Reducing the Risk of Falls by ActivLives

Reducing the Risk of Falls

Step by Step – Reducing the risk of falls. ActivLives offer Better Balance sessions at various community locations in Ipswich and East Suffolk. The sessions combine a mixture of seated and standing exercises incorporating OTAGO exercises to help improve muscle strength, co-ordination, flexibility and confidence as well as being a great opportunity to socialise. As well as attending Better Balance sessions, there are other things you can do to help keep you steady on your feet at home and reduce the chances of a fall occurring.

Keeping active Keeping active and mobile is a good way to maintain your muscle strength and flexibility. If you are able to, activities such as walking, gardening and even housework can all be a good little workout. If you are not usually very active, any physical activity is better than none. Making small changes can help you increase your activity levels, such as moving your teabags away from your kettle so you have to walk slightly further when making a cup of tea, or standing up as opposed to sitting when talking to someone on the telephone. Taking regular breaks from sitting is another good way to increase activity levels. If you are sitting for extended periods of time, stand up and have a little stretch and walk about – movement is good for you and all helps to maintain muscle and bone strength.

Things to consider to help reduce a fall occurring: •

Wear the right Footwear - Wear a supportive shoe / slipper that fits well, has a good grip and fastens up. Loose or worn out footwear may cause us to trip or slip as can shoes / slippers that are backless. It is a good idea to wear slippers indoors as we are more likely to slip wearing socks / bare feet, especially on smooth flooring.

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Looking after your Feet – Sore or painful feet can impact how we walk and make us less stable on our feet. Let your GP know of any foot problems. Try and look after your feet – as we get older it can be more difficult to reach to our feet and attend to footcare, so consider a podiatrist (Chiropodist) to help keep your feet pampered and healthy.

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Clothing – Try to ensure that clothing isn’t too loose or long as it could easily get caught under your feet. Watch out for trailing belts from a dressing gown.

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Look after your Eyes – Eyesight often changes with age – it can become more difficult to see obstacles and judge depth. Have regular eye checks and ensure you wear your glasses. Be careful of stairs / curbs when wearing varifocals / bi-focal glasses and keep your glasses clean.

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Hearing – Hearing loss is more likely as we age and can affect our balance. Speak with your GP if you notice changes to your hearing.

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Medication - Taking more than 4 different medicines can increase our risk of having a fall. Some medications may cause side effects that can cause dizziness and affect balance. It is good to have regular reviews of your medication from your GP in case they are no longer needed or the dose needs to be changed.

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Keep hydrated – If we don’t drink enough we can become dehydrated which can cause our BP to lower and can even make us feel a bit dizzy. Try and make sure you drink regularly throughout the day.

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Try not to rush – It can be very easy to rush, for example, to answer the telephone but try not to – you can always call the person back. Try and allow plenty of time and where you can plan ahead to avoid rushing.

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Don’t take unnecessary risks – If you need to do a task, such as changing a lightbulb and don’t feel confident, ask someone to help you. If you do want to tackle the task, make sure you use the correct equipment such as a set of steps as opposed to standing on a chair.

Environment considerations to help reduce a fall occurring: •

Look for hazards – Keep your floor free of obstacles. Remove trailing flexes and cables. Consider removing loose rugs and look out for frayed carpets edges which can cause a trip. Avoid leaving objects on the stairs. Ensure you have plenty of space around your furniture so you can easily manoeuvre around, especially if you have a walking aid to help you.

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Pets – be mindful where your pet is – it can be very easy for them to get under our feet when we are not expecting it.

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Lighting – Try to ensure there is good lighting within your home. When the nights start to draw in, make sure if you have lights on a timer you adjust the time that they need to come on. If you get up at night, put a bedside light on to help you clearly see your way or you could consider motion lighting. Don’t forget about good outside lighting too.

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Seating – have a chair that is a good height for you and you are able to get in / out of it easily. Often chairs are too low.

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Paths and driveways – try to keep paths clear from weeds, moss and fallen leaves. Watch out for uneven and slippery surfaces as well.

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Equipment – If it is getting more difficult to get around at home there may be equipment that can help you, such as grab bars and hand-rails, chair raisers and other equipment to help you in daily living. A community therapist should be able to advise on this, as well as, an assessment for a mobility aid.

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Pendant alarm – If you are very worried about falling or have previously fallen it might be worth considering a pendant alarm. They can often bring peace of mind not only to yourself but also to your relative.

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Weather conditions – Be aware of changing weather conditions, especially if rain or freezing temperatures are forecast.

If you do fall, let your GP know. Although, as we get older we are more likely to fall, it is not an inevitable part of ageing and there may be an underlying cause that can be addressed and prevent further falls occurring.

Better Balance Sessions ActivLives is working in partnership with the Ipswich & East Suffolk Clinical Commissioning Group to deliver the Step by Step programme. We are working with people 55+ within community settings to support and improve access to falls prevention OTAGO Better Balance sessions in Ipswich and East Suffolk. The Better Balance programme is designed to help people keep mobile, active and independent. The OTAGO exercise can help make it easier to get out of a chair, stay steady on your feet, improve your confidence, reduce your risk of falling as well as the ability to carry out day to day tasks. Attending the sessions also give people a purpose to get out more and meet other in the community, whilst taking part in a beneficial activity. All activities provide the opportunity to socialise and have a chat with others and also to find out about other ActivLives services and activities. For more information about how to attend a Step by Step Better Balance Session, please contact Jemma Prentice or Del Keeble on 01473 345350. Also visit our website at www.activlives.org.uk We currently have sessions in: • Ipswich • Felixstowe • Woodbridge • Leiston Future Sessions • Needham Market • Shotley

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What to do if you do fall • • •

Try to stay calm and try not to panic. Take a moment to check and establish whether or not you are injured – move your arms and legs Do you think you can get up?

YES - If you are able to: • • • • • •

Plan how you will get up Take your time Roll onto your side and get onto your hands and knees Crawl to a stable chair or settee to lift yourself onto If you can’t get onto your hands and knees you may find a bottom shuffle works better for you. Or anyway that allows you to move to a chair or near to a telephone Once standing, find a place to sit down

NO - If you are injured and unable to move: •

Summon help - try to attract attention – call out, bang on the floor, wall, radiator or use a personal alarm • Try to keep warm - grab anything that you can pull over yourself to keep warm. Support your head with a cushion or roll up an item of clothing • Try and keep yourself moving whilst waiting for help to avoid stiffness and help with your circulation • Stay Dry – try to move away from any wet areas

Most of us do have mobile phones now. Try and get into the habit of having this on you, even within your home.

Do you feel safe and secure? • • • • •

If you are concerned about falling, a pendant alarm would also be a good consideration Would aids and adaptations help you in or outside the home, such as a handrail? Are your alarms / pull cords easy to reach when necessary? NHS 111 is the number to call if you have an urgent health need and are not sure what to do about it. Ring 999 if it is an emergency

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Keeping moving as we age, is really important. The following exercises will help you keep mobile and steady on your feet. Remember, just 30 minutes of exercise a day can improve your health and wellbeing and your mental health and help reduce your risk of a fall.

Warming up before you exercise Before you begin any exercises make sure: • You never exercise holding on to an object which may move. Always use the side of something stable like a work surface or solid table. • You are wearing comfortable clothing and suitable footwear • You have enough space and it is clear of any obstacles • You have a bottle / glass of water • You do some gentle warm up exercises first • Build up slowly and aim to gradually increase the repetitions of each exercise over time. • You contact your GP if you experience any dizziness, chest pain or shortness of breath (such that you are unable to speak because you are short of breath) while you are exercising. • If you experience pain in your joints or muscles, stop, check your position and try again or stop.

Warm up exercises • Stand up straight and march on the spot at a steady pace for 1-2 minutes. • Stand (or sit) up straight with your arms at your sides, slowly lift both of your shoulders up towards your ears, then move them backwards and bring them back down to your normal relaxed sitting position – repeat this circular movement five times. • Stand up straight (or sit up straight on the front edge of your chair) and put your heel down on the floor with your toes pointing upwards, then lift your foot, point your toes down and put them in the same place as you put your heel. Repeat five times on both feet. • Stand (or sit) up straight with your feet hip width apart. With your arms folded across your chest twist your upper body and head to the right and then to the left. Repeat 5 times in both directions and keep your hips and legs facing forwards.

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Chest Stretch a) Sit upright and away from the back of the chair. Pull your shoulders back and down. Extend your arms out to the side. b) Gently push your chest forward and up until you feel a stretch across your chest.

This stretch is good for posture.

Upper-body twist

c) Hold for 5 to 10 seconds and repeat 5 times.

a) Sit upright with your feet flat on the floor, cross your arms and reach for your shoulders. b) Without moving your hips, turn your upper body to the left as far as is comfortable. Hold for 5 seconds. c) Repeat on the right side.

This stretch will develop and maintain flexibility in the upper back.

d) Do 5 times on each side.

Hip Marching a) Sit upright and do not lean on the back of the chair. Hold on to the sides of the chair. b) Lift your left leg with your knee bent as far as is comfortable. Place your foot down with control. c) Repeat with the opposite leg. This exercise will strengthen hips and thighs, and improve flexibility.

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d) Do 5 lifts with each leg.

Ankle Stretch

a) Sit upright, hold on to the side of the chair and straighten your left leg with your foot off the floor. b) With your leg straight and raised, point your toes away from you. c) Point your toes back towards you. d) Try 2 sets of 5 stretches with each foot.

This stretch will improve ankle flexibility and lower the risk of developing a blood clot.

Arm Raises

a) Sit upright with your arms by your sides. b) With palms forwards, raise both arms out and to the side, and up as far as is comfortable. c) Return to the starting position.

This exercise builds shoulder strength.

d) Keep your shoulders down and arms straight throughout. Breathe out as you raise your arms and breathe in as you lower them. Repeat 5 times.

Neck Rotation a) Sit upright with your shoulders down. Look straight ahead. b) Slowly turn your head towards your left shoulder as far as is comfortable. Hold for 5 seconds and return to the starting position. c) Repeat on the right. This stretch is good for improving neck mobility and flexibility.

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d) Do 3 rotations on each side.

Sit-to-stand a) Sit tall, move bottom to front of chair. Place your feet slightly behind your knees, feet hip width apart b) Lean slightly forwards, look straight ahead. Stand up, using your hands on the chair for support if you need to and pushing through your legs and feet c) To sit: walk backwards until you feel the chair on the back of your legs, look over each shoulder to check you are safe to sit down. Stick your bottom out and sit down slowly, again without using your arms for support. Do not drop down in to the chair. d) Repeat 10 times. For maximum benefit, these exercises should be done every day

Mini-squats a) Rest your hands on the back of the chair for stability and stand with your feet hip-width apart. b) Slowly bend your knees as far as is comfortable, keeping them facing forwards. Aim to get them over your big toe. Keep your back straight at all times, keep your bottom in. c) Gently come up to standing and gently march on the spot. d) Repeat 5 times.

Heel & Toe Raises a) Rest your hands on the back of a chair for stability. b) Lift both heels off the floor as far as is comfortable. The movement should be slow and controlled. c) Repeat 5 times. d) Holding on to the chair raise your toes off the floor and lower. The movement should be slow and controlled – repeat 5 times ActivLives – Reducing the Risk of Falls 22

Sideways Leg Lift a) Rest your hands on the back of a chair for stability. b) Raise your left leg to the side as far as is comfortable, keeping your back and hips straight. Avoid tilting to the right. c) Return to the starting position. Now raise your right leg to the side as far as possible. d) Raise and lower each leg 5 times.

Leg Extension

a) Rest your hands on the back of a chair for stability. b) Standing upright, raise your left leg backwards, keeping it straight. Avoid arching your back as you take your leg back. You should feel the effort in the back of your thigh and bottom. c) Repeat with the right leg.

d) Hold the lift for up to 5 seconds and repeat 5 times with each leg.

Cool Down Exercises The main aim of the cool down is to promote recovery and return the body to a preexercise level. You can use the warm up exercises, but instead of repeating the exercise , allow a more leisurely pace, moving slowly in and out of the positions and holding them for a little longer. A couple of suggested exercises: Back Thigh Stretch Sit tall away from the back of the chair • Place your left foot flat on the floor, then straighten your right leg out in front with your heel on the floor, foot relaxed • Place both hands on your left thigh, then sit tall, and lean forwards and upwards until you feel the stretch in the back of the right thigh • Hold for 8 seconds • Repeat on the other leg

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Calf Stretch Sit tall away from the back of the chair • Hold the sides of the chair • Place your left foot flat on the floor then straighten your right leg out in front of you with your heel on the floor • Pull the toes up towards the shin until you feel the stretch in the back of your calf • Hold for 8 seconds • Repeat on the other leg When you have completed your cool down exercises. Put some relaxing music on and sit quietly in a chair. Sitting still in your chair – close your eyes, calm the breathing and lower the heart rate. Think about each part of your body that you have exercised and relax those muscles. Just sit calmly, breathing normally for a few minutes, listening to the sounds around you. Open your eyes – take a deep breath in through your nose, hold it and breath out through your mouth – repeat these 3 times. Rub your arms, body and legs, ready for moving after your exercise session. (Images & exercise information from the NHS website: https://www.nhs.uk/live-well/exercise/strength-and-flexibility-exercises/how-to-improve-strengthflexibility/)

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Contact us: ActivLives 160 Hadleigh Rd Ipswich Suffolk IP2 0HH Telephone: 01473 345350 Website: www.activlives.org.uk Email: Info@activlives.org.uk Visit us on Facebook, Instagram and Twitter Charity No: 1147615

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