Risk factors for falls

Nutrition

You may have lost your appetite and have lost weight. This can result in loss of muscle leading to muscle weakness. It is very important to ensure that your food intake is adequate and to seek the advice of your nurse or dietician if you feel your intake is not adequate. They may be able to offer supplements where appropriate.

Muscle Weakness/ Reduced Mobility

Reduced mobility and loss of muscle strength increases your risk of falling. You may feel unable to do as much exercise as before and therefore become less active. It is important that you adapt your exercise to ensure that you can continue to do as much as you are able to.

Chair based exercises can be useful, a simple sit to stand from a chair is very worthwhile in maintaining power in the large muscles of the thigh. If you are unsure how to maintain your mobility ask your doctor or nurse to refer you to your local physiotherapist who will see you at home and discuss an exercise program suited to you as an individual. It may be that you would benefit from using a walking aid to help steady your walking if you feel weak. The physiotherapist can also provide a suitable aid. Advice to family members on how best to support you during walking can also be given if you need supervision to maintain your mobility.

Fatigue

You may find that as a result of your condition, that you tire more easily and this can increase your risk of falling. Any exercises that you do should be adapted to avoid over tiring. The principal ‘little and often’ of a few repetitions of each exercise should be adopted. If fatigue is an issue for you, try not to do full body exercises, stick to arms or legs on their own, as this will not be so tiring. Fitting exercise into your usual routine can also help. Activities such as getting dressed or showered may be more tiring and can be broken down into more manageable chunks; dress top half then rest before dressing your bottom half. Again this can minimize the risk of falling during dressing. Our section on fatigue may be useful for you to read.

Medication

You may be taking a significant amount of medication and while this is usually required for managing your symptoms, some medication can cause drowsiness and alteration to your blood pressure. If you experience dizziness when getting out of bed it may be that your blood pressure is dropping when changing position. Be aware of this and take your time changing position; sit on the edge of the bed before rising. If you are experiencing any dizzy symptoms, discuss this with your doctor, who may be able to make some adjustments to your medicine.

Environment/Equipment

It may be that you have more equipment around the house than previously or that you are spending more time in slippers rather than outdoor shoes. Make sure that your clothing and footwear are not adding to the risk of falling. Your clothes may be large on you if you have lost weight and this may result in you tripping over them. Slippers if well fitting can be adequate but often they are ill fitting and offer no support. Try to consider your clothing and footwear if you have been experiencing trips in the house.

If there is a lot of equipment around consider if loose cables and lack of space are likely to increase your risk of falls.

Some equipment may help maintain your safety. If you are struggling standing from sitting or fearful of falling while showering for example, you may wish to ask for a referral to your local authority occupational therapist for assessment. Some areas also have occupational therapists in their Community teams.