Falls can be prevented. Take action to stay mobile and ... · 5 How to use this booklet Step 1: Be Active Step 2: Manage Your Medicines Step 3: Manage Your Health Step 4: Improve

Falls can be prevented.Take action to stay mobile and independent.

One in three people 65 years and over will fall each year.

www.health.tas.gov.au/stayonyourfeetDepar tment of Health

Who is this booklet for?Many people may not see falls as an important issue because they feel it is just a ‘sign’ of getting older and that it will happen anyway. Those who see falls as an ‘expected’ part of ageing, may not realise that, just like any other potential injury, there are things that can be done to reduce the likelihood of a fall. Understanding that falls can happen to anyone, whatever their age, helps everyone to take falls seriously and to find ways to prevent falls before they happen.

Yes, you can reduce your risk of falling

Staying mobile and independent is an important part of healthy ageing. Falls and their associated injuries are a serious health issue and are the leading cause of injury hospitalisation for older people. The good news is that taking some simple and effective steps outlined in this booklet can prevent most falls.

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Many people believe that falls are an issue for someone else. “It won’t happen to me” is a common but unwarranted attitude. Falls prevention is about realising that you can influence your own mobility and independence. Being active and independent is extremely important when it comes to enjoying your life and contributing to your community.

Most people mistakenly believe that tripping, slipping or ‘not being careful’ causes falls. But the fact is that most falls are caused by personal issues – something to do with a person’s lifestyle, physical or mental state – or by interaction between one or more of these personal issues and an environmental hazard.

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Try this checklist to determine your personal risk of fallingHave you had a fall in the last year? Having previously fallen increases your chance of falling again

Do you do less than 30 minutes of physical activity a day? Are you unsteady on your feet, do you find it difficult to get up from a chair or do you have trouble walking? Many falls are the result of muscle weakness and/or impaired balance

Are you taking three or more medicines? Are you taking sleeping tablets, tranquillisers or anti-depressants? Has it been more than 12 months since your GP reviewed your medicines? Some side effects and combinations of medicines can increase your risk of a fall

Do you have diabetes, arthritis or Parkinson’s Disease? Have you had a stroke or do you have problems with your heart or circulation? Has it been more than 12 months since your eyes were tested or your glasses checked? Do you experience dizziness, light headedness, unsteadiness, drowsiness, blurred or double vision or have difficulty thinking clearly? Many health conditions can increase your risk of falling

If you answered “yes” to one or more of these questions you are at risk of falling. The good news is that there are steps you can take now to reduce your risk.

If you answered “no” to all of these questions, but are aged 65 or over, take falls seriously and read on to find out how to prevent falls before they happen.

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How to use this booklet

Step 1: Be Active

Step 2: Manage Your Medicines

Step 3: Manage Your Health

Step 4: Improve Your Balance

Step 5: Walk Tall

Step 6: Foot Care and Safe Footwear

Step 7: Regularly Check Your Eyesight

Step 8: Eat Well for Life

Step 9: Identify, Remove and Report Hazards

The nine steps to Stay On Your Feet® reflect the main factors that contribute to falls. You need to review all the steps to Stay On Your Feet® – but focus on those parts that relate to you, your lifestyle, independence and environment.

Make the booklet work for youAt the end of each of the nine steps you will find a quick and simple personal review section. After reading all the steps we suggest you bring all this personal review information together into a Personal Action Plan – specially developed by you with you in mind.

Take positive steps now to stay mobile and independent. Don’t put off considering your risk of falling until you have had an injury or scare. Do it today and you can prevent falls before they happen.

Falls prevention is an important part of healthy ageing. Healthy ageing is not just about avoiding illness and disease, it’s about being able to enjoy our lives. This involves maintaining a healthy lifestyle, keeping physically and mentally active and being involved in a social network.

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Contents

Step 1: Be Active 8 Physical activity and falling 8 How can you be active and reduce your risk of falling? 8 Your personal review on physical activity 13 Step 2: Manage Your Medicines 14 Medicines and falling 14 How can you manage your medicines and reduce your risk of falling? 15 Your personal review on managing your medicines 19 Step 3: Manage Your Health 20 Health status and falling 20 How can you manage your health and reduce your risk of falling? 20 Your personal review on managing your health 23 Step 4: Improve Your Balance 24 Balance and falling 24 How can you improve your balance and reduce your risk of falling? 25 Your personal review on improving your balance 27 Step 5: Walk Tall 28 The way you walk and falling 28 How can you improve the way you walk and reduce your risk of falling? 29 Your personal review on walking tall 31

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Step 6: Foot Care and Safe Footwear 32 Foot care, footwear and falling 32 How can you improve your foot care and footwear and reduce your risk of falling? 32 Your personal review on foot care and safe footwear 33 Step 7: Regularly Check Your Eyesight 36 Eyesight and falling 37 How can you look after your eyes and reduce your risk of falling? 38 Your personal review on eyesight 39 Step 8: Eat Well for Life 40 What you eat and falling 40 How can you improve your nutrition and reduce your risk of falling? 41 Your personal review on eating well 43 Step 9: Identify, Remove and Report Hazards 44 Hazards and falling 44 How can you minimise hazards and reduce your risk of falling? 45 Your personal review on hazards 47

Your Personal Action Plan 48 What if I do Fall? 52

Acknowledgements 58

Step1 Be ActiveStep1

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Everyone knows that some form of physical activity is good for our long-term health and mobility. Being active in as many ways as we can provides many benefits, regardless of age, body weight, health condition or disability.

Activity can include going for walks with family and friends, walking the dog, doing active gardening, doing regular active housework, dancing, washing the car, swimming or playing golf.

However physical activity may be interrupted if there’s a change in our routine. For example going on holiday or having an illness or injury might result in a reduction in physical activity for a while and then it can be hard to start again. You might think you are too out of shape and unable to keep up with others in a group. But physical activity with others is a great way to get the body back into action.

Physical activity and fallingThe best thing you can do to reduce your risk of falling is to be physically active. This:• maintains leg and hip strength

and ankle flexibility• improves bone strength and

slows osteoporosis• improves balance, coordination

and walking patterns• assists joint movement and

stability• increases cardiovascular stamina.

How can you be active and reduce your risk of falling?The best kinds of physical activity use all parts of the body and get muscles, bones, heart and lungs all going at a level the body can manage. The types of activity most effective in preventing falls are those that increase muscle strength in the lower limbs and the upper body, and improve balance, posture and stamina.

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Choose an activity you will enjoy and be able to do regularlyThe easiest activity for many people is walking. This strengthens your leg muscles and improves your balance which then improves your walking pattern and your core stability. Going for a walk costs nothing, needs no equipment and you can choose your time and place. All you need is a good pair of shoes.

Step 5: Walk Tall has more information. There are many walking groups you can join, including some specifically designed for older people. You might like to contact your local council for information.

Other good forms of physical activity are:• regular household activities such

as active gardening, regular active housework, washing the car, walking the dog

• activities that focus on balance such as tai chi, yoga, pilates

• recreational activities such as swimming, cycling, tennis, dancing, golf and lawn bowls

• strength training or organised fitness classes such as aerobics or aqua-aerobics.

People with long-term health conditions can still participate in physical activity, but will need to talk to their GP first.

Step1 Be ActiveStep1

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How much is enough?Any amount of activity is better than none. Putting together at least 30 minutes of physical activity a day is recommended on most, preferably all days.

You can accumulate your 30 minutes or more throughout the day by combining shorter sessions of at least 10 minutes if you are just starting out or finding it hard to find the time.

If you are not doing any physical activity at present, you need to start slowly and build up to the 30 minute target over time.

Fear of fallingSometimes being afraid of falling limits what you can do. The fear of having a fall can reduce your quality of life and possibly your mobility and independence. If you think that you have an increased fear of falling, see your GP or health care professional to discuss and determine if you are unduly limiting yourself, reducing your levels of physical activity or becoming isolated.

Participating in some form of physical activity helps your strength, balance, flexibility, mobility and independence.

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More information on this and all the other steps• Department of Health

www.health.tas.gov.au/stayonyourfeet• Major regional Falls Prevention Information Activities and Resources

Launceston Community Health Services (Kings Meadows) – Phone: (03) 6777 1427 North West Regional Hospital (Physio) – Phone: (03) 6493 6250 Mersey Community Hospital (Physio) – Phone: (03) 6478 5325 Community Outreach Physiotherapy (South) – Phone: (03) 6166 7279

Barbara had some sort of balance problem. After talking with her GP she spent time in hospital and when she returned home she still had a minor problem but it was improving. She had to surrender her driver’s licence so she couldn’t drive to her regular fitness classes. She felt that this was slowing her recovery so friends and relatives were called on to help with transport. She attended more classes than ever and regained her balance and her licence.

Step1

Be ActiveStep1

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Did you know about 40% of pet dogs are overweight or obese? They too need 30 minutes of physical activity a day. Dogs that are physically active are less likely to suffer boredom, obesity, poor health, social and behavioural problems such as chewing and digging. Perhaps you can go for a walk together.

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Your personal review on physical activityHaving read through this step, review your current action on physical activity and complete the table below. A couple of examples are given to help.

Who else do you know would benefit from this information?

What positive steps are you already taking?

What changes might help you Stay On Your Feet® ?

How will you make these changes?Is there anyone you need to contact?

Weeding the rose beds weekly.

Walking to pick the grandchildren up from school on Mondays.

Find a walking partner for early morning walks.

Sign up for the Thursday morning tai chi at the Recreation Centre.

Check with Mary next door if she is interested in walking early in the morning.

Medicines come in many forms including tablets, liquids, drops, sprays, creams, inhalers, suppositories and injections.

You can get medicines from health professionals such as GPs, pharmacists, dentists and nurses. These may be obtained on prescription or recommended. You can also get medicines from alternative practitioners such as homeopaths, naturopaths and herbalists. Or you may choose medicines yourself from pharmacies, supermarkets or health food shops in the form of vitamin supplements, herbal or natural remedies, painkillers and antacids.

Medicines and fallingAll medicines have side effects and some side effects can increase the risk of falling. The side effects will vary from person to person. They can also change when different medicines are combined. For this reason, it is important for you to understand how various medicines may affect you if they do interact. Sometimes it is not easy to notice if you have been affected by a new medicine.

Your initial reaction may be that you feel better than before and you may not notice that you are a little less steady on your feet or that your vision is slightly blurred.

Manage Your Medicines

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Step2

It is important to talk to your GP or pharmacist if you experience:• drowsiness• dizziness• light headedness• unsteadiness• blurred or double vision• difficulty thinking clearly.

How can you manage your medicines and reduce your risk of falling?Take an active role when choosing your medicinesKnow about your health and your likes and dislikes – such as when you wake up and go to bed, and when you have your meals. Share this information with your GP or pharmacist. They can then work with you to choose the best medicines for you.

Keep an up-to-date list of the medicines you takeKnow why you are taking the medicines on your list. Know the names of your medicines and what they look like.

Ask questions and learn about your medicinesCheck with your GP or pharmacist before mixing over-the-counter medicines, prescription medicines or alternative medicines. All medicines can cause unwanted side effects and may interact with other medicines.

Make sure you understand the medicines you are taking – Consumer Medication Information leaflets are available from your pharmacy for each prescription medicine and some medicines that you buy without prescription.

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These leaflets provide easy-to-understand information including what the medicine is for, things to consider before using the medicine, how to use the medicine, the possible side effects and what to do if they occur.

Find out about side effects and discuss any side effects with your GP or pharmacist. Side effects may be avoided or managed by planning ahead.

Ask your GP or pharmacist about using a special pack such as a dosette box or a Webster pack to help you separate your medicines into the times and days when you need to use them.

Take out-of-date or unused medicines to your pharmacy for safe disposal.

Manage Your Medicines

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Step2

Gwen leads an active life and finds it difficult to always take her medicines at the same time each day. She was in the habit of taking some in the morning before she got involved in the day’s activities and the rest in the evening. When her pharmacist explained to her that it was important to take her medicines on time and in the correct combinations, it was decided it would be easier for Gwen to manage her medicines if the pharmacy put them in a special Webster pack. This contains the correct combinations of medicines for different times of the day. That way she could easily take the right pack with her if she was going to be away all day.

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Get your medicines reviewed regularlyHaving a regular medicine review with your GP or pharmacist will ensure that you are taking the right medicines at the right dose and at the right time.

You should do this every six to 12 months.

Ask your GP or pharmacist whether a Home Medicines Review would be useful to help you avoid problems with your medicines.


www.health.tas.gov.au/stayonyourfeet• Medicine Wise – Phone: 1300 633 424

www.nps.org.au

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Your personal review on managing your medicinesHaving read through this step, review your current action on managing your medicines. A couple of examples are given to help.





All my medicines are in the same cupboard.

I throw out all medicines once they reach their expiry date.

Talk with my GP about that Home Medicine Review program.

Make an appointment with my GP.

Most long-term health conditions can be managed. They include:• heart conditions• diabetes• Parkinson’s Disease• arthritis• osteoporosis• high/low blood pressure• depression• dementia.

Health status and fallingThe above health conditions can increase the risk of falling by causing dizziness, confusion, light-headedness, slowed reactions, reduced awareness of surroundings, blurred vision or a drop in blood pressure.

Other conditions which can increase your likelihood of falling include muscle or joint stiffness, poor vision, reduced concentration, pain and lack of energy. Poor posture can result in unsteadiness or poor balance.

How can you manage your health and reduce your risk of falling?Take notice when things don’t feel right and try to find a solution. Taking control of long-term health conditions can prevent further deterioration, maintain ability and in some cases even restore any lost ability.

“You know having a long-term health problem isn’t all bad”, explained Nancy. “I was diagnosed with diabetes when I was 62. I wasn’t very fit and a bit overweight but not too bad. But getting diabetes made me stop and consider my health – I lost about 7 kilos over six months and started doing yoga classes. In a way it was like being told to think about myself for a change. After six months I felt better than I had done for years, and I’ve stayed that way for ten years now.”

Step2

Step3 Manage Your HealthStep3

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If you have low blood pressure for example, you will feel more in control if you understand what causes it, how it can increase your risk of falling and what you can do to deal with it.

Listed below are some ways in which you can manage long-term health conditions and the severity of symptoms.

Review your lifestyle• Eat a wide variety of nutritious

foods.• Do at least 30 minutes of physical

activity each day.• Drink alcohol in moderation.• Quit smoking.

Get to know your conditionAfter being diagnosed, learn as much as you can about your health condition by asking your GP or health care professional, get fact sheets or join a relevant support group. Have regular check ups with your GP to discuss any concerns, prevent complications and get early treatment.

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Review your medicinesSome medicines can have side effects which can increase your risk of falling. Refer to Step 2: Manage Your Medicines for more information.

Participate in lifeStrive for a balance in life by ensuring you:

• participate in enjoyable social and recreational activities

• manage your stress, maybe through meditation or talking to someone

• participate in suitable pain management activities. (e.g. relaxation, yoga, tai chi, massage, hydrotherapy).


www.health.tas.gov.au/stayonyourfeet• Primary Health Tasmania - 1300 653 169• Please see contact list on pages 52-53 for health-related organisations.

Step2

Step3 Manage Your HealthStep3

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Your personal review on managing your healthHaving read through this step, review your current action on managing your health. A couple of examples are given to help.





I have 3 alcohol-free days per week.

I do meditation to help with my stress levels.

Check out hydrotherapy for my arthritis.

Get some more information about my arthritis from Arthritis Tasmania Phone 1800 011 041.

Balance sensors are found in many places in our bodies – the inner ear, the eyes and in the joints and muscles. Any disruption to these organs and pathways can upset your balance. Up to 25% of falls among older people can be attributed to poor balance or walking style abnormalities.

Balance and fallingFactors that may affect your balance are:• loss of muscle strength• reduced joint movement

and stability

• the side-effects of some medicines• ear problems (including wax

build up)• sudden movements, especially

rising quickly from a sitting or kneeling position

• the effect of a hip or knee replacement in the short term.

Your GP can help you to identify things which may affect your balance. They may suggest that you consider trying exercises aimed at increasing your strength and balance. A health professional such as a Physiotherapist can help you with this.

Step4

Step3

Step4

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Improve Your Balance

How can you improve your balance and reduce your risk of falling?• Participate in some form of

physical activity that helps your strength, balance and flexibility – Step 1: Be Active has relevant information.

• Manage your medicines – refer to Step 2: Manage Your Medicines for more information.

• Consider the use of a walking aid – talk with your GP, physiotherapist or occupational therapist.




Marie was a regular attendee of a Pilates class which aimed to improve her strength and posture. One day during class she felt wobbly and dizzy and felt she may fall during the standing exercises. She went to see her GP who diagnosed a virus that affected her inner ear and balance. Rather than taking just the few weeks off, Marie didn’t go back to class for several months. Finally she got reorganised and arranged to return. Unfortunately, on the day she planned to return she slipped and broke her ankle. She didn’t realise how much balance and strength she had lost just by not doing any physical activity for a few months.

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Your personal review on managing your balanceHaving read through this step, review your current action on managing your balance. A couple of examples are given to help.





I do a tai chi class once a week.

Talk with my GP about whether I need a walking aid.

Check out whether I should do some weight training at the gym.

Call the local gym to see if they have special weight training classes for older people.

Talk to GP about referral for Falls Assessment.

Step5

Step5

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Walk Tall

Walking tall is about moving around while keeping your body upright and straight. Over time, changes may take place in the way you walk – which is also known as your gait. Some changes come from physical conditions such as hip degeneration and others are caused by insufficient physical activity.

Common changes involve:• loss of strength in leg muscles,

which can lead to shuffling and changes in foot/toe clearance, and putting your feet closer together (women) or further apart (men)

• poor flexibility at the hip and reduced shoulder mobility that can result in taking shorter steps

• loss of strength in the upper body and back, which can make you lean forward in order to balance.

The way you walk and fallingThe changes listed can contribute to falls because they increase the likelihood of tripping (including over your own feet) and make it harder to balance. However, these changes need not be permanent. Increasing physical activity over time can help remedy these problems and help you return to being straight and upright once again.

How can you improve the way you walk and reduce your risk of falling?• Participate in some form of

physical activity that helps your strength, balance and flexibility – Step 1: Be Active has relevant information.

• Manage your medicines – refer to Step 2: Manage Your Medicines for more information.

• Consider the use of a walking aid – talk with your GP, physiotherapist, occupational therapist or podiatrist.

• If you use a walking stick or frame or other walking aid, make sure:– it has been designed and fitted

especially for you– a walking stick which is the

wrong length for you can make your gait crooked as you are likely to lean to one side so you can use the stick

– you keep it clean and in good working order (especially the rubber tips or any wheels)

– to remove or reorganise furniture in your home so a walking aid can be used without hindrance.

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Step5

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Walk Tall

Bill’s friend likes to walk bare foot whenever he can, particularly on the beach. He found that one big toe seemed to develop a drooping problem and either tripped him up or got stubbed regularly. After discussing it with the podiatrist he did some simple foot exercises which seem to have brought his toe back into line and he enjoys walking more.

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Your personal review on walking tallHaving read through this step, review your current action on walking tall. A couple of examples are given to help.





I walk quite a bit but not as regularly as before.

I’ll try to walk 3 times a week.

Maybe I can try Pilates.

Dave next door does early morning walks. I can call him to see if I can join him.

Check out the local gym for Pilates classes.

An Australian study found that the rate of foot problems among older people was nearly double that of the rate for the general population.

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Foot Care and Safe Footwear

Step6

Managing your shoes and feet is an important part of preventing falls. Common foot problems such as corns, calluses, bunions, ingrown or thick nails and ulcerations can be diagnosed and treated by a podiatrist. However, if you take care of your feet and wear correctly fitted shoes many of these problems may be prevented.

Foot care, footwear and fallingFoot problems can upset your balance and change the way you walk which could put you at risk of falling. Footwear styles that have minimal contact with the ground and have poor grip can upset your balance and are a contributing factor in many falls. Combine unsafe footwear with foot problems and the risk of falling is even greater.

How can you improve your foot care and footwear and reduce your risk of falling?Look after your feet• If you have any foot pain or

foot problems, see your GP or a podiatrist.

• Maintain good circulation in your feet, ankles and legs by doing foot exercises – ask a physiotherapist for advice.

• Visit your local podiatrist to have your feet checked out, nails cut and corns dealt with – a referral is not needed.

• Try a foot massage – a friend or relative may be able to help or you can try it yourself – at least give your feet a soak and a rub with moisturiser.

Wear suitable footwearSuitable footwear does not have to mean expensive or unattractive shoes. There are now many brands and styles of shoes that are safe, comfortable and designed to fit an orthotic if needed.

Check your current footwear and consider the following features:• A good fit can help you maintain

a safe walking pattern and proper balance – slippers, scuffs and thongs are usually poor fitting and dangerous.

• Laces or Velcro fasteners are the best choice. If you find tying laces difficult, look for special gadgets from pharmacies.

• A lot of contact with the ground – flat shoes with low, broad heels give your feet the most contact with the ground and offer good stability.

• A sole with a good grip – this is provided by the material used or a pattern in the sole or both. A shoe repairer may be able to add grips to your existing shoes.

Ruth was proud she was still an attractive woman well into her seventies. She felt that she should never surrender to comfort over style. She could rival her grand daughters for glamour – and the height of their heels. One day while shopping with her daughter she tried on some light-weight special walking shoes (in a beautiful shade of red). They made her feel twenty years younger; she positively danced across the floor. They were a little more expensive than the fashion shoes she used to wear but she wears them all the time, her feet feel better and they last for years.

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Foot Care and Safe Footwear

Step6

• A rounded or bevelled edge to the heel – this increases the contact area and grip at the heel end and therefore may be safer.

• A thin, firm mid sole – unless you have been advised by your GP or podiatrist to have extra cushioning in the mid sole, you should avoid very soft soles which can lead to instability.

• A higher heel counter at back of shoe may be of assistance to some people, however it should not restrict foot flexibility.

Generally, unsafe footwear includes:• high or narrow heels• slippery or worn heels• soft or stretched uppers• slip-on shoes• worn shoes or slippers• loose or ill-fitting shoes• heavy shoes.


www.health.tas.gov.au/stayonyourfeet• Australian Podiatry Association – Phone: (03) 9416 3111

www.podiatry.org.au

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Your personal review on foot care and safe footwearHaving read through this step, review your current action on foot care and safe footwear. A couple of examples are given to help.





I see a podiatrist once a year.

I’m going to use the footwear features listed in this step to see if my shoes are safe.

I’ll see what I might need to do about my shoes.

I’ll talk to my friend about this. He wears very old sneakers which he doesn’t tie up and nearly fell over the other day.

Over time, physical changes take place in your eyes that can affect your eyesight. The most common changes to the eyes are:• blurred or less acute vision

(i.e. seeing fewer fine details when looking at nearby objects)

• blurring of distance vision (i.e. difficulties seeing street signs when driving)

• watering of the eyes, often because of changes in the tear film

• eyes taking longer to adjust to light changes, especially in the dark

• greater sensitivity to glare• less accuracy when judging

distances and depth• loss of ability to see well in

low-contrast situations (i.e. like trying to read black print on a grey background or see furniture in a room with poor light and contrast)

• the development of eye disorders such as cataracts, glaucoma or macular degeneration.

Many of these changes are gradual and you may not notice them immediately. It is important that you see an eye care professional (optometrist or ophthalmologist) regularly, usually every two years, so that any changes in your eyesight can be detected and managed appropriately.

Some eye disorders may be temporary, such as those resulting from changes in blood pressure or increased pressure within the eyeball. These conditions may reduce your vision for 5-10 minutes. If this happens, you should talk to your GP as soon as possible.

Step7

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Regularly Check Your Eyesight

Eyesight and fallingAny one of the changes listed above may contribute to a fall. In many cases older people have several changes occurring at once and are therefore at a higher risk of falling. Some people assume that if they can still read the headlines in a newspaper or watch television then their eyesight is fine. This is not necessarily true. You may be able to watch television but still be at risk of falling from eyesight deterioration, for example by misjudging the depth of a step.

John had found that lately he was having difficulty recognising the number of his bus until it had past him. After a visit to his local optometrist it was decided that he would benefit from bifocals which would help him read the number of his bus. On picking up his new glasses, John was amazed at how clear everything now was around him. All was well for the first few days, then John noticed that he was tripping on steps and uneven ground. Concerned, he rang his optometrist who advised him to come in for another check. The optometrist checked John’s bifocal glasses and noticed that they were twisted and not sitting on his face evenly, which caused his vision to be distorted. John remembered sitting on his glasses one evening, which had probably caused them to go out of alignment. Once the optometrist had readjusted his bifocal glasses all was fine again.

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How can you look after your eyes and reduce your risk of falling?• Have your vision tested regularly,

at least every two years – more often if you notice that your sight is changing, blurred or cloudy.

• Regularly do simple eye checks yourself – for example look at distant targets and cover one eye and then the other to see if your vision is changing.

• Have your glasses and eyewear checked annually by your optometrist.

• Wear your prescribed glasses or eyewear as recommended by your optometrist.

• Allow up to two weeks to get used to new eyewear, particularly bifocals or multifocals. If after that time there are still difficulties, return to your optometrist.

• If you wear bifocal or multifocal glasses take care when walking up and down steps and when stepping off road verges.

• Eat a balanced diet (yellow and green vegetables are high in vitamins A and E which are important for maintaining good eyesight).

• Take breaks when you are doing close work like reading or sewing.

• Give your eyes time to adjust when you move into a darker or much brighter area.

Step7

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Regularly Check Your Eyesight


www.health.tas.gov.au/stayonyourfeet• Optometrists Association (Tas) – www.optometrists.asn.au

Phone: (03) 6224 3360

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Your personal review on eyesightHaving read through this step, review your current action on eyesight. A couple of examples are given to help.





I have my eyes tested each year.

I need to mark the front edge of the steps at the back door with bright paint.

When I come inside from doing the gardening, I will sit down for a few minutes to help my eyes adjust to the light inside the house.

I’ll take my glasses to the optometrist to have the fitting checked.

Step8

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Eat Well for Life

Nutritious foods and an active lifestyle can help achieve optimal health throughout life. While most people know how important good nutrition is in preventing long term health conditions like heart disease, diabetes, high blood pressure and osteoporosis, sometimes they lack the motivation to cook for one or two people. It can be easy to make do with tea and toast or find excuses not to eat fresh fruit and vegetables.

What you eat and fallingPoor nutrition, skipping a meal or not eating enough at meals, can cause dizziness, weakness, light headedness and reduced concentration, all of which can lead to a fall.

More specifically:• drinking too much alcohol

impairs judgement, coordination and concentration

• too much salt may contribute to calcium loss and high blood pressure

• insufficient calcium causes thinning and weakening of bones, which increases your risk of developing osteoporosis and experiencing a bone fracture if you fall

• vitamin D deficiency prevents optimal absorption of calcium from your diet which can contribute to osteoporosis

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• not drinking enough water may lead to dehydration, confusion and dizziness

• inadequate protein in your diet can make it difficult to maintain muscle mass and means wounds may take a long time to heal.

How can you improve your nutrition and reduce your risk of falling?Try the following tips from the Australian Dietary Guidelines:• Eat at least three meals every

day, with plenty of fruits and vegetables, and foods high in calcium for strong bones.

• Enjoy a wide variety of nutritious foods from the five food groups.

• Enjoy meal times – try to share with friends and family.

• Drink plenty of water instead of drinks with added sugar or alcohol.

• Add a little sunshine to your life to maximise your Vitamin D absorption. To avoid skin damage keep sun exposure to short bursts (10-15 minutes) during summer.

• Talk to your GP to find out if you would benefit from Vitamin D supplements.

• Be active to maintain muscle strength, bone strength and improve your appetite.

Step8

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Eat Well for Life


www.health.tas.gov.au/stayonyourfeet• Australian Dietary Guidelines – www.eatwellforlife.gov.au• Dietitians Association of Australia – 1800 812 942

Peter and Ingrid are co-carers for each other. During the week Peter cooks and Ingrid, who has a bad back, decides on the menu and prepares the vegetables. On the weekend they take a break and have Meals-on-Wheels delivered for their main meals. These come on Friday and they simply microwave them when they want to eat. They find this a great way to have nutritious meals and also have a break from cooking.

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Your personal review on eating wellHaving read through this step, review your current action on eating well. A couple of examples are given to help.





I drink plenty of water/fluids a day instead of drinks with added sugar or alcohol.

I try to eat 5 serves of vegetables and 2 serves of fruit per day.

I have dinner with the grandchildren once a week.

Nothing at this time.

I’ll check the Australian Dietary Guidelines http://www.eatwellfor life.gov.au/

\

A Western Australian study of ‘well’ older people showed that 28% of falls occurred in the bedroom, 21% in the family or living room, 13% in the kitchen and only 11% in the bathroom/toilet. 10% happened just outside the home, near the back or front doors. The other 17% of falls occurred in the laundry, hall or other places around the home.

Many people think that hazards around the home are the major causes of falls, but this is not actually the case. In fact most falls are caused by personal issues – something to do with an individual’s lifestyle, physical or mental state – or the interaction between one or more of these personal issues and an environmental hazard.

A hazard for one person may be less of a hazard for another. For example, someone with good muscle tone and fitness may be less likely to trip over a small step because they can lift their feet higher. Or if they do trip, they may be able to regain their balance and avoid falling altogether. A less fit person, someone who has not managed their medicines, or someone with a foot problem will be more at risk of falling and at greater risk of injuring themselves in the same circumstance.

Hazards and fallingSome common hazards that contribute to falls inside the home include:• slippery floors• clutter or obstacles on the

floor, including unsecured electrical cords

• loose mats or scatter rugs.

Some of the common hazards that contribute to falls outside the home include:• garden paths that are cluttered

or in disrepair

Step5

Step5

44

Step9 Identify, Remove

and Report Hazards

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• uneven or pot-holed footpaths and other surfaces

• slippery floors in shopping centres or other premises

• poorly lit stairs in public places, or carpeted stairs with busy patterns that lack contrast, making the edges harder to see.

How can you minimise hazards and reduce your risk of falling?Of course the safest house would be designed without stairs or changing levels, with wide corridors and no nooks and crannies. But most people can’t afford to re-design their house! Removing some of the tripping and slipping hazards can reduce your risk of falling.

In the homeThe best approach is to:• have good lighting• remove items you could trip over• keep walkways and passages wide

and clear of hazards• reduce the danger of slipping

– clean up spills straight away• make any steps safer with a rail

and edging strips on each step.

When Pam was widowed, she moved to be closer to her daughter and son-in-law. She bought a house that needed some renovations and before this was done had a home safety assessment done by an occupational therapist. The bathroom was designed to include a safety rail and a bathing seat in the shower. An area at the bottom of the back steps was also raised and leveled. This cost little extra and Pam thinks she’ll never have to move again.

45

Outside the homeUndertake any maintenance that is required to make all garden paths and walkways even and non slippery.Store gardening tools, hoses or other obstacles away after use.

Away from homeIf you do fall or see a potential hazard, you should report it to your local council or the owner or manager of the relevant commercial premises.Many councils have Disability Access Plans that encourage organisations to improve access for older people and people with disabilities.

Step5

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Step9 Identify, Remove

and Report Hazards


www.health.tas.gov.au/stayonyourfeet• Department of Veterans’ Affairs (DVA), Veterans’ Home and Garden

Maintenance – Phone: 1300 550 450• Occupational Therapy Australia (Tas) – 1300 682 878• Contact your local Council to report hazards.

47

Your personal review on managing hazardsHaving read through this step, review your current action on managing hazards. A couple of examples are given to help.





I phoned the council the other day and told them about the dangerous paving near the tree at the corner.

I’ll put in a night light that comes on automatically when anyone goes near the back steps.

Call the electrician.

Falls are not a normal part of ageing. Understanding that falls can happen to anyone, whatever their age, helps everyone to take falls seriously and to find out ways to prevent falls before they happen.

Falls prevention is about realising that you can influence your mobility and independence. You can take steps to stay mobile and independent and prevent falls before they happen.

Completing your Personal Action PlanIt’s easy – just follow a few simple steps:• Refer back to the Personal Review section at the end of each of the

nine steps.• Transfer over the actions that you identified for each step into your

Personal Action Plan on page 49.• Decide when you will do these things and record this as well.• When you have completed each action, tick it off.An example is provided on the next page.

Action PlanYour Personal

48

49

Laura’s Personal Action Plan

Step Things I need to do I’ll do it ... Have I done it yet?

1 Make an appointment at the gym to see what classes are available and suitable

Today

2 Ask at the pharmacy about a Home Medicine Review

Monday, while shopping

3 Ring Arthritis Tasmania for information about my arthritis

Tomorrow

5 Check a copy of the Australian Dietary Guidelines

Tomorrow

6 Make an appointment at the podiatrist

Tomorrow

8 Get a copy of the Dietary Guidelines for Older Australians

Tomorrow

9 Have the sunken bricks in the path at the front fixed

Next time my son visits

2 and 7

Get a diary so I can remember when to get annual reviews of medicine and eye tests (and birthdays)

Next time I go to the newsagency

Making the most of your Personal Action PlanTo get the most out of your Personal Action Plan you will need to refer back to it from time to time, perhaps adding new actions or ticking off completed actions. Your Personal Action Plan is not something to complete then put aside.

Why not cut it out and place it on your fridge as a reminder?

As you complete the plan, keep in mind that you can influence your own health and independence.

5250

51

My Personal Action Plan

Step Things I need to do I’ll do it ... Have I done it yet?

$

52

If you fall, it is not always possible to know how little or how much you might be injured.

Most falls don’t result in serious injury but many people are unable to get up without help. Minimising injury from a fall will depend on how and where and when you land, how strong your bones and skin are, and how quickly help arrives.

Making a plan of things you can do to safeguard yourself if you fall is wise. This may help you feel more confident and in control in the event of a fall, and will be reassuring to your family and friends.

If you fall• Don’t panic – stay calm and still

for a moment and assess the situation.

• Check to see if you have any injuries or pain.

• Consider how serious these injuries are before deciding whether you should try and get up.

• If you are not badly injured and think that you can get up, take time to make sure you are doing it safely. If you can, use stable furniture to help pull yourself up.

What if I do Fall

• If you can’t get up, try sliding or crawling to the phone, front door or a personal alarm to call for help. Then make yourself comfortable and warm if possible (pull down a bedspread or towel if you can) and wait calmly for help to arrive.

• If you are in doubt about how serious the injury is, call an ambulance. Stay warm until the ambulance arrives.

After every fall it is important to talk with your GP about your fall and the possible causes. It may be important to tell someone else (family, friend or neighbour) that you have fallen so that together you can think about whether your emergency plan needs to change in case you fall again.

Emergency numbers to callDial 000 and ask for the ambulance.

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Turn ontoyour back

Roll ontoyour side

Push ontoyour hands

Push up ontoyour handsand knees

Kneel, usingstable furnitureto STEADY

yourself

Place yourstrongest

leg forward Stand up

TurnSLOWLY

Sit down. REST.TELL somebodyyou have fallen

1

2 3

4 5

6 7

8 9

How can I getup from the

floor at home?

Turn ontoyour back

Roll ontoyour side

Push ontoyour hands



yourself

Place yourstrongest


TurnSLOWLY


1

2 3

4 5

6 7

8 9


floor at home?

Turn ontoyour back

Roll ontoyour side

Push ontoyour hands



yourself

Place yourstrongest


TurnSLOWLY


1

2 3

4 5

6 7

8 9


floor at home?

Turn ontoyour back

Roll ontoyour side

Push ontoyour hands



yourself

Place yourstrongest


TurnSLOWLY


1

2 3

4 5

6 7

8 9


floor at home?

Turn ontoyour back

Roll ontoyour side

Push ontoyour hands



yourself

Place yourstrongest


TurnSLOWLY


1

2 3

4 5

6 7

8 9


floor at home?

54

yes no

Do not practice this unattended, speak to your Doctor or Physiotherapist.

Can I get up from the floor?

I must get help. I can:I will roll onto my side and pushup onto my hands and knees

I will use stable furnitureto help me stand up

(Please see pictures overleaf)

Stand up slowlyAnd safely

To try and getsomebody’s attention

Now remember to rest.I will tell somebody I have fallenAnd see my doctor if necessary

Now, I must remember toconserve my energy and

lie quietly until help arrives

Use pillows or blankets within reach to stay

comfortable and warm

My Fall Action PlanWhat should I do if I fall at home?

DON’T PANICStay calm, remain positive,

assess the situation

Make a loud noise

Try and reach the phoneSlide or crawl for the front door

Press my personal alarm

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Contact Details

Alzheimers Australia 1800 100 500 www.dementia.org.auArthritis Foundation of Tasmania 1800 011 041 www.arthritistas.org.auAustralian Association of Social Workers (Tas) (03) 6245 3170 www.aasw.asn.auAustralian Physiotherapy Association (Vic/Tas) 1300 306 622 www.physiotherapy.asn.auAustralian Podiatry Association (03) 9416 3111 www.podiatry.org.auAustralian Psychological Society 1800 333 497 www.psychology.org.auAustralian Red Cross (Tas) 1800 733 276 www.redcross.org.auBeyond Blue 1300 224 636 www.beyondblue.org.auDepartment of Veterans' Affairs (DVA) www.dva.gov.au Veterans’ Home and Garden Maintenance 1300 550 450Commonwealth Respite and Carelink 1800 052 222 www.dss.gov.au/disability-and-carers/programmes-services/for-carers/

commonwealth-respite-and-carelink-centresCommunity Rehabilitation Unit (Hobart) 6166 7312

Council on the Ageing (COTA Tas) (03) 6231 3265 www.cotatas.org.auDiabetes Tasmania 1300 136 588 www.diabetestas.org.auDietitians Association of Australia 1800 812 942 www.daa.asn.au Falls Prevention Information Activities and ResourcesLaunceston Community Health Service (Kings Meadows) (03) 6777 1427 North West Regional Hospital (Physio) (03) 6493 6250 Mersey Community Hospital (Physio) (03) 6478 5325 Community Outreach Physiotherapy (South) (03) 6166 7279

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Independent Living Centre 1300 885 886 www.ilctas.asn.auMacular Degeneration Foundation 1800 111 709 www.mdfoundation.com.auMedicine Wise 1300 633 424 www.nps.org.auMy Aged Care 1800 200 422 www.myagedcare.gov.auNational Continence Hotline 1800 330 066 www.continence.org.auNational Stroke Foundation 1800 787 653 www.strokefoundation.com.auOccupational Therapy Australia (Tas) 1300 682 878 www.otaus.com.auOptometrists Association (Tas) (03) 6224 3360 www.optometrists.asn.auOsteoporosis Australia 1800 242 141 www.osteoporosis.org.auParkinson's Disease (Tas) 1800 644 189 (03) 6224 3360Primary Health Tasmania 1300 653 169 www.primaryhealthtas.com.auTasmanian Community Care Referral Service 1300 769 699 www.health.tas.gov.au/service_information/service_delivery_points/tccrsThe Heart Foundation 1300 362 787 www.heartfoundation.org.auVision Australia 1300 847 466 www.visionaustralia.org.au

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Numerous people have contributed to this booklet including staff from:• Department of Health and

Human Services – Population Health and Wellbeing

• Tasmanian Health Services – Clinicians

• Department of Health WA, Injury Prevention Branch

• Department of Health WA, Rehabilitation, Aged and Continuing Care, South-East Coastal Health Service, Stepping Out, Great Southern Population Health Unit, South Metropolitan Public Health Unit (Mandurah and Armadale), South West Population Health Unit, Wheatbelt Public Health Unit, Marketing and Campaign Support Branch, Nutrition and Physical Activity Branch

• Commonwealth Department of Health and Ageing, Injury Prevention Section

• Injury Control Council of WA

• Office of Seniors Interests and Volunteering

• Disability Services Commission• Council on the Ageing• Department of Veterans’ Affairs• Australian Podiatry Association

(WA)• Optometrists Association

Australia (WA)• Royal Australian College of

General Practitioners WA• Rob Wright Concepts & Copy• Centre for Research into Aged

Care – Curtin University• Real Options International• Prevention and Primary Health

Care Stay on Your Feet WA® Planning Group

Acknowledgement is given to Stepping Out: Passport to Falls Prevention, Sir Charles Gairdner Hospital, North Metropolitan Area Health Services, Western Australia and the Australian Government Department of Health and Ageing.

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Acknowledgments

Additional Stay On Your Feet® information can be viewed online at

www.health.tas.gov.au/stayonyourfeet

Information has been adapted from the Australian Council for Safety and Quality in Health Care (2009). ‘Preventing falls and harm from falls

in older people. Best practice guidelines for Australian community care, hospitals and residential aged care’.

Stay On Your Feet® is a registered trademark of the Department of Health WA and is used with permission.

This booklet was developed by the Department of Health WA and adapted by the Department of Health Tasmania. TH

S SO

YF –

Dec

201

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Documents

Falls can be prevented. Take action to stay mobile and ... · 5 How to use this booklet Step 1: Be Active Step 2: Manage Your Medicines Step 3: Manage Your Health Step 4: Improve