• 65+ years: 1 in 3 fall at least 1 x year

• 80+ years: 1 in 2 fall at least 1 x year

• 1 in 4 people require residential aged care after a fall

• 1 in 5 people will break a bone due to a fall, or have a serious injury

• Of all injuries for 80+ years: 75% linked to falls

• Previous / history of falls

• Foot problems and unsafe footwear

• Poor / inadequate nutrition

• Chronic conditions and reduced physical activity causing changes in balance and walking

• Issues associated with changes in vision

• Poor / inadequate medication management

• Home hazards including unsafe home maintenance practices

• Hazards outside and in public places

Eye changes and disorders may put you at a higher risk of having a fall.

Condition examples

• Glaucoma

• Cataracts

• Macular degeneration

NB. An increased risk of falls can also occur if the eye prescription is out of date or bi or multi-focal glasses are used

Prescription glasses • Have your eyes checked regularly by an optometrist and

report any changes to your doctor.

• Take extra care while wearing bifocal glasses….. it is recommended that people use two pairs of glasses - one for

reading and one for long distances.

Lighting • Allow your eyes to adjust when going from light to dark

rooms and from dark to light rooms. Sunlight • Wear sunglasses and a hat to reduce glare when outside.

The foot and ankle area provides position sense necessary to maintain good balance and body control

Foot problems may change walking patterns mainly due to the pain and stiffness associated with a condition which can increase the risk of slips trips and falls

Foot condition examples • Bunions and corns • Arthritis • Dropped arches and flat feet • Decreased sensation and neuropathies such as Diabetes • Hammer toes

• Wear correctly fitting supportive shoes to suit the activity you are doing

a) Feet tend to swell during the day, so try shoes on mid

afternoon when they may be bigger

b) Have shoes properly fitted, (with orthotics if you have

them) try both shoes on, and buy for fit not size

• Inappropriate footwear – shoes providing minimal support

Examples - sloppy slippers; sling backs, high heels,

thongs, scuffs

• Visit your local podiatrist if you have foot pain and problems

as well as for regular reviews to manage any issues

• Inspect your feet on a regular basis to check for any changes

or skin damage (special care with Diabetes and Neuropathies)

• Do exercises regularly to keep the muscles in the feet strong

and to maintain good circulation in the area

Some possible side effects of inappropriate use of medicines are linked to an increased falls risk

• Some medication increase risk of falls such as dizziness, low

blood pressure, urinary urgency etc.

• 4 or more medications can increase the risk if not properly

prescribed and regularly reviewed

• Confusion and or dementia may lead to inappropriate

administration and management

The following are some examples of medications that can

increase that falls risk

• Allergy medications

• Analgesics

• Heart medication

• Anxiety and sleeping medications

• Anti – inflammatory medications

• Anti-depressants

• Cold and flu medications

Prescribed medicines

• Seek advice and talk to your doctor or pharmacist for a review

of your medication or you have any concerns …..and/or

• If you start taking a new medication, change brands, take

multiple medicines or change the dose as you may

experience some side effects

NB. Complementary medicines and over the counter and herbal

medicines may react with prescribed medication. e.g. sedative

cough medicines.

• Keep an up to date list of your medications – a medication card can be useful

• Do not take any one else’s medicines and do not use out of date medicines, return them to your pharmacist for safe disposal

• Read medicine labels in good light and follow instructions carefully. If you can not read or understand the instructions, seek advice

• A pill organiser or ‘Webster Pack’ from your pharmacist, can help avoid confusion when taking several medicines and can help you mange things easily

Having a chronic condition can increase your falls risk. Examples

• Musculo-skeletal conditions e.g. Arthritis, Osteoporosis

• Neurological conditions e.g. Stroke and Parkinson’s disease

• Cardiovascular and respiratory conditions e.g. uncontrolled blood pressure, arrhythmias, syncope

• Metabolic changes and conditions e.g. Diabetes

• Others - Mental health conditions and cognitive changes e.g. Dementia /acute delirium/ depression / sleeping problems

Identify your illness

• Seek as much information about your condition and work

with others to assist you to manage it.

Find Support and information

• Contact relevant organisations

Take action

• Follow the treatment plan as prescribed

• Have a good nutritious diet to maintain good health

• Exercise to remain strong and well balanced

• Subtle changes can occur with movement which decreases

the ability to walk safely around the environment and

negotiate obstacles

• Poor balance and decreased strength reduces the ability to

transfer safely to get out of chairs, climbing stairs etc.

• This is mainly due to weaker muscles in the ankle, knee, hip

and trunk areas. It is import to keep muscles strong

by undertaking regular correct exercises

Keep safe and the body better balanced by …..

Using a Walking Aid

• A stick or frame provides better support and stability of the body which makes it easier to move safely, easily and with

confidence.

• Walking aids need to be properly prescribed, used and regularly maintained. Have them prescribed and checked by a

Physiotherapist or Occupational therapist

• For safety reasons do not use some one else’s aid

People need to safely manage the environment inside and outside

Examples of hazardous situations / issues

• Inside and outside areas e.g. bedroom, bathroom, toilet,

kitchen , hallways, general traffic areas

• Different surfaces and slopes e.g. slippery and wet floors due

to liquid, powder and food spills; uneven ground

• Obstacles to negotiate e.g. clutter, furniture, stairs, animals

• Poor lighting e.g. areas that are not easily visible in the

bedroom, the hallway , on the stairs

19

Home Hazards

Around the Home In the Yard

60 % of falls of people aged 65 + happen in and

around the home

• 54% in living areas, hallways and the bedroom

• 10-12% in bathrooms,

kitchens, laundry and toilets

• Stairs 9%

Slippery and uneven surfaces e.g. wet moss, pebbles and leaves • 57% garden e.g. tripping

over hose left out • 15% driveway • 12% verandah

• 6% garage/shed • 3% roof/tree e.g. falling off

ladder

Wet or slippery floors

• Clean up spills as soon as they occur.

In the Kitchen

• Don’t climb on chairs to reach things – ask for help

In the bathroom and shower

• Be careful on wet and powdered floors

• Install handrails in the shower

• Use a bath seat or shower chair and a non-slip mat for extra

safety if required.

Clutter

• Keep rooms and hallways clear of clutter.

• Remove cords and cables from walkways

Mats and rugs

• Remove all loose rugs and mats or have the edges secured.

• Have non slip floor surfaces

Lighting

• Ensure there is adequate lighting in all rooms, steps and

stairs. Use night lights and install sensors outside

Stairs and Steps

• Install handrails.

• Paint the front edge of outside steps with a contrasting

colour; apply adhesive non-skid strip and install hand rails

The garden

• Make sure that paths are clean, dry, even and free of moss

• Put garden tools and hoses away when not in use

Skilled assessment

• The aged care assessment team (ACAT), located at your local

hospital can help spot hazards in your home.

Footpaths and Natural Hazards

• Be aware of broken footpaths caused by tree roots

• Be aware of things such as soft edges, unstable ground and

overhead branches. …………

• Keep lifting up your feet to reduce your risk of tripping,

slipping or falling over these hazards

Be visible

• Dress in bright clothes or wear some reflective clothing

especially if going out early evening and at night time

Lighting

• Avoid poorly lit places or going out when dark

Stairs and steps • Take time to walk up and down stairs (and on transport)

• Always use handrails if provided

At the shops

• Take care with people moving around you

• Stay alert to avoid any water spills

Crossing the road

• Take extra care and be ready to step off and onto the opposite kerb when the traffic lights change

Lighting

• If street lighting is inadequate or damaged contact your local electrical company.

Footpaths

• Report any problems with footpaths to your local council.

At the shops

• Report to shop staff or centre management any water spills and/ or If you have had a fall

High usage

• Make a request to council to install handrails and seating in areas that are used a lot by the community

Poor nutritional status e.g. malnutrition can result in an

increased risk of falls either due to ……

• Low body weight - poor muscle and bone mass with associated

reduced strength

• High body weight - more fat than muscle mass with associated

reduced strength

General and heart health food intake recommendations

• Eat 3 good meals a day, or regular small meals and snacks to keep up your energy. Have low fat serves of fish, meat poultry

with 2 fruit and 5 vegetables

Poor hydration can lead to you becoming light headed, weak and

dizzy which can lead to an increased risk of falls

Fluid intake recommendations

• Drink 6-8 glasses of fluid such as water, tea, fruit juice, milk shakes, soups a day.

With age and inactivity bones can become more fragile and

more likely to break (after a fall)

Strong bones and muscles food intake recommendations

• Eat plenty of calcium rich food which is also Vitamin D enriched every day such as dairy products, tinned fish

Tip: spend more time in sun to boost Vitamin D levels

Eating a balanced diet is very important for good health and

energy as well as maintaining strong bones and muscles.

Exercise is the single most important thing you can do to

remain active and strong

• To reduce your risk of falls and fractures, progressive strength

exercises incorporating some balance work helps maintain

good body control

• Undertake regular exercise most days of the week ……..just 30

minutes a day can make a real difference!

• Exercises that are beneficial include Tai Chi, dancing, home

based exercises as well as tailored group exercise programs

The major focus on strength and balance elements should involve the following areas (example exercises)

• Feet and Ankles

Walking on the Spot Calf Stretch

• Knees

Straight Leg Raises Hamstring Curl

• Hips and Trunk

Side leg raise

And many more standing activities

Stop Slipping, Tripping and Falling

• Consider all the falls risk factors that may apply to you and work systematically through them to address the problems as far as you are able

Keep up to date ….Keep checking

• Undertake regular checks for changes in eyesight; medication; feet and footwear and act on the advice given

Stay Alert

• Be constantly on the alert and aware of your environment inside and out to ensure it is safe for you to be able to move

around easily

Eat Well

• Eat well and take sufficient calcium with Vitamin D to stay healthy and strong allowing you to have enough energy throughout the day

Exercise to Stay Strong and Healthy

• Keep exercising most days of the week to keep your muscles and bones strong to help keep you safe and active

Be proactive …don’t wait for something to happen before you make changes

Needing help? • Problems Shopping or cooking for your self? -

Commonwealth care link ON 1800 052 222 (free call)

• Assessments – local Aged care services/ or community health team can assist in assessing your home and health . This can be contacted through your local hospital

• Vitamin D sun exposure recommendations

Vitamin D and health in adults in Australia and New Zealand :a position statement

Newson et al MJA 196(11)-18 June 2012

Staying Active and on Your Feet booklet

Ministry of Health website

Website www.activeandhealthy.nsw.gov.au

Osteoporosis Australia website

Website www.osteoporosis.org.au

NSW Falls Prevention Program

Clinical Excellence Commission

Level 13, 227 Elizabeth Street Sydney NSW 2000

Website : www.cec.health.nsw.gov.au

Free resource

booklet

Health Professionals are able to order this resource on-line: www.activeandhealthy.com.au

The 'Stepping On'

program is a free falls

prevention group program

for older, community

dwelling people who have

had a fall or are fearful of

falling:

- The target audience is

community residing

residents over the age of

65 yrs.