Falls

Overview - Falls

Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.

Falls are a common, but often overlooked, cause of injury. Around 1 in 3 adults over 65 who live at home will have at least one fall a year, and about half of these will have more frequent falls.

Most falls do not result in serious injury. But there's always a risk that a fall could lead to broken bones, and it can cause the person to lose confidence, become withdrawn, and feel as if they have lost their independence.

What should I do if I fall?

If you have a fall, it's important to keep calm. If you're not hurt and you feel strong enough to get up, don't get up quickly.

Roll on to your hands and knees and look for a stable piece of furniture, such as a chair or bed.

Hold on to the furniture with both hands to support yourself and, when you feel ready, slowly get up. Sit down and rest for a while before carrying on with your daily activities.

If you're hurt or unable to get up, try to get someone's attention by calling out for help, banging on the wall or floor, or using your aid call button (if you have one). If possible, crawl to a telephone and dial 999 to ask for an ambulance.

Try to reach something warm, such as a blanket or dressing gown, to put over you, particularly your legs and feet.

Stay as comfortable as possible and try to change your position at least once every half an hour or so.

If you're living with or caring for an elderly person, see what to do after an incident for more information and advice.

What causes a fall?

The natural ageing process means that older people have an increased risk of having a fall.

In the UK, falls are the most common cause of injury related deaths in people over the age of 75.

Older people are more likely to have a fall because they may have:

A fall is also more likely to happen if:

  • floors are wet, such as in the bathroom, or recently polished
  • the lighting in the room is dim
  • rugs or carpets are not properly secured
  • the person reaches for storage areas, such as a cupboard, or is going down stairs
  • the person is rushing to get to the toilet during the day or at night

Another common cause of falls, particularly among older men, is falling from a ladder while carrying out home maintenance work.

In older people, falls can be particularly problematic because osteoporosis is a fairly common problem.

It can develop in both men and women, particularly in people who smoke, drink excessive amounts of alcohol, take steroid medication, or have a family history of hip fractures.

But older women are most at risk because osteoporosis is often associated with the hormonal changes that occur during the menopause.

Preventing a fall

There are several simple measures that can help prevent falls in the home.

For example:

  • using non-slip mats in the bathroom
  • mopping up spills to prevent wet, slippery floors
  • ensuring all rooms, passages and staircases are well lit
  • removing clutter
  • getting help lifting or moving items that are heavy or difficult to lift

The charity Age UK has more advice about how to make tasks easier around the home.

Healthcare professionals take falls in older people very seriously because of the huge consequences they can have for the health and wellbeing of this group.

As a result, there's a great deal of help and support available for older people, and it's worth asking your GP about the various options.

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 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 give advice
  • doing exercises to improve your strength and balance (read about exercise for older adults)

Read more about preventing falls.

Information:

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled - including family members

Our guide to care and support explains your options and where you can get support.

Page last reviewed: 24 April 2018
Next review due: 24 April 2021

Prevention - Falls

There are ways you can reduce your risk of having a fall, including making simple changes to your home and doing exercises to improve your strength and balance.

If you have fallen in the past, making changes to reduce your chances of having a fall can also help you overcome any fear of falling.

Some older people may be reluctant to seek help and advice from their GP and other support services about preventing falls because they believe their concerns will not be taken seriously.

But all healthcare professionals take falls in older people very seriously because of the significant impact they can have on a person's health.

Discuss any falls you have had with your GP and say if it's had any impact on your health and wellbeing. 

Your GP can carry out some simple balance tests to check whether you're at an increased risk of falling in the future. They can also refer you to useful services in your local area.

Avoiding falls at home

Tips for preventing falls in the home include:

  • immediately mopping up spillages
  • removing clutter, trailing wires and frayed carpet
  • using non-slip mats and rugs
  • making sure all rooms, passages and staircases are well lit
  • organising your home so that climbing, stretching and bending are kept to a minimum, and to avoid bumping into things
  • getting help to do things you're unable to do safely on your own
  • not walking on slippery floors in socks or tights
  • not wearing loose-fitting, trailing clothes that might trip you up
  • wearing well-fitting shoes that are in good condition and support the ankle
  • taking care of your feet by trimming your toenails regularly and seeing a GP or chiropodist about any foot problems

Strength and balance training

Doing regular strength exercises and balance exercises can improve your strength and balance, and reduce your risk of having a fall.

This can take the form of simple activities such as walking and dancing, or specialist training programmes. 

Many community centres and local gyms offer specialist training programmes for older people.

Exercises that can be carried out at home are also available. Ask your GP about training programmes in your area.

It's important that a strength and balance training programme is tailored to the individual and monitored by an appropriately trained professional.

There's also evidence that taking part in regular tai chi sessions can reduce the risk of falls. Tai chi is a Chinese martial art that places particular emphasis on movement, balance and co-ordination.

Unlike other martial arts, tai chi does not involve physical contact or rapid physical movements, making it an ideal activity for older people.

Read more about physical activity guidance for older adults.

Medication review

If you're taking long-term medication, your GP should review your medicines at least once a year to make sure they're still right for you.

It's particularly important that your medicines are reviewed if you're taking 4 or more medicines a day. 

Your GP may recommend alternative medication or lower doses if they feel the side effects increase your chances of having a fall. In some cases, it may be possible for the medication to be stopped.

See your GP or practice nurse if you have not had your medication reviewed for more than a year, or if you're concerned that the medicines you or a relative are taking may increase the risk of falling.

Sight tests

Make an appointment to have a sight test if you're concerned that poor vision (even when wearing glasses) is increasing your risk of having a fall.

Not all vision problems can be cured, but some problems can be treated with surgery – for example, cataracts can be removed using cataract surgery.

Home hazard assessment

You can request a home hazard assessment if you're concerned that you or a relative may be at risk of having a fall, or if you know someone who has recently had a fall.

As well as identifying potential hazards, the aim of a home hazard assessment is to explore how a person's actual use of the environment affects their risk of falling.

A healthcare professional with experience in fall prevention will visit you or your relative's home to identify potential hazards and advise on how to deal with them.

For example, as the bathroom is a common place where falls occur, many older people can benefit from having bars fitted to the inside of their bath to make it easier for them to get in and out.

Fitting a personal alarm system may also be recommended so that you or your relative can signal for help in the event of a fall.

An alternative would be to always keep a mobile phone in your pocket so you can phone for help after having a fall.

Contact your GP or local authority to ask about the help available in your area. You can find your local authority on the GOV.UK website.

Alcohol

Drinking alcohol can lead to loss of co-ordination and exaggerate the effects of some medicines.

This can significantly increase the risk of a fall, particularly in older people.

Avoiding alcohol or reducing the amount you drink can reduce your risk of having a fall.

Excessive drinking can also contribute to the development of osteoporosis.

Page last reviewed: 24 April 2018
Next review due: 24 April 2021