Falls Prevention for Older Adults in Worcestershire

About a third of people over 65 fall at least once a year. Most falls do no lasting harm, but they change how people live: they go out less, do less, and get weaker, which makes the next fall more likely. Falls are one of the risks of getting older that respond well to the right kind of exercise.

Why do falls happen?

Hardly ever for one reason. A fall is usually several small things lining up at once, which is why fixing just one of them is often not enough.

• Weak legs — the most common cause, and the most fixable
• Stiff, painful joints — arthritis in the hips, knees or feet changes the way you walk
• Slower balance reactions — so a trip that was once a wobble becomes a fall
• Tablets — blood pressure tablets, sleeping tablets and some antidepressants all add to the risk. Ask for a review; do not stop anything yourself.
• Blood pressure dropping when you stand up, which causes falls getting out of a chair or bed
• Eyesight — and varifocal glasses, which blur the edge of a step
• Feet and footwear — painful feet, and slippers with no backs
• The house and garden — rugs, trailing wires, dark stairs, uneven paths and steps
• Fear of falling — which makes people walk stiffly, and stiff walking is less steady

Many older cottages in the county's villages have steep, narrow stairs, low beams and uneven floors. None of that has to be a problem, but it needs to be part of the plan.

What actually reduces the risk?

This is one of the best-studied areas of physiotherapy, and the answer is quite specific. Exercise cuts falls, but only the right kind.

What works: programmes that properly challenge balance, combined with strength work for the legs that gets harder over time, done at least twice a week and kept going for months. The balance part has to be genuinely challenging — standing with the feet together or one in front of the other, reaching, turning, stepping in different directions. If it feels easy, it is not training your balance.

What does not work on its own: walking. Walking is good for lots of things, but it does not build leg strength or train balance, and walking programmes on their own do not cut falls. Gentle seated exercise has the same problem.

If painful joints are what stop you exercising, treating the pain first often makes the rest possible.

What does a home falls assessment involve?

You. Simple tests that give a number to work from: how many times you can stand up from a chair in thirty seconds, how long you can balance with your feet in a line, how long it takes to stand, walk a few steps, turn and sit down. Plus a look at how you walk and at any painful joints.

Your house. Room by room. The stairs and the rails, the lighting, the height of the bed and chair, rugs, thresholds, the bathroom, and the path to the front door.

Your life. What you have stopped doing, and what you want to get back to. The plan is built around that.

What does the exercise look like?

Usually a short daily routine using things you can do in your kitchen holding the worktop: standing up from your own chair, heel raises at the sink, stepping practice, standing with your feet closer together and then in a line. It gets harder by using less support and a narrower stance, not simply by doing more.

After six to twelve weeks most people can do measurably more. The chair test is the easiest to watch, and usually the first to improve.

What if I have already fallen?

Tell your GP, even if you were not hurt. A fall is the best sign that another may follow, and it should lead to a look at the cause and at your tablets. If you could not get up, or it took a long time, see our guide on how to get up safely after a fall.

Home visits across Worcestershire

Strength and balance checks and programmes are available at home across Worcester, Droitwich Spa, Malvern, Kidderminster, Redditch, Bromsgrove, Evesham and across Worcestershire, including in care and nursing homes.

About Charlotte Dyke

Charlotte Dyke is a chartered physiotherapist (HCPC PH91656) providing home visit physiotherapy across Worcester, Droitwich Spa, Malvern, Kidderminster, Redditch, Bromsgrove, Evesham and across Worcestershire. She qualified from Keele University in 2009 and has run Black Pear Physio since 2017, treating back and neck pain, joint pain and arthritis, sports injuries and recovery after a joint replacement. She also trains student physiotherapists.

Read Charlotte's profile or call 01905 611010.

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