • impairments, such as poor vision or muscle weakness
  • conditions that can affect balance, such as labyrinthitis (inflammation of the delicate structure deep inside the ear known as the labyrinth)

Among older adults, the most common reasons for accidentally falling or slipping include:

  • wet or recently polished floors, such as in a bathroom
  • dim light
  • rugs or carpets that are not properly secured
  • reaching for storage areas, such as cupboards
  • stairs

Another common cause of falls, particularly among older men, is falling from a ladder while carrying out home maintenance work.

In older women, falls can be particularly troublesome because osteoporosis (thinning and weakening of the bones) is a widespread problem.

Osteoporosis can develop in men and women - especially in people who smoke, drink excessive amounts of alcohol or take steroid medication - but older women are most at risk because the condition often develops as a result of the hormonal changes that occur during the menopause.

Preventing a fall

There are several measures you can take to help prevent a fall. Simple, everyday measures around the home include:

  • using non-slip mats in the bathroom
  • mopping up spills to avoid wet floors
  • getting help lifting or moving items that are heavy or difficult to lift

Removing clutter and ensuring that all areas of the home are properly lit can also help to prevent falls. The charity Age UK provides advice about how to make tasks easier around the home.

Healthcare professionals take falls in older people very seriously because of the serious impact that falls can have. As a result, there is a great deal of help and support available for older people and it's worth asking your doctor about the various options.

Your doctor may carry out some simple tests to check your balance and they can review any medicines you are taking, in case their side effects may increase your risk of falling.

Your doctor may also recommend:

  • having a sight test if you are having problems with your vision, even if you already wear glasses
  • requesting a home hazard assessment - where a healthcare professional visits your home to identify potential hazards and offer advice
  • doing exercises of improve your strength and balance

Read more about preventing falls.

Prevention

There are a number of ways you can reduce your chances of having a fall, including making simple changes in your home and doing special exercises.

If you have fallen in the past, making changes to reduce your chances of having a fall can also help you overcome any fear of falling.

Some older people may be reluctant to seek help and advice about preventing falls from their doctor and other support services because they believe that their concerns will not be taken seriously. However, all healthcare professionals take falls in older people very seriously because of the impact falls can have on a person's health.

Discuss any falls you have had with your doctor and mention if the fall has had any impact on your health and wellbeing. Your doctor can carry out simple balance tests to see if you are at increased risk of falling in the future and they can refer you to useful services in your local area.

Avoiding falls at home

Tips for preventing falls in the home include:

  • mopping up spillages straight away
  • removing clutter, trailing wires and frayed carpet
  • using non-slip mats and rugs
  • using high-wattage light bulbs in lamps and torches so that you can see clearly
  • organising your home so that climbing, stretching and bending are kept to a minimum and to avoid bumping into things
  • getting help to do things that you are unable to do safely on your own
  • not walking on slippery floors in socks or tights
  • not wearing loose-fitting, trailing clothes that might trip you up
  • wearing well-fitting shoes that are in good condition and support the ankle
  • taking care of your feet by trimming toenails regularly, using moisturiser and seeing a doctor or chiropodist about any foot problems

Strength and balance training

Doing regular exercises to improve your strength and balance can help reduce your risk of having a fall. This can range from simple activities like walking and dancing, to specialist training programmes.

Many community centres and local gyms offer specialist training programmes for older people. Exercise programmes that can be carried out at home are also available. Ask your doctor about training programmes in your area.

There is also evidence that taking part in regular sessions of tai chi can help reduce the risk of falls. Tai chi is a Chinese martial art that places special emphasis on balance, co-ordination and movement. However, unlike other martial arts, tai chi does not involve physical contact or rapid physical movements, making it an ideal activity for older people.

Medication review

If you are taking long-term medication, your doctor will review your medicines every year to make sure they are still right for you, especially if you are taking four or more medicines a day.

Your doctor may recommend alternative medications, or lower doses, if they feel the side effects may increase your chances of having a fall. In some cases, it may be possible for the medication to be stopped.

You should see your practice nurse or doctor if you have not had your medicines reviewed for more than one year, or if you are concerned the medications you or a relative are taking may increase the risk of falling.

Sight tests

If you are concerned that poor vision (even when wearing glasses) is increasing your risk of having a fall, make an appointment to have a sight test.

Not all visual problems can be treated, but some can. For example, cataracts (cloudy patches in the lens of the eye) can be surgically removed.

Home hazard assessment

If you are concerned that you or a relative may be at risk of having a fall, or if you know someone who has recently had a fall, you can request a home hazard assessment.

The assessment will involve a healthcare professional with experience in fall prevention visiting your home, or your relative’s, to identify potential hazards and to give advice about how to deal with them.

For example, as the bathroom is a common place where falls occur, many older people can benefit from having bars fitted to the inside of their bath to make it easier for them to get in and out.

The healthcare professional who carries out the assessment may also recommend getting a personal alarm system so that you or your relative can signal for help in the event of a fall. An alternative would be to keep a mobile phone in close reach so that it is possible to phone for help after having a fall.

Contact your local authority or your doctor to find out what help is available in your local area.

Alcohol

Drinking alcohol can lead to loss of co-ordination and it can exaggerate the effects of some medicines. This can significantly increase the risk of a fall, particularly in older people.

Therefore, avoiding alcohol or reducing the amount you drink can help to reduce your chances of having a fall. Avoiding alcohol can also reduce your risk of having a more serious fall, because excessive drinking can contribute to the development of osteoporosis (thinning and weakening of the bones).

Content supplied by NHS Choices