Staying Steady at Home: Falls Prevention in North and East London

About one in three people over 65 has a fall each year. Many falls cause no serious injury, but they knock confidence. People go out less, move less and get weaker, which makes another fall more likely. The good news is that the right exercise can break that circle, and it can all be done at home.

Why do falls happen?

A fall is rarely down to one thing. Usually several small things add up:

• Weaker legs, the most common cause and the most fixable
• Slower balance reactions, so a trip turns into a fall
• Some medicines, such as blood pressure tablets and sleeping tablets. Ask your GP or pharmacist for a review; never stop a medicine on your own.
• Feeling dizzy when standing up, from a drop in blood pressure
• Eyesight, and varifocal glasses that blur the edge of a step
• Feet and footwear, especially loose slippers
• The home itself: rugs, clutter, poor lighting and stairs with one rail
• Fear of falling, which makes people walk stiffly and less steadily

London homes bring their own challenges

Victorian terraces in Islington, Hackney and Walthamstow often have steep, narrow stairs and a step down to the back garden. Many people live in flats where the lift is not always working, or where the walk from the car park or bus stop is long. Outer areas such as Enfield, Harrow, Chingford and Romford have more houses with gardens, but also front paths and kerbs that can be slippery in the wet. A falls plan should take all of this into account.

What really reduces falls?

Exercise is the best-proven way to cut falls, but it has to be the right kind:

• Balance practice that is a real challenge, such as standing with your feet closer together, stepping in different directions and turning
• Leg strengthening that gets harder over time, such as standing up from a chair without using your hands
• Done regularly, at least two or three times a week, and kept going for several months

Walking is good for health and mood, but on its own it does not build enough strength or balance to cut falls. Gentle seated exercises have the same problem.

What does a home falls check involve?

A first visit lasts an hour and looks at three things.

You: simple tests such as how many times you can stand up from a chair in thirty seconds, how long you can balance with one foot in front of the other, and how you walk and turn.

Your home: the stairs and rails, lighting, rugs, the bathroom, the height of your bed and chair, and the route to the toilet at night.

Your goals: what you have stopped doing and would like to do again, such as getting to the market, the park or the bus stop on your own.

You are then given a short routine, usually done in the kitchen holding the worktop, that gets harder as you get stronger.

If you have already fallen

Tell your GP, even if you were not hurt. If you could not get up by yourself, practising how to get up from the floor safely is an important part of the plan. The NHS has falls services across North and East London, and your GP can refer you. Private home physiotherapy can help if you would rather not wait, or if you want more visits.

Home visits across North and East London

Falls checks and strength and balance programmes are available at home in Islington, Camden, Hampstead, Finchley, Harrow, Enfield, Hackney, Stratford, Walthamstow, Ilford, Romford and across North London and East London.

About Mehmet Solak

Mehmet Solak is an HCPC registered physiotherapist (PH109064) providing home visit physiotherapy across Islington, Camden, Hampstead, Finchley, Harrow, Enfield, Hackney, Stratford, Walthamstow, Ilford, Romford and across North London and East London. He spent seven years in neurological rehabilitation with a national disability charity, has worked in musculoskeletal clinics, and has visited patients at home across London since 2020.

Read Mehmet's profile or call 07376 030885.

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