Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.
Falls are a common, but often overlooked, cause of injury. Around one in three 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 don't result in serious injury. However, there's always a risk that a fall could lead to broken bones, and it can cause the person to lose confidence, become withdrawn and feel as if they've lost their independence.
What should I do if I fall?
If you have a fall, it's important to keep calm.
If you're not hurt and you feel strong enough to get up, don't 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're hurt or unable to get up, try to get someone's attention by calling out for help, banging on the wall or floor, or using your aid call button (if you have one). If possible, crawl to a telephone and dial 999 to request an ambulance.
Try to reach something warm, such as a blanket or dressing gown, to put over you, particularly your legs and feet. Stay as comfortable as possible and try to change your position at least once every half an hour or so.
What causes a fall?
The natural ageing process means that older people have an increased risk of having a fall. In the UK, falls are the most common cause of injury related deaths in people over the age of 75.
Older people are more likely to have a fall because they may have:
- balance problems and muscle weakness
- poor vision
- a long-term health condition, such as heart disease, dementia or low blood pressure (hypotension), which can lead to dizziness and a brief loss of consciousness
A fall is also more likely to happen when:
- the floor is wet or recently polished, such as in the bathroom
- the lighting in the room is dim
- rugs or carpets aren't properly secured
- the person is reaching for storage areas, such as a cupboard, or is going down stairs
- the person is rushing to get to the toilet during the day or at night
Another common cause of falls, particularly among older men, is falling from a ladder while carrying out home maintenance work.
In older people, falls can be particularly problematic because osteoporosis is a fairly common problem. Osteoporosis can develop in both men and women, particularly in people who smoke, drink excessive amounts of alcohol, take steroid medication or have a family history of hip fractures. However, older women are most at risk, because it's often associated with 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 prevent wet, slippery floors
- getting help lifting or moving items that are heavy or difficult to lift
Healthcare professionals take falls in older people very seriously, because of the huge consequences they can have for the health and wellbeing of this group. As a result, there's a great deal of help and support available for older people, and it's worth asking your GP about the various options.
Your GP may carry out some simple tests to check your balance. They can also review any medicines you're taking, in case their side effects may increase your risk of falling.
Your GP may also recommend:
- having a sight test if you're having problems with your vision, even if you already wear glasses
- having an electrocardiogram (ECG) and checking your blood pressure while lying and standing
- requesting a home hazard assessment, where a healthcare professional visits your home to identify potential hazards and offer advice
- doing exercises to improve your strength and balance (try some exercises for older people)
Read more about preventing falls.
There are ways you can reduce your risk of having a fall, including making simple changes to your home and doing exercises to improve your strength and balance.
If you've 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 from their GP and other support services about preventing falls, because they believe their concerns won't be taken seriously. However, all healthcare professionals take falls in older people very seriously because of the significant impact they can have on a person's health.
Discuss any falls you've had with your GP and say if it's had any impact on your health and wellbeing. Your GP can carry out some simple balance tests to check whether you're at an increased risk of falling in the future. They can also refer you to useful services in your local area.
Avoiding falls at home
Tips for preventing falls in the home include:
- immediately mopping up spillages
- removing clutter, trailing wires and frayed carpet
- using non-slip mats and rugs
- using high-wattage light bulbs in lamps and torches, so 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're 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 your toenails regularly and seeing a GP or chiropodist about any foot problems
Strength and balance training
Doing regular strength exercises and balance exercises can improve your strength and balance, and reduce your risk of having a fall. This can take the form of simple activities such as walking and dancing, or specialist training programmes.
Many community centres and local gyms offer specialist training programmes for older people. Exercises that can be carried out at home are also available. Ask your GP about training programmes in your area.
It's important that a strength and balance training programme is tailored to the individual and monitored by an appropriately trained professional.
There's also evidence that taking part in regular tai chi sessions can reduce the risk of falls. Tai chi is a Chinese martial art that places particular emphasis on balance, co-ordination and movement.
Unlike other martial arts, tai chi doesn't involve physical contact or rapid physical movements, making it an ideal activity for older people.
Read more about physical activity guidance for older adults.
If you're taking long-term medication, your GP should review your medicines at least once a year to make sure they're still right for you. It's particularly important that your medicines are reviewed if you're taking four or more medicines a day.
Your GP may recommend alternative medication or lower doses if they feel the side effects increase your chances of having a fall. In some cases, it may be possible for the medication to be stopped.
See your GP or practice nurse if you haven't had your medicines reviewed for more than a year, or if you're concerned that the medications you or a relative are taking may increase the risk of falling.
Home hazard assessment
You can request a home hazard assessment if you're 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.
As well as identifying potential hazards, the aim of a home hazard assessment is to explore how a person's actual use of the environment affects their risk of falling.
A healthcare professional with experience in fall prevention will visit you or your relative's home to identify potential hazards and advise on 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.
Fitting a personal alarm system may also be recommended, 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 within reach, so it's possible to phone for help after having a fall.
Contact your GP or local authority to ask about the help available in your local area. You can find your local authority on the GOV.UK website.
Drinking alcohol can lead to loss of co-ordination and exaggerate the effects of some medicines. This can significantly increase the risk of a fall, particularly in older people.
Avoiding alcohol or reducing the amount you drink can reduce your risk of having a fall. Excessive drinking can also contribute to the development of osteoporosis.