Falls and Frailty
Falls and fall-related injuries are common and serious problems for older people. People aged 65 and above have the highest risk of falling with 30% of people older than 65 and 50% of people older than 80 falling once a year (source NICE clinical guideline 161, June 2013).
Despite this, falls are not an inevitable part of ageing. Children and athletes often fall, but the reason that such interest is taken in people over the age of 65 is that implications of a fall for this group are often very significant and can often result in the failure to recover to their previous level of health. Frailty is related to the reduction in an individual’s function that develops as part of the ageing process.
Experts believe that the vast majority of falls could be prevented with some fairly modest changes to our lifestyle. People at risk of falls are often reluctant to discuss it because they fear their independence may be taken away from them, its up you us to persuade them that the opposite is true: that by taking positive steps to prevent falls they will preserve their health and independence for longer.
Very Brief Intervention
OBSERVE if the person seems unsteady when walking or rising from a seating to a standing position
ASK - You seem a bit unsteady, which much be annoying, I hear that you can do something about that
OBSERVE if the person is shuffling or walking really slowly
ASK - Have you had a fall over the last 12 months or do you have a fear of falling?
- A fear of falling is a common symptom in people who have had a fall even when person had not injured themselves, its increases the chance of further falls, because they are often unable to act rationally when about to fall, as panic kicks in.
- Check if they informed their GP of the fall as they can often help by reviewing medication, supporting eye test etc
Do you spend quite a lot of time sitting down if you are worried about having a fall?
- Sitting down for long periods can actually harm balance, body strength and mobility, which in turn makes a fall even more likely, its a vicious circle that damages confidence and independence.
Would you like some information on the benefits of keeping active and moving?
- The more active you can be the more you can offset the effects of ageing
- These activities are fantastic for maintaining balance and mobility
- Walking to the shops rather than driving
- Strengthening and balance fitness classes
- When sitting, keep your back as straight as possible to avoid a stooped posture
- When watching TV, roll your shoulders regularly and get up and walk about in ad breaks or between programmes
Would you like some information on the top five ways to avoid slips trips and falls?
- Badly fitting shoes - Our feet change shape with age and lose some feeling and flexibility, soles should be thin enough for you to feel the ground but have enough cushioning for shock-absorption and good tread for gripping
- Trailing clothes - Hems of trousers that are too long or loose belts or cords for dressing gowns
- 'Shuffly' walking - Its easy to get in the habit of not lifting your feet as high as you used to when walking but this increases your chance of tripping
- Worn out slippers - Its may be time to say goodbye to your old friends, frayed uppers and sloppy backs, Slippers should fasten and stay on and provide grip.
- Walking on socks/tights on hard floors - Don't do it, wear good slippers instead
Would you like some information on ways to try and fall proof your home?
Fall proof your home - 6 out of 10 falls happen in the home but a few simple changes can help
- Lighting - Avoid trailing cables - Use a bedside lamp when getting up at night
- Living areas - Check rugs have a non slip underlay, consider replaying or repairing frayed carpets - remove any clutter from hall, landing, stairs and doorways
- Garden - Keep paths free of moss and leaves where possible - Repair cracks in paving
- Kitchen/Bathroom - Rearrange cupboards so that frequently used items are in easy reach - Use a non slip matt in the shower/bath, consider installing grab rails in bathroom
Remember installing hand rails and non-slips mats might make you feel older but they can ensure that you are able to be more independent for longer and give you more freedom, not less.
There is a wealth of information and ways to prevent falls on the following websites
- Saga - Discover ways to stay fit at https://www.saga.co.uk/magazine/health-wellbeing/wellbeing/falls-guide
- Age Uk - Information on falls prevention, exercise classes and handyman services in some areas. Call free on 0800 169 6565 or see https://www.ageuk.org.uk/information-advice/health-wellbeing/fitness/falls-prevention/
- The effective assessment of an individual’s risk of a fall would be a multifactorial intervention considering falls history, visual impairment etc. This assessment would enable the referral of an individual to effective interventions targeted at specific risk factors
- Your GP may carry out some simple tests to check your balance. They can also review any medicines you're taking, in case their side effects may increase your risk of falling. Your GP may also recommend:
- having a sight test if you're having problems with your vision, even if you already wear glasses
- having an electrocardiogram (ECG) and checking your blood pressure while lying and standing
- requesting a home hazard assessment, where a healthcare professional visits your home to identify potential hazards and offer
- advice doing exercises to improve your strength and balance (try some exercises for older people)
- NHS Choices - Find this leaflet and other resources at https://www.nhs.uk/live-well/healthy-body/keep-your-bones-strong-over-65/
Local Support and Contact Details
Live Well Barnsley
A full range of services can be found on the Live Well Barnsley website
Chair Based Exercises and Healthy Bones (classes around Barnsley)
When people have major health issues in their lives, it is important that Physical Activity Practitioners work with them to develop an appropriate physical activity programme to enable them to have greater control of their illness or disease and increase their physical activity levels. This activity should be a constant feature of the individual’s lifestyle and not just a short burst.
We hold many classes in community settings throughout the Barnsley area that happen on an ongoing basis. Many GPs refer patients to us and the difference that we make to their lives is amazing. We are able to accommodate and recommend appropriate exercises specific to individuals and Bronia is a qualified Level 4 exercise specialist. Activities include posture stability/falls prevention for conditions such as arthritis, osteoporosis, Parkinsons, MS and those who have suffered a stroke.
All exercises are tailored to the individual, and include options like movement to music, tai chi, chair based exercises suitable for people with dementia.
Tel: 07895 380615
South West Yorkshire Partnership NHS Foundation Trust
Equipment, adaptation and sensory impairment service.
Tel: 01226 775800
The service provides assistance to people with physical and/or sensory disabilities. We help people make the most of their abilities to remain as independent as possible in their own homes. We provide advice and information, assistance with obtaining specialist equipment, assistance with adaptations to the home, advice regarding moving and handling, mobility training for people with visual impairment.
My Best Life Barnsley - (GP Referral Only)
Our advisors work with people to connect them with local non-medical support. They can visit you at home, or wherever you feel
most comfortable, at a time that suits you best – including evenings and weekends They’ll work with you to put together your own action plan that can help with a range of things, including:
• Improve mental wellbeing
• Manage your physical health and symptoms
• Lead a healthier lifestyle
• Improve your home environment
• Get involved in your local community
• Maximise your income and access benefits
• Find work, training and volunteering opportunities
Move More Doncaster
Aimed at/suitable for
People looking to increase their physical activity opportunities- whatever their ability.
What’s on Offer
A tailored programme of physical activity, free for 12 weeks, at a time and place to suit you. There's something for everyone, from a leisurely stroll, or a fast paced salsa dance, to geocaching, an activity the whole family can enjoy? An opportunity to meet new friends and try something different.
All Doncaster residents over the age of 50
Online Referral: http://www.movemoredoncaster.nhs.uk/referrals/new
Tel: 0800 0169 187
Your Life Doncaster
This website provides resources for you to look after yourself within your own community; focusing on you keeping well, safe and connected.
East Riding Falls Service
The East Riding Falls Service provides a multi-disciplinary holistic health assessment aimed at identifying reasons for falls. The East Riding Falls Service provides interventions that focus on minimising the risks of further falls, strength and balance rehabilitation and mobility. The interventions that follow are jointly agreed between the service and the client. Clients registered with an East Riding GP can access this service. Falls-related enquiries can be directed to:
Tel: 01482 336553
Address: East Riding Falls Service
Highlands Health Centre
Social Prescribing Service
Feel like no one has time to listen to you? The Social Prescribing service provides a totally confidential service to discuss the things that affect you and your health and well being, it will then work with and support you to access appropriate local services, groups and amenities to help you improve your situation.
Situated in the majority of GP practices, the Link workers will listen and help you to arrive at the best solution for you, It can advise and support you with a wide variety of issues and can be accessed via a participating GP surgery without a referral.
If you want more information or details of how you can access the service please telephone: 0800 9177752 or email: email@example.com
or call your nearest Social Prescribing Link Worker:
Bridlington: 07816863639 / 07970151668 / 07970155722
Beverley and Driffield: 07973 895011
Withernsea and Hornsea: 07515788266
Hedon: 07702 975417
Market Weighton and Pocklington: 07973894829
The Medicines Use Review Service involves the pharmacist reviewing the patient's use of their medication, ensuring they understand how their medicines should be used and why they have been prescribed, identifying any problems and then, where necessary, providing feedback to the prescriber, this isn't usually conducted more than once a year. If someone is worried about falling, their mobility is reducing, experiences slips, trips or stumbles or has maybe had one minor fall, the pharmacist can check that medication is being prescribed correctly in relation to falls risk. Ask at your usual pharmacy where you collect your prescriptions for a Medication Use Review.
East Riding Lifeline service provides a home safety and personal security system that enables East Riding residents to live independently within their own homes. This is achieved through the Lifeline unit which creates a telephone communication link 24 hours a day between the home and the monitoring centre base in Driffield. When this is activated via a pendant or sensors, the monitoring centre trained operators take appropriate action, depending on the level of service chosen.
Lifeline offers a Responder Service to attend alarm activations, giving piece of mind that a response will be given to emergency calls or support needs. The Responders are trained with the latest lifting equipment called a "Razier" and are able to assist customers who may have fallen.
The service is available to customers 24 hours a day and operates 365 days of the year, providing individualised support to enhance the opportunity for people to maintain independence whilst living in their own home. People who are frail and at risk of a fall can benefit from this service.
For more information contact the Referral Line 01482 396040
Neighbourhood Care Service (City Health Care Partnership)
The Neighbourhood Care Service (NCS) consists of a number of clinical staff, including District Nurses, Community Staff Nurses, Physiotherapists, Occupational Therapists, Staff Nurses, Healthcare Assistants and Rehabilitation Assistants. The NCS delivers high quality, evidence-based care to patients with an identified nursing and/or therapy need in their own home or a clinical setting. The service works together to support care delivery, utilising a multi-disciplinary team approach.
Patients must be 18 years or over and registered with an East Riding GP. Patients are able to self-refer, or referrals can be made on their behalf (family/carers). Referrals can also be made by GPs and Health Care Professionals, and when being discharged from hospital.
Referrals should be made via Single Point of Contact
Tel: 01482 247110
East Riding Partnership – Substance Misuse
Do you think alcohol/substances may be contributing to your client’s falls? The East Riding Partnership is a confidential service who are here to listen, and help put plans in place to reduce the intake of alcohol/substances. We are easy to access, available drop in clinics run throughout the East Riding of Yorkshire within pharmacies and we also work in many of the GP practices.
East Hub (Bridlington) 01262 458200
Central Hub (Hull) 01482 336675
West Hub (Goole) 01405 608210
Humberside Fire and Rescue Service Safe & Well Visits
Safe and Well is a Home Fire Safety visit that is tailored to an individual’s needs, relating to fire risk and their health and lifestyle choices.
These visits are only carried out by trained Fire and Rescue service staff, at a convenient time for the person.
Whilst we would like to offer visits to all Humberside residents we simply aren’t able to. As such we focus our visits on the most vulnerable people in our community.
During a Safe and Well visit, we will:
- accompany you to assess fire safety in every room in your property
- identify and make you aware of the potential fire risks in your home
- make sure you know what to do to reduce or prevent these risks
- discuss with you, a bed-time routine that will help keep you safe at night
- help you put together an escape plan in case a fire breaks out in the future
- ensure you have a working smoke alarm on the ceiling of every level of your home, and ensure you know how to test and maintain it
Give basic advice on topics such as:
- Falls prevention
- Cold homes
- Smoking cessation
- Social isolation
- Crime prevention.
If you have fire safety concerns about anyone you know or work with, you can make a Safe & Well referral to us to see if they are eligible for a fire safety in the home visit.0300 300 8242– Request a Safe & Well Visit (Assisted Support). If you or the occupier are not eligible for a home safety visit, you will be sent free tailored advice to keep you and your family safe in your home.
Web: www.humbersidefire.gov.uk – Safe & Well Visit Online Referral Pathway (Self-Help and Partner Referral).
East Riding Leisure
Physical Activity that promotes strength and balance can be helpful for falls prevention. Instructors are trained to identify falls risk and support people to participate in appropriate exercise. Exercise on referral may also be helpful for falls prevention and is available via referral from the clients GP practice.
Tel: 01482 395230
Adult Social Care
Adult Social Care provide short term care services as an emergency eg when leaving hospital or long term support needs can be assessed to ascertain eligibility to receive help which could include:
- Staying safe in your own home
- Maintaining independence in your own home
- Care services in your own home
- Day care and social activities for adults
- Access to long-term residential care if receiving care at home is not possible
- Support for carers if eligible, clients receive a ‘Personal Budget’ which allows you to purchase care outlined in a support plan which is provided following the assessment Information advice and support is available to adults who need help to live as well as possible with an illness or disability, including people who are older or frail, who have mental health issues or are vulnerable for other reasons. Information and advice is free for all, access to services is only available to those who are eligible for funding via their Personal Budget. Contact should be made via Customer Services and a decision will be made on whether an assessment is needed.
Tel: 01482 393939
Hull Falls Prevention Service
The Hull Fall Prevention Service provides a multi-disciplinary health assessment aimed at identifying reasons for falls and providing intervention plans which focus on minimising risks of further falls. The interventions that follow are jointly agreed between the service and the client. The service can be accessed via a single point of contact. Clients registered with a Hull GP can access this service.
Tel: 01482 247111
Kirklees Council - Gateway to Care
Gateway to care is the first point of contact for everyone that would like information or advice on adult social care and support services available in Kirklees. Gateway to care people to stay safer and more independent in their homes with the help of equipment and adaptations.
Tel: 01484 414933 (24 hours a day 7 days a week)
Customer Service Centre, Civic Centre 3, Market Street, Huddersfield, HD1 2YZ
Customer Service Centre, Walsh Building, Town Hall Way, Dewsbury, WF12 8EQ
SWIFT is a service to support people aged 50 years plus who may be living with frailty, severe mental health issues, social isolation and other complex issues. SWIFT helps with what matters most to people, this could include;
- Being active and healthy
- Being able to do the things you enjoy
- Being socially connected
- Living independently
How can SWIFT help you?
You will receive a home visit or call by a SWIFt worker who will listen to you and understand your motivations and goals.
SWIFT can work with someone to build on strengths and co-produce an action plan with you whilst providing support to make it happen.
This support will depend on needs and could include;
- Home visits
- Emotional support
- Access to digital technology
- Assistance to get out and about
- Information on local services and activities
- Help to stay connected to the local community
What happens next?
After being referred to SWIFT – City-wide at Age UK Leeds, you will be contacted by ourselves or by one of the SWIFT partner organisations in your area who can best support you based on your needs.
If you or someone you know would like support, please contact the SWIFT City-wide provider at Age UK Leeds.
Tel: 0113 389 3001
Active Leeds for Health
Active Leeds offer a programme of activities for people at the risk of falls. These 'Strength and Balance' sessions are designed to improve strength, balance and co-ordination for people with low mobility. The progressive sessions involve a mixture of chair based exercises and standing strength and balance exercises.
- Due to COVID19 group sessions have been suspended. The programme now includes;
- Using the Keeping Well at Home Resources.
- Support via phone or online.
There are a limited amount of loan “digital tablets” that people can borrow. This means people that are digitally excused can access online resources to help them keep active
Tel: 0113 378368
Website: Falls Prevention (leeds.gov.uk)
Hope Specialist Service (Care Plus Group)
Hope Specialist Service provides a patient centred one stop shop for older people at risk of falls.
Tel: 01472 313400
Address: Hope Street Medical Centre
North Lincolnshire Council
'Active Ageing' - A programme that offers a 'gentler' less strenuous approach to exercise.
Tel: 01724 297270
Age UK - Lindsey
Activities for older people to support balance including games group and mobility aids for sale or to hire at Lifestyle Centre. Foot care service also available in Centre.
Tel: 01724 849819
Address: 34a Crosby Road,
The North Lincolnshire Council staying independent webpages have really useful information on a range of topics associated to maintaining independence and functional health and fitness such as: Adaptations, Falls Prevention, Home Care, Telecare/Care Call & Handy Person Service.
Occupational therapist home adaptations / falls prevention
For help on how to be referred contact your nearest Network Team directly:
Scunthorpe West Network Team
(anything North of Queensway, including Frodingham Road and the Isle of Axholme)
Tel: 03033 306802
Scunthorpe South Network Team
(anything South of Queensway, up to Messingham and everything in-between including Kirton Lindsey and Hibaldstow)
Tel: 03033 306804
East Network Team (Broughton to Killingholme and everything in-between)
Tel: 01724 298180
Sheffield City Wide Care Alarms
City Wide Care Alarms can provide fall sensors and care alarms that can provide peace of mind for you or someone you care for. (There is a charge for this service.)
Tel: (0114) 242 0351
If you think you need help talk to your GP about the Sheffield Falls Prevention Service.
Public Health - Wakefield Council
Live Well Wakefield community based service which has been set up to support adults aged 18+ to improve their health and wellbeing. Please contact this service through by using the telephone number above or you can contact this service through the website.
Tel: 01924 255363
YorWellbeing Falls Prevention Scheme
If you are worried about falling in your own home, or sometimes feel unsteady on your feet at home, YorWellbeing are offering free home safety visits to all residents in Clifton and Guildhall Wards who want practical help and advice to reduce the risk of falls in their home.
Tel: 01904 567456