Reduce fall risk with these home safety, exercise, self-care and nutrition tips from our OTs, physios and dietitians.
For people living with disability and those whose mobility and balance are limited by the physical and/or cognitive effects of ageing, the risk of falling is often greatly increased. This risk is often especially high for those living independently due to the absence of risk assessments, checks and precautions that are in place in assisted or supported living environments. Even for those whose home environments have been assessed and even modified, many household items such as electrical cords, rugs and doormats can become major hazards.
Why falls matter
While the obvious and very real danger of heightened fall risk is injury, from cuts and abrasions to sprains and strains and fractures and head injury, fall risk can also compromise vulnerable people by undermining their confidence in independently performing daily living tasks or engaging in activities. It is not uncommon for those who have previously had a fall to report living in fear of reoccurrence and in turn limiting activities in a bid to prevent another fall. Indeed, a fall within the last year is a significant predictor of another fall. So what can be done to mitigate both fall risk and confidence issues associated with fall risk?
There are many simple checks and precautions that can be taken by an individual or by a carer or visiting allied health practitioner such as an occupational therapist (OT) to reduce fall risk. These include simple precautions around the home as well as self-care measures including dietary patterns and timings. Exercises tailored to reducing fall risk can also be prescribed by a physiotherapist.
- Place electrical appliances close to the socket rather than having an extended exposed cord that may cause tripping.
- Ensure that any carpets, rugs and mats (including doormats) are securely fixed. Curling or lifting edges are prime trip hazards. If a rug or mat is required, look for those with minimal edge height.
- Keep floor areas clear of objects. Everything from a book or newspaper left beside a chair to shoes or slippers left on the floor can cause falls.
- Ensure that halls and stairs in particular are brightly lit. Consider placing a high-contrast adhesive strip on steps.
- Store regularly-used items from linen to spare lightbulbs within easy reach to prevent the need or temptation to climb on a chair or ladder.
- Ensure that any liquid spills are promptly and thoroughly dried. Spills on kitchen and bathroom floors are slip hazards.
- Be conservative in your risk appraisal and ask for assistance with tasks that stretch your capacities. If a task or activity presents any fall risk, wait for help.
- If you are unable to safely perform certain tasks around the home or garden, explore local home assistance options. Ask our team about home and garden assistance options.
Poor balance and impaired gait are known risk factors for falls. Key indicators may include inability to walk in a straight line or at a steady speed; requiring support in order to walk; inability to stand on one leg or to sit down in a controlled manner. Exercise can significantly mitigate fall risk by strengthening physical deficits that contribute to fall risk. Ideally, these exercises are prescribed by a physiotherapist based on your unique physiology. You can also help to decrease your fall risk by remaining physically active to maintain strength and agility. Consider these exercise types:
- Swimming. This can help to build strength and stamina without the weight-bearing of land-based exercise.
- Weight-bearing exercise such as walking, especially carrying weights or exercises such as lunges and squats (again, using weights such as suitably-weighted dumbbells, soup cans or bottles of water enhances the beneficial effects). This is particularly useful for maintaining bone density and in turn reducing your risk of fractures if you do fall.
- Balance-based exercises. This can be as simple as standing on one leg for 15-30 seconds and swapping legs. If it is safe for you to do so, you may use a prop such as a balance ball or board.
Few people consider food types or meal timing as risk factors for falls, but the effects of irregular food intake or unbalanced meal composition and dehydration can contribute to fall risk. This can be mitigated by adhering to a schedule of snacks and meals, planning snacks and meals that will sustain energy and maintain stable blood sugar and getting into a routine of drinking water throughout the day.
- Eat regularly to keep blood sugar levels steady. Low or unstable blood sugar can cause dizziness and fatigue, which increase fall risk. Four or five small meals are more helpful than two large ones with multiple hours between. Meal and snack composition can also assist with this. A snack or meal containing high-fibre, slow-release or low-GI carbohydrate (think wholegrain bread) and protein (e.g. egg) will keep blood sugar and energy levels more even than will a piece of white bread with honey or a bowl of low-fibre cereal.
- Maintain hydration by regularly drinking water throughout the day. Even mild dehydration you don’t notice can cause dizziness. Make a habit of keeping a water bottle with you or schedule glasses of water for one-hour intervals. Consider setting an alert on a device such as a phone or creating a simple chart on paper with the day and eight glasses and tick each one off.
Many health conditions including hypotension or hypertension and diabetes can, without proper medical management, increase fall risk. Conditions affecting vision, hearing and balance can also increase one’s risk of falling. Maintaining general healthcare and adherence to medical advice are important measures in fall prevention. Consider this checklist.
- Have your eyes tested regularly and wear your glasses if you need them. If glasses with multifocal lenses cause problems, consider having two separate pairs for distance vision and close-range or detailed activities.
- Keep your feet healthy by regularly visiting a podiatrist. Corns, bunions and other foot conditions can compromise walking and stepping technique and in turn increase fall risk.
- Maintain general health with regular GP visits and check-ups. Many common medical conditions including diabetes and hypertension can contribute to fall risk due to lightheadedness or dizziness, which can lead to loss of balance. Ear infections and build-up of wax in ear canals can also compromise balance.
- Choose sensible shoes that fit well and have good grip. Avoid floppy slippers and sandals, backless shoes and high heels. With clothing, avoid drapy clothing that hangs around your legs or feet or arms.
If you or someone in your care is concerned about fall risk, consider a home assessment by an occupational therapist, who can provide a comprehensive assessment of the home environment and recommend modifications and measures to maximise safety and confidence. If you experience dizziness or light-headedness due to a medical condition or unknown cause, bring it to the attention of your primary healthcare practitioner and other healthcare providers.