Recent research by the University of Sheffield has found that more than half of repeat hip replacements could be prevented with an osteoporosis drug. Hip replacements are commonly needed in elderly individuals especially after a hip fracture. Hip fractures are most commonly caused by a fall.
Whilst the research provides some promising hope on the horizon, it is of course best to try and prevent falls in the first place. There are a number of simple ways in which this can be done.
Before we dive into some important fall prevention tips, it is worth noting that there are a number of different reasons why falls are more likely in elderly individuals. Stiffness and mobility issues are perhaps the most obvious. However, problems such as eyesight difficulties, medication side effects, certain diseases (such as Parkinson’s) and reduced confidence all play a part.
Therefore, it can be worth checking out if there is a particular medical reason behind the falls if they have increased in frequency, or recently started. These following tips are designed to be used in addition to medical support.
If falls seem to happen often or regularly, try to keep a diary. Write down the time of day and what was happening immediately before the fall. This may enable you to spot a pattern and eliminate the trigger.
Both eyesight and hearing changes can affect the way you understand spatial awareness. Hearing and vision problems can make it difficult to orientate yourself and accommodate changes in your environment. It’s always worth ensuring that sight and hearing prescriptions are up-to-date.
Regular physical mobility can help to prevent falls. Daily short walks, as well as basic strengthening exercises getting up and down from seated positions can really help. Gentle exercise suited to the individual’s level, such as yoga or Tai Chi, positively impact balance, strength and coordination.
It’s not unusual for those who have fallen to lose confidence in their physical ability and they may need active encouragement and support to maintain mobility and rebuild their confidence after a fall. Physiotherapy may help.
Footwear has an important role to play in fall prevention. Footwear should always be worn, avoiding slippery socks or stockings. It should fit well and be sturdy, flat or low-heeled and with non-slip soles. Within the house, slippers are absolutely fine, but again they should be well-fitted and have a firm sole. Shoes which are loose can cause trips and falls.
It’s important that clutter is removed from the floor and from areas where an individual may place their hand to steady themselves. It’s worth looking at the environment where the fall-prone person spends most of their time. Move magazines and books off the floor and to a table within reach and tuck all wires back against skirting and secure them using cable ties and tape.
Rugs and thresholds are notable trip hazards. Either remove rugs or secure the edges using double-sided tape designed for the job. Slip-resistant backing for rugs and runners is another alternative. If rugs remain in place, try to ensure there is a clear colour difference between the rug and the surrounding flooring, making it easier to see. Thresholds can be reduced to the same height as the surrounding floor, be made a clearly different colour, or have more gradual and wider height.
Don’t regularly move things around but try to keep furniture in exactly the same place as usual. Encourage cleaners and carers to make sure that furniture stays exactly in its usual spot – even a small difference can cause confusion and precipitate a fall. If there are spills, packages delivered, or other unusual things in place, ensure they are removed as soon as possible.
The bathroom poses numerous difficulties for those prone to falls. Numerous adaptations, such as grab rails and raised toilet seats can help. Simply adding a non-slip mat into the shower base or bath can also provide stability.
Lighting needs careful attention to help prevent falls in the elderly. Problems of darkness, or shadows caused by the positioning of the light can make it difficult for spatial and depth awareness. Lights should be used, using a mixture of overhead and side lights to prevent this. Making sure switches are within reach, and/or timers are used, will make sure that lights are on when needed. Hallway lights and reasonably bright night lights can be particularly important for middle of the night trips.
When thinking about fall prevention, people typically think about floor level. Whilst this is important, as our above tips show, it’s also vitally important to think about how an individual uses their hands to steady themselves and securely guide themselves as they walk.
Try to ensure hand rails are placed in areas where there isn’t obvious and stable furniture to lean on. Encourage use of a stick or a walker. Ensure banisters and rails are clear of coats, hats and other items! Particularly make sure that in the places that the person will need to move from sitting to standing, they have secure things they can hold onto. Think about near the bed, arm chair, bathroom and where they eat.
If you need help making adaptations to prevent falls, but aren’t sure what would help, an occupational therapist will be able to give good advice.
Falls in the elderly can be worrying and not least because of the risk of injury to the hip. Unfortunately, not all falls can be prevented. However, by making sure careful thought is given to the environment around the individual, as well as aiding their confidence and mobility, it is possible to reduce the risk as much as possible.