Falls are a common but often overlooked source of injury and, unfortunately in many cases, death.
Everyone is potentially at risk of having a fall although certain groups of people are more vulnerable than others. Causes of falls include muscle weakness, problems with balance or mobility, alcohol, medications or poor eyesight.
Around 30% of adults who are over 65 years of age, and who are living in the community, will experience at least one fall a year, and this figure rises to 50% for those who are living in residential care.
A third of women and one in twelve men develop osteoporosis (brittle bones) which makes it more likely that they will have a 'fragility fracture'. Fractures of the hip, neck or femur are the most serious of such injuries.
Making small changes in and around your home can make a big difference in reducing falls.
Here is some general advice:
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Mop up spills straight away,
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Remove clutter, trailing wires, and frayed carpet,
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Use non-slip mats and rugs,
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Use high wattage bulbs in lights and torches so that you can see clearly,
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Organise your home so that climbing, stretching, and bending are kept to a minimum, and so that you do not bump into things,
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Get help to do things that you cannot do safely,
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Do not walk on slippery floors in socks or tights, and
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Avoid wearing loose-fitting, trailing clothes that might trip you up. Falls are a common but often overlooked source of injury and, unfortunately in many cases, death.
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Everyone is potentially at risk of having a fall, but certain groups of people are more vulnerable than others.
30% of people over 65 years fall at home. This figure rises to 50% for those who are living in nursing homes or residential care.
Some older adults have a combination of health-related factors that increase their risk of having a fall such as muscle weakness, problems with balance or mobility, and poor eyesight.
There is an increased risks of falls in the over 75s of fragility fractures to the wrist or arm as well as the hip, neck or femur among those with osteoporosis.
Not all falls will result in injury, but a significant minority do. For example, one fifth of older adults will require medical attention for a fall, and 5% will experience a serious injury, such as a fracture.
Falls can also have an adverse psychological impact, particularly on older people. If you’ve had a fall you may sometimes lose confidence, become withdrawn, and feel like you have lost your independence or be afraid of having another fall. All health professionals take the issue of fall prevention in older people very seriously because they know the potentially serious impact that falls can have. As a result of this, a great deal of help and support is available.
Home hazard assessment
If you are concerned that you, or a relative, may be at risk of having a fall, or if they have recently experienced a fall, you may wish to request a home hazard assessment. A home hazard assessment involves a health professional with experience in fall prevention visiting a person’s home in order to identify potential hazards, and provide advice about how to deal with them.
For example, as the bathroom is a common place where falls can occur, many older people would benefit by having bars placed inside their bath to make it easier to get in and out.
The health professional carrying 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. Alternatively, it is a good idea to keep a mobile phone in close reach so that you can phone for help in the event of a fall.
You should contact your local authority and/or your GP to see what help is available in your local area.
Exercise
Research has shown that older people who take part in regular strength and balance training are less likely to have a fall. Regular exercise can lower our risk of getting serious conditions, such as stroke, heart disease and certain cancers. It can add years to our lives, but most importantly, it keeps us happy and helps us maintain our independence.
Specific exercises have been designed to help strengthen the muscles and bones we need to keep us active and prevent us from having a fall in later life. Many community centres and local gyms offer specialised training programmes for older people.
Alternatively, 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 and movement. However, unlike other martial arts, Tai Chi does not involve physical contact, or rapid physical movements, so it is ideal for older people.
Exercises have been designed for us to use on our own at home, but to get the best results, supplement them by joining a class, and speaking to a qualified instructor. Your GP will be able to advise you on local classes and activities suitable for you.
Diet
It’s very important to eat a healthy diet. Falls are less likely to result in fractures if you have a healthy bone density.
Taking daily vitamin D and calcium supplements can strengthen muscles and bones, helping to prevent falls in people who are 65 years of age and over. Young people with a long-term condition, such as multiple sclerosis, that increases a risk of having a fall, may also benefit from taking vitamin D and calcium supplements or drinking soya milks which are also a rich source of vitamin D.
The vitamin D and calcium supplements that are found in supermarkets may not contain a high enough amount to provide full protection. Therefore, if you think that you would benefit from having daily supplements, you should speak to your GP who will be able to prescribe stronger supplements.
Your body also makes vitamin D when you are exposed to the ultraviolet B (UVB) rays in sunlight. Five to 30 minutes of exposure to the skin on your face, arms, back or legs twice every week is enough, depending upon the time of year and season. However, since exposure to sunlight is a risk for skin cancer, you should use sunscreen in the sun and even in the winter and on hazy, cloudy days.
Sight Tests
If you are concerned that poor vision is increasing your risk of having a fall, you should make an appointment to have a sight test so that your vision can be tested and assessed.
Although not all causes of age-related visual impairment can be treated, a number can. For example, surgery is an effective treatment for cataracts (a common age-related eye condition where cloudy patches develop over the lens of the eye).
Medicine Management
Some medicines can make you feel drowsy, dizzy or unsteady on your feet, and this might mean you’re more likely to lose your balance and fall over. It’s important to be aware of this. Take care when getting out of a chair or the bath. If you take sleeping tablets, be extra careful if you have to get out of bed during the night and when you first get up in the morning. Some psycho-active medication, like tranquilizers, and medication for some other conditions, like angina, may increase the risk of falling, especially in combination with alcohol. Feeling dizzy when you stand up is more common as you get older, and some medicines can make the problem worse.
If you are concerned that the side effects of medication that you, or your relative, is taking is putting you (or them) at an increased risk of a fall, you can request a medication review with your GP. There may be alternative medications that you can use, or the dose of your current medication could be lowered or, in some cases, stopped altogether.
Here are some tips on taking your medicines safely:
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Do follow the instructions on the label. If you don’t understand them, ask your pharmacist or doctor to explain.
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Do take medicines at meal times to help you remember them (unless the directions tell you to take them on an empty stomach).
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Do ask your pharmacist for advice. If you buy any medicines over the counter check that the ingredients do not duplicate or interfere with what you are already taking.
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Do check whether you need to stick to the same brand of medicine when offered repeat prescriptions.
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Do make regular appointments with your doctor to make sure that the medicines that have been prescribed for you are still appropriate.
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Do make sure that you fully understand the directions that the doctor or pharmacist has given you.
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Don’t crush your tablets or open capsules and dissolve them in a drink without checking with your pharmacist or doctor first.
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Never take more than the dose stated on the label of your medicine container.
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Never share your medicines or give them to anyone else.
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Avoid taking extra medicines in addition to those prescribed by the doctor.
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Always take medicines you no longer need or use back to a pharmacy.
One of the main reasons why young men and women aged 16-24 find themselves in hospital when they’ve been drinking is because of an injury relating to a fall.
Alcohol affects the parts of the brain that control judgment, concentration, coordination, behaviour and emotions. If you are binge drinking, you may be at greater risk of having an accident, such as a road accident or a fall.
Binge drinking can cause blackouts, memory loss and anxiety. Young people's brains are particularly vulnerable because the brain is still developing during their teenage years.
Tips for managing your drinking
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Eat before or while drinking, and avoid salty snacks, which make you thirsty.
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Be assertive – don’t be pressured into drinking more than you want or intend to.
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Know your limits and stick to them.
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Stay busy – don't just sit and drink. Dance or have a game of pool if you're at a pub.
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Try not to confuse large measures of alcohol with standard measures. For example, a glass of wine served at a party, pub or at home may be much larger than the standard 125ml. In most pubs and bars the smallest measure served is actually 175ml. Shots can also be served as 35ml single rather than as 25ml – this can create quite a staggering difference if you order a double.
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Keep track of your drinks and don't let people top up your drink until it's finished.
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Try alternating alcoholic drinks with water or other non-alcoholic drinks. Add plenty of mixer to your drinks to make them last longer.
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Avoid rounds, ‘shouts’ and kitties – drink to your own pace, not someone else's.
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Drink slowly – take sips not gulps.
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Wear lower heels if you are going to consume alcohol beyond the recommended limits.
Due to the natural impulse to play and take part in risky behaviour, most children will experience a fall at least once during childhood. Thankfully, falls in children are seldom fatal, but they often require medical attention. Each year, in the UK, an estimated 390,000 children are taken to accident and emergency (A&E) following a fall.
Advice for children
Preventing falls in children can be somewhat of a balancing act. It is natural for parents to want to protect their children from harm, but most parents would not want to deprive their children of having fun and taking part in normal childhood activities.
While it is true that taking part in sporting activities increases the risk of falling, such activities also have important health benefits, and can help boost a child’s self-esteem and confidence.
It is virtually impossible to prevent all falls from occurring, but you can take steps to minimise the risk, or prevent serious damage in the event of a fall.
You may find the advice below helpful.
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One of the most common causes of falls in toddlers is falling down the stairs. To prevent this, you should install protective stair guards both at the top and the bottom of your stairs.
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If you have a toddler, make sure that your home is ‘toddler-friendly’. Rugs should be secured with tape or rubber pads. Use padding to cushion the sharp edges of furniture, such as tables. Also, avoid leaving anything on the floor, or stairs, such as toys or a handbag.
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If you have a young child, make sure that their bedroom windows are securely locked with a child-proof lock, but also make sure that the windows can be opened quickly in the event of a fire.
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Young children playing on playground equipment should always be supervised.
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Make sure that your child always wears a helmet when they are cycling, rollerblading, roller-skating, or skateboarding. Children who do not wear a helmet are 14 times more likely to die if they are involved in an accident, compared with children who are wearing a helmet.
Falls from height are one of the most common reasons for serious workplace injury and death. Some of the most common activities that can lead to falls from the workplace include:
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working on scaffolding,
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working on a ladder,
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working on a roof,
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cleaning gutters,
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cleaning windows,
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stacking shelves,
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putting up displays,
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unloading vehicles, and
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maintaining machines.
Work place advice - Ladders
You should only use ladders in a workplace environment for short-term, light work. Any work that requires spending a considerable amount of time at height, and/or involves heavy lifting, should be carried out on scaffolding, or another suitable platform.
Before using a ladder, you should inspect it carefully for any damage. If the ladder is damaged, do not attempt to repair it, buy a new ladder.
Before you go up a ladder, check that the base is secure. Ladders are only safe when they rest on a firm, level surface, not on loose bricks, or packing. Ladders should always be secured with a rope, or another suitable device.
Make sure that the ladder is properly angled to minimise the risk of it slipping it out from under you. The Health and Safety Executive (HSE) recommends that a good rule of thumb is ‘one rung out for every four rungs up’. For example, if the ladder is 16 rungs up then it should be angled four rung lengths away from the wall.
Roof work
Any work that involves going up onto a roof should be considered high-risk, and therefore high standards of safety are essential.
Before starting the work, you should ask yourself whether it is absolutely necessary and, if it is, whether there is an easy way to complete the work, such as using a powered access platform like a mechanical ‘cherry picker’.
Getting on and off the roof is a major risk so securing the means of entry and exit is very important. At the very least, you will need a properly secured ladder.
If anyone working on the roof could fall more than two metres (6 foot), you will need to install a guard rail around the edge of the roof. You should also consider using a safety harness that is securely attached to an anchorage point.
Never work on a roof in rainy, windy, or icy conditions. In such weather conditions, it is easy for you to be blown off the roof by a sudden gust of wind, or to slip over on the wet or icy roof.
Many accidents occur when people fall through a roof because they under-estimate how fragile the roof is. Therefore, you should always confirm how secure the roof is before beginning any work.
