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Falls

Slips, trips and falls are a very common cause of accidents with hundreds of thousands of incidents reported each year. Falls often result in serious injury, often to bones and joints, and there are many fatalities, particularly among older people and people at work.
Brought to you by NHS Choices

Introduction

Accidental falls are by far the biggest killer in the home. An estimated 1,000 older people die each year from a fall on stairs. Falls cause the most deaths and long-term health problems among older people.

Good health and safety practices at work can prevent many slips, trips and falls. While it is impossible to make all jobs completely safe, there are laws that help to protect you at work to ensure a safe working environment.

Additionally, employees have a responsibility to look after their own health while at work, taking sensible steps to protect themselves from hazards and avoid accidents. Accidents can occur in any workplace, not just in building sites and manufacturing, but in offices as well.

Causes

The causes of slips, trips and falls can be divided into environment-related and health-related causes.

Common environment-related causes of slips, trips and falls include:

  • unsafe ladders,
  • unsafe stairs, steep stairs, or slopes,
  • slippery surfaces,
  • obstructions (things you can trip over),
  • poor footwear,
  • untidy areas,
  • running,
  • low lighting,
  • hurried or careless movements,
  • distractions, and
  • poor manual handling, carrying large objects incorrectly, and not having your hands free to break your fall.

Health-related causes of slips, trips and falls include:

  • weak muscles,
  • sleepiness,
  • confusion,
  • dizziness,
  • poor balance, and
  • poor eyesight.

Some diseases and conditions can cause weak muscles, balance problems, dizziness, confusion or sleepiness, increasing the risk of a fall. They include stroke, multiple sclerosis, dementia, Parkinsons disease, arthritis, low blood pressure, coronary heart disease and osteoporosis. Balance problems can also be caused by ear conditions such as tinnitus or labyrinthitis, or ear infections such as otitis media.

Some medicines can cause dizziness, balance problems, confusion or sleepiness, increasing the risk of a fall. Interactions between medicines can also cause these symptoms; research shows that those on four or more medicines are at greater risk of having a fall. If you think that a medicine you are taking may be causing any of these symptoms, you should continue to take the medicine as normal and make an appointment to see your GP.

What to do

If you have a fall, the most important thing to remember is not to panic. You may feel a little shaken and shocked, but if you try to stay calm it will help you to gather your thoughts and remember what you need to do. When you feel calm, ask yourself whether you feel you are able to get up again.

If you don’t feel hurt and you feel strong enough to get up, follow these steps:

  • don’t get up quickly roll onto your hands and knees and look for a stable piece of furniture, such as a chair or bed,
  • crawl over to the furniture, and if possible put something soft under your knees,
  • hold onto the furniture with your hands and support yourself, 
  • put one foot flat on the floor, with your knee bent in front of your body,
  • when you feel ready put your other foot flat on the floor as well, and slowly get up, and
  • sit down and rest for a while before carrying on with your day.

If you do feel hurt and/or unable to get up, follow these steps:

  • try to get someones attention use your aid call button if you have one, call out for help, bang on the wall or floor (if there is someone in the floor below you), or if possible, crawl to a telephone and call 999,
  • while you are waiting for help, get as comfortable and warm as you can get to a carpeted area of floor if you can, and try to reach something warm to put over you (particularly your legs and feet), like a blanket or dressing gown, and
  • remember to move regularly to avoid pressure sores and help you keep comfortable try to change your position every half an hour or so.

Always report a fall to your GP, as they may recommend that a healthcare professional carries out a falls risk assessment in your home. The aim of this assessment is to ensure that there is a minimal chance of you having another fall. They can then make some helpful suggestions on ways to improve your safety in the home.

Prevention

Advice on preventing falls is relevant to everyone, but older people need to take special care because they are more likely to suffer serious injury due to a fall.

In the home

Making small changes in and around your home can make a big difference in reducing accidents:

  • mop up spills straight away,
  • remove clutter, trailing wires, and frayed carpet,
  • consider getting handrails for the bathroom,
  • use non-slip mats and rugs,
  • use high wattage bulbs so you can see clearly,
  • organise your home so that you keep climbing, stretching, and bending to a minimum, and don’t bump into things,
  • get help to do things you can’t do safely,
  • slow down in your regular routine and take things gradually,
  • consider using a personal fall alarm system,
  • don’t walk on slippery floors in socks or tights,
  • avoid wearing loose-fitting trailing clothes which might trip you up, and keep your home warm - cold muscles can lead to accidents.

Your health

  • have regular eye tests,
  • take regular exercise, keep physically active, and keep your muscles as strong as possible,
  • look after your feet, and wear well-fitting sensible shoes with thin soles, high sides and good grip,
  • hip protectors worn under clothes reduce the risk of hip fracture by at least 50%,
  • get a flu jab - being unwell can make people more prone to fall,
  • don’t mix alcohol with medication - it may cause dizziness and loss of balance,
  • let your GP know if you feel dizzy, and review your medication with your GP regularly,
  • if you feel unwell, let your family, friend, or neighbour know,
  • jerky movements may make you feel dizzy, particularly if you have arthritis.