Guide to Preventing Falls – Patient information – South Manchester Community Falls Prevention Team

Contents

Contents, Introduction, The Importance of Exercise, Keeping Your Bones Healthy, The Importance of Good Fluid Intake, Continence, Vision and Falls, Managing Your Medication, Tips on Preventing Slips and Trips, What To Do In Case of a Fall, Agreed Falls Prevention Action Plan, Contact Telephone Numbers

Information about our service

Introduction

This information booklet provides information on how to maintain a healthy lifestyle in order to minimise your risk of future falls. It gives information on different falls risk factors and how you can make changes to reduce the risk of falling and reduce your risk of injury should you fall. It also provides advice of getting up from the floor and how to summon help if you are unable to get up from the floor. A member of the Falls Team will help you fill in your falls action plan.

The Importance of Exercise

Benefits of exercise

By keeping up with your program and by keeping active, you can improve your:

Metabolism, Confidence, Bone Strength, Balance, General fitness, Stamina.

You will also find that doing everyday things will become easier and less tiring. You may even be able to get back to doing some things that you have not been able to do for a while.

Exercise can prevent some symptoms

Exercise can also help to decrease: Risk of Falls, Constipation, Depression, Insomnia.

The psychological benefits of exercise

Exercise has also scientifically been proven to boost mood. Even a moderate amount of physical activity will result in improved mood. Exercise reduces symptoms of both depression and anxiety and kicks up endorphin levels, which produces feelings of happiness and euphoria. Exercise also helps regulate your sleep pattern, improves self esteem and the confidence that follows this. These benefits can be achieved by following your exercises programme or even going out for a brisk 10-minute walk a day.

Psychological benefits can include:

Natural mood booster, Improved confidence, Increased social activity, Positive distraction, Reduced anxiety and depression, Increased feelings of energy, Improves self-esteem

Staying motivated to exercise

Make physical activity part of your routine. This will make it more difficult to miss or forget them. This includes scheduling time on certain days for your exercises.

Set goals. Set an achievable goal with your exercises for you to work towards. This can be a personal goal or in conjunction with the Falls Prevention Team.

Join an exercise class or club. As you start to feel more confident and active, think about what activities and exercises you enjoy. The PARS team can help you find classes near you (contact information at the back of this booklet).

Be active with others. A great way of finding the motivation to be active is to schedule in time with a friend, family member or colleague for physical activity or exercises.

Exercise ideas

Types of exercises you can try to stay active:

Exercise classes, Walking, Dancing, Gardening, Tai Chi, Swimming

Exercising safely

When exercising you should:

Always use the side of something stable like a work top or solid table unless otherwise instructed. Follow the guidance given by your therapist and do not deviate from the programme given. Never exercise holding onto an object that may move away, for example a door handle or chair.

Is it normal to feel stiff or painful?

You may feel a bit stiff after you first start to exercise. This is quite normal. It is because you are starting to use muscles that you probably haven’t used for a long time. It is important to keep your body moving and keep on exercising. The stiffness will leave as your body becomes more familiar with the exercise. Exercise should not be painful. Start gently and build up gradually If you are unsure or concerned, please contact your therapist for advice.

When not to exercise

Do not exercise if:

You are feeling unwell, You have new or worsening symptoms, You have had a recent fall and not yet seen your GP

Warning signs when exercising

Stop your exercise and contact your GP If you experience any of the following during exercises:

Dizziness, Chest pains, Shortness of breath such that you are unable to speak because of the level of your breathlessness

Keeping Your Bones Healthy

Why is this important?

As we get older, our bones become more fragile. Sometimes, this is due to a condition called osteoporosis. Osteoporosis causes your bones lose strength, making you more likely to break a bone after a minor bump or fall. You may hear these described as fragility fractures. A broken bone and a fracture are the same thing. Your lifestyle can reduce your chance of developing osteoporosis and help keep your bones as healthy as possible.

What lifestyle changes can impact our bones?

Body weight – try to maintain a healthy weight. Being overweight puts additional pressure on our bones and being underweight can be a sign that our body is not getting the nutrients it needs.
Balance and coordination – regular standing exercise such as walking helps to maintain balance and coordination.
Nutrition – maintain a balanced diet with plenty of calcium and vitamin D, which are essential for strong bones.
Smoking – smoking stops bones strengthening and healing by restricting the flow of oxygen-rich blood. It also affects the body’s ability to absorb calcium.
Alcohol intake – excessive alcohol interferes with the balance of calcium and production of vitamin D, which are needed for strong bones. Stick to recommended safe drinking limits for alcohol.

If you think you may be at risk of osteoporosis talk to your doctor or a member of the falls team.

Eat well for your bones

Eating and drinking the right things can support bone health. There are four main food groups. Fruit and vegetables Carbohydrates – potatoes, pasta, cereals Dairy (and alternatives) Proteins – beans, eggs, fish and meat. This diagram shows how what proportions of these food groups you need to maintain a balanced diet. For example, it is better to eat twice as much fruit and vegetable than protein.

Vitamin D

Vitamin D helps your body to absorb and use calcium. There are three main sources of vitamin D: Food Sunlight Supplements Food There is a small amount of vitamin D in oily fish, eggs, lambs liver and fortified products such as bread and yogurt. Sunlight and Supplements From the end of September to the beginning of April, you should consider taking a daily 10 microgram (sometimes called 400 units) vitamin D supplement. This is because you can’t get vitamin D from the sun in winter. Levels of vitamin D You don’t need blood tests to monitor your vitamin D levels before you start a supplement, or while you’re taking one. Do not take a higher dose than recommended, unless your healthcare professional tells you to. Too much vitamin D can be dangerous.

Calcium

Calcium gives bones strength and hardness.
Foods rich in calcium include: Dairy products – milk and cheese, Green leafy vegetables, Almonds, Dried fruit, Pulses, Sardines

The Importance of Good Fluid Intake

Fluid intake

It is recommended that everyone drinks eight cups (three pints) of non-alcoholic fluid a day so the body can work properly. Good fluid intake is essential to maintain stable blood pressure and prevent dizziness that can lead to a fall. Drinking enough fluid keeps your bladder healthy and helps to prevent infections, which will prevent you going to the toilet as often. In some cases your GP may advise you differently due to your medical condition. In this case, follow your GPs advice.

Top tip

Have a mug or cup of non-alcoholic drink with each meal, and one in between each meal.

Continence

Incontinence is accidental leakage of urine or bowel motion. To be continent, a person will know when need to go to the toilet and be able to get there on time. Problems with continence can lead to a fall. For example, you may lose your balance rushing to get to the toilet in time.

What can help continence?

Try to drink at least six to eight cups of liquid each day.
Cutting down on liquids will make things worse, not better.
Cut down on drinks that can upset the bladder, such as fizzy drinks, alcohol and drinks containing caffeine.
Cranberry juice can help to maintain a healthy bladder.
Help avoid constipation by eating plenty of fibre.
Keep as active and as mobile as you can, this helps the bladder and bowel to work well.
If you need to go to the toilet frequently at night, consider a commode or urinal at your bedside.
Plan having your last drink at least one hour before bed.
Always put the light on when going to the toilet.
There is help available for incontinence.
Don’t be afraid to speak to your GP, nurse or other health professional for advice.

Bladder infection symptoms

A bladder infection may cause pain, or a burning feeling when urinating. The urine may be smelly and you may need to go more often. Seek medical advice if you experience these symptoms.

Vision and Falls

How does vision increase risk of a fall?

Poor vision – if you are unable to read a newspaper with your glasses on or unable to recognise objects across the room, you are more likely to trip over or bash into unseen objects.
Cataracts can affect your sight. Your optician will be able to check for this and they can be removed with an operation.
Bifocal glasses can make some people unsteady, particularly on stairs or slopes as the lenses can distort the perspective of what we see and make it difficult to judge step heights. You may be better to have separate glasses – one pair for reading and another for general use.
Poor lighting – walking in the dark can increase the risk of slips/trips and impact balance.

Accessing the optician

Take advantage of the free eye test to have your eyes checked every year by an optician. If you cannot travel to an optician, some now provide a home visiting service – ask your therapist about how to access this service.

Managing Your Medication

Beware of side effects of medicines

Some medicines, including those you buy over the counter, have side effects that can make you more likely to fall. If you suffer from any side effects, please inform your GP or consider talking to the Falls Prevention Team Pharmacist.

Medicines review

Your doctor will need to review your medicines every year, especially if you take four or more medicines a day, to make sure they are still right for you. If you have not had your medicines reviewed for more than one year, please see your doctor or practice nurse.

Tips on taking medicines

When you collect or buy your medicines make sure you can see, read and understand the instructions. If you are in any doubt ask your pharmacist to explain.
Only take medicines prescribed for you.
If you forget to take your medicine do not take double next time, ask your pharmacist or GP for advice.
Make sure you store your medicines safely in a sealed box or cupboard away from excessive heat.
Be sure to finish each course of treatment.
Check with your doctor or pharmacist before taking over the counter and prescribed medicines.
If you are unsure what your medicines are for, how to take them, whether they are working for you, or if you feel they are causing problems, please talk to your doctor, practice nurse or pharmacist as soon as possible.

Tips on Preventing Slips and Trips

Store daily items in reach to minimise overreaching and bending.

Avoid standing for too long in one go.

Prevent hazardous tasks such as standing on a chair to changing a light bulb.

Do tasks little and often. Long periods of activity can be followed by feelings of fatigue, tiredness and stiffness.

Sit down for tasks that might cause you to lose balance such as putting on shoes and socks, having a wash, or getting dressed.

Where possible remove tripping hazards like rugs, flexes and clutter from the floor and stairs.

When standing from a chair – stand still for a few moments and get your balance before moving.

When getting out of bed, sit on the side of the bed for about a minute before you stand up. Wiggle you toes or ‘march’ your feet if you can. This helps to stabilise your blood pressure before you stand up.

What To Do If You Fall

If you can get up, follow these steps

Ease yourself up onto your elbows
Move onto your hands and knees
Hold onto a firm surface such as a chair to support yourself
Face the firm object to ease yourself into a standing position
Turn yourself gently to sit on the firm surface

If you can’t get up, follow these steps

Can I attract attention? Shout and bang something.
Press your pendant alarm or use the telephone if you can.

Can I get comfortable? Find a nearby pillow or cushion or use rolled up clothing as a pillow.
Cover yourself with clothing, a tablecloth or rug to keep warm.

Can I food and drink? Keeping a cold drink and biscuits within reach from the floor can be helpful.

Can I keep moving? Move position to avoid getting pressure ulcers Move joints to avoid stiffness and help circulations.
If you pass urine, roll away from the damp area.

Agreed Falls Action Plan

What are your risks or concerns about falling?

What changes are you going to make?

Contact Telephone Numbers

Community Falls Prevention Team
Advice and assistance about falls and re-referrals back into the service. Tel: 0161 946 8227

Care and Repair Repairs and installation of falls prevention measures such as grab rails and changing light bulbs.
Tel: 0161 827 5500

Manchester Equipment and Adaptations Partnership (MEAP) Equipment collections and repairs
Tel: 0161 227 3280

Age UK Manchester General advice for older people, such as accessing social activities, cleaning services, home help and advocacy
Tel: 0161 833 3944

Manchester City Council Contact Centre
We are the first point of contact for Children’s and Adult’s Social Care services. You should also use this number if you have concerns about a child or vulnerable adult. The service is available 24 hours a day, 7 days per week. Tel: 0161 255 8250

Citizens Advice Manchester Free, confidential, impartial and independent advice and information on a wide range of subjects
Tel: 0344 411 1222

PARS (exercise classes) Finding / joining exercises classes in your area
Tel: 0161 271 0505

Silverline – Free 24-hour confidential telephone helpline offering information, friendship and advice to older people
Tel: 0800 470 8090

Cyril Flint Provide one-to-one befriending in the community
Tel: 0161 942 9465

Feedback and concerns

Patient Advice and Liaison Service (PALS)

We welcome all of you feedback about our service. If you have any suggestions, comments or concerns about the services you have received, the Patient Advice and Liaison Service (PALS) team are here to help. Whether you are a patient, a relative, friend or carer, they will listen to your concerns, help make your voice heard and liaise with the relevant staff to sort out any problems quickly. They can also guide you through the NHS complaints policy. Contact the team by email pals@mft.nhs.uk or call 0161 276 8686.

Other languages and accessibility

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Who provides this service?

This service is provided by Manchester Local Care Organisation (MLCO). MLCO is the public sector organisation that provides NHS community health care and social adult care in Manchester. It works across the NHS and the local authority to join up the care you need in the community. You can find out more about MLCO and how it works at www.manchesterlco.org