1. Pride comes before a fall
Dr Raj Thakkar
BSc (Hons) MBBS MRCGP MRCP
Clinical Commissioning Director – Chiltern and Aylesbury Vale CCGs
Thames Valley Cardiac Lead for HF and AF, Oxford AHSN,
NHS England

2. This presentation is designed to reduce your risk of falls.
It is important to consider your own risk of falling and do something about it – it may save your life.
Feel free to share this with as many people as possible.

3. What are your risks of falling?
30% of those over age 65 will fall at least once per year
50% of those over age 80 will fall at least once per year
A significant number of falls are preventable
Falls: assessment and prevention of falls in older people, NICE CG 161, 2013

4. What are your risks of falling?
Have you fallen in the past?
What did it feel like?
What would happen if you fell and couldn’t get up?

5. What are the effects of falling?
Annual NHS cost £2.3 billion
>4 million beds days (England)
Doubles the hospital length of stay
70,000 hip fractures
Unsustainable for health economy
Vast social care bill
National
Personal injury e.g. osteoporotic fracture
30-73% left with loss of confidence/independence
Mortality (10% annual, deaths/year)
Leading injurious cause of death in elderly
Patient
Huge Pressure
Family/Carers

6. Why do people fall? Falls is not a diagnosis, it is a symptom
Cause often not considered or misdiagnosed
Detailed history and assessment required
May be multifactorial

7. Why do people fall? Environmental (1 in 3 falls) Rugs Doormats
Slippery stairs
Loose slippers
Wet floors
Slippery baths
Wires
Lighting
Living alone
Alcohol
Muscular
Muscle weakness
Arthritis
Spinal disease
Contractures
Pain
Use of walking aids
Neurological
Stroke
Epilepsy
Parkinson’s disease
Dementia
Neuropathy
Depression
Anxiety

8. Why do people fall? Cardiac Systemic Medication
Low blood pressure
Faint
heart failure
abnormal heart rhythm
valve disorders
carotid hypersensitivity
Systemic
Infection
Vitamin D deficiency
Anaemia
Poor fitness
Low sugar
Thyroid disease
Stopping steroids suddenly
Medication
Four or more drugs – 30% increased risk of falls (if live in the community)

9. Keep moving for a balanced life
What can I do?
Gardening
Housework
Walking to the shops
Exercise classes
Yoga or Tai Chi
Ageing can affect your balance, muscles and joints
This is made worse if we spend long periods sitting down
The more active you are, the more you can offset the effects of ageing
Click on the above link, to watch a video on how exercise has benefited people’s strength and balance

10. Keep moving for a balanced life
If you feel unsteady or have weak legs exercise can often help.
If you have already had a fall targeted strength and balance training works best
Get advice from a physiotherapist or postural stability instructor or discuss this with your GP

11. Sit to Stand Exercise Sit tall near the front of your chair
Place your feet slightly behind your knees
Lean slightly forward
Stand up (using your hands as support if needed)
Progress to no hands after time
Step back until your legs touch the chair, bend your knees and slowly lower your bottom back into the chair
Repeat 10 times
Age UK, Preventing Falls, Strength and balance exercises for healthy ageing

12. Active Bucks – Move more, feel great!
Programme to get more Bucks residents regularly active – particularly those who are inactive/sedentary people
holds over 2500 activities to search through – including those to improve your strength & balance such as Tai Chi and Dance
Why not download a voucher and get your first session free?

13. What to do if you are unable to get up
Getting Help
If you are unable to get up, you may need to consider phoning 999
Make sure you are warm and comfortable
It is not a good idea for family members/friends/passers-by to lift you from the floor.  This can cause injury to the person who has fallen, and also to the person assisting
Be Prepared
Consider what you would do in the event of a fall and were unable to get up
Have a pendant alarm or a mobile phone, or ensure that phones are low down and accessible

14. Getting up safely after a fall
1. Ease yourself up onto your elbows
2. Move onto your hands and knees
3. Hold onto a firm surface to support yourself
4. Facing the chair ease yourself to a standing position
5. Turn yourself gently and sit on a firm surface
Bucks Integrated Falls and Bone Health Service, I’ve had a Fall

15. What are we doing in Bucks?
Public campaign
Hiya Bucks (
Posters
Education
Screening our patients
Medication reviews

16. What can you do to reduce your risk?
If you’re concerned keep a falls diary and ask for help
Assess your home for dangers – don’t delay
Think about falls when out and about
Look after those at risk
Age UK, Top tips for staying steady