WIXLIB

R Exercises and activities that make youboth stronger and improve your balancelower the risk of having a fall.R Some examples are Tai Chi, dancing orgroup exercise programs that includebalance and muscle strengthening.R Talk to a physiotherapist about whichKeeping yourself mobileInactive or unfit people tend to have poorerbalance and weaker muscles and can beunsteady when walking. These can allincrease the risk of falling. It is commonfor people who feel unsteady to do lesswalking. Over time this actually makes youmore likely to fall because your muscles getweaker, your joints stiffer and your balancegets worse.Our bodies were designed to move. Physicalactivity keeps us healthy and reduces therisk of falls. It can also: Improvebalance Improvemuscle strength and flexibility Keepbones strong Increase Helpenergy levelswith sleeping problems Helpto control blood pressure, bloodsugar levels and weight Helpyou to feel good about lifeWhat you can do:R Be physically active every day. Whateveryour age, aim to do at least 30 minutesof activity, at least 5 times a week.R The activity should make you breathea bit faster and your heart pump a bitharder, but you should still be able totalk while doing the activity.balance and strengthening exercises oractivities will best suit you, and how tomanage any pain you might have.R A physiotherapist can also advise youabout whether a walking aid, such as astick or frame, would help you. Using awalking aid can increase your steadinessand confidence to walk more. It isimportant that walking aids areproperly adjusted for you, and thatthey are properly maintained (eg replaceworn stoppers).R Talk to your doctor if your healthproblems or pain make you worriedabout attempting more activity.R If you have arthritis, being active helpsto control pain, weakness and stiffness.Where you can find help or advice: CommonwealthCarelink, for help findingphysiotherapists, accredited exercise orfitness instructors and physical activities inyour area Yourlocal council, for information onactivities in your area CommunityHealth Centres and DayTherapy Centres for physiotherapy services Yourlocal library, for booklets or videoson exercise for older people ArthritisAssociation, for informationabout exercising with arthritisSee page 29 for a list of support servicesfor older people.page 7

MedicinesSome types of medicines can increase yourrisk of falling. You may also be at greaterrisk simply because you take four or moredifferent medications. Medicines includethose prescribed by your doctor, boughtover the counter and herbal remedies.The types of medicines which can be aproblem include those taken for anxiety,depression or difficulty sleeping. This isbecause of possible side effects such as: Drowsiness Confusion Unsteadiness DizzinessWhat you can do:R Tell your doctor if you are concerned orhave felt any of the side effects listedabove, especially if you are starting anew medicine. Your doctor can thenreview your medicines to see if changesare needed. This is important becausemedicines affect different people indifferent ways.R Keep a list of all your prescription andnon-prescription medicines, and alwaystake this to any appointments withdoctors.R Talk to your doctor if you are taking, orthinking about taking, any alternative,natural or herbal remedies as theymay interact badly with your othermedicines.R To get the most from your medicines,follow the instructions on the labeland any other instructions given byyour doctor or pharmacist. Never takesomeone else’s medicine.page 88pageRAlcohol can react with medicines check the labels or ask your doctor orpharmacist.R Ask your pharmacist about using aspecial pack such as a ‘dosette box’ or‘webster pack’ to help you keep track ofwhat medicines you take and when. Ifyou take many different medicines, askyour doctor about a Home MedicinesReview at home with your pharmacist,to help sort out all your medicines.R The doctor is the only one who shouldchange your medicines.R Ask your doctor about ways to dealwith sleep problems without usingsleeping tablets. Also, you can tryavoiding coffee and tea before bed,doing more exercise, taking only shortnaps during the day and using quietmusic at bedtime to improve your sleep.Where you can find help or advice: Yourlocal pharmacist YourdoctorAsk questions about your medications

What you can do:R Have your eyesight and glasses checkedby an optometrist at least once everytwo years and yearly by your doctor.R If you notice changes in your eyesight,make an appointment with your doctoror optometrist. Early detection of eyeproblems can stop them getting worse.R Keep your glasses clean and alwaysHave your eyes and glasses checked everytwo yearsMaking the most ofyour eyesightYour eyes not only allow you to seeobstacles and judge steps, they help you tokeep your balance.But from the age of 40, your eyesightgradually worsens and this can lead to anincreased risk of falling. By the age of 65we all need three times more light to seethan we did at 20 and our eyes: Takelonger to adjust to sudden changesin light and dark. Aremore sensitive to glare. Areless able to judge distance and depth,for example on steps.It is important for safety, as well as dailyactivities, to make the most of youreyesight.wear the correct glasses - readingglasses are for reading and distanceglasses are for walking around.R Take extra care on steps if you wearbifocals or multi-focals - they can makeit difficult to judge where to put yourfeet.R Wear sun glasses and a hat outside.R Avoid sudden changes in light. If yougo from light to dark, or the other wayaround, stop and give your eyes time toadjust before moving.R Refer to the lighting section of thisbooklet (page 14) for ideas about thingsyou can do in and around your home.Where you can find more help oradvice: VisionAustralia Occupationaltherapists (OT)(Commonwealth Carelink or OTAustralia can provide details of servicesin your area) OptometristsAssociation AustraliaSee page 29 for contact details.page 9

Falls prevention fromthe ground up - feetand footwearAs we age, our feet can change shapeand lose some feeling and flexibility. Thischanges the way we walk and affectsbalance. Painful or swollen feet can makeit difficult to walk. Also, some shoes orslippers can make you more likely to slip,trip or stumble, leading to a fall.Prevent falls with safe shoes.Firm heel cupprovides supportwhen walking.Laces, buckles orvelcro fastenings holdthe foot more firmly.Wide and deeptoe box allowsplenty of room fortoe movement andcomfort.What you can do:R See a podiatrist or doctor if you havepainful or swollen feet, tingling or pinsand needles in your feet or if you haveany changes in the shape of your feet(for example, bunions).R Choose comfortable, firm-fitting, flatshoes with a low broad heel and solesthat grip (see picture).R Don’t wear poorly fitted slippers or walkCorrect lengthallows normalfoot function.Thin sole withtread enablesyour feet to ‘read’the underlyingsurface andprevents slipping.Low, wide heelwith rounded edgesprovides more contactwith the ground andprevents slipping.in socks.R If you have difficulty finding suitableshoes because of foot problems,ask your podiatrist for the names ofspecialist shoe stores.R Ask your podiatrist or physiotherapistto suggest ways to improve circulation,decrease swelling and reduce pain inthe legs and feet.Where you can find help or advice: CommonwealthCarelink AustralianPodiatry Association canprovide names of podiatrists in your area LocalCommunity Health Centres and DayTherapy Centres often have podiatristsSee page 29 for contact details.page 10page10

R Talk to a physiotherapist or accreditedexercise or fitness instructor about howto improve your strength and balance.After building up your strength andbalance you are likely to have moreconfidence in your abilities.R Make your home and surroundings saferto move around in. See pages 12-19.R Make a plan for getting help in anemergency or in the event of a fall. Seepages 20-27. This will help you, yourfamily and your friends feel confidentthat you can get help if you need it.Managing worriesabout fallingR Talking with a clinical psychologist,If you have had a bad fall it is natural tofeel worried about falling again. Somepeople become fearful of falling even if theyhaven’t fallen. This fear may be because ofunsteadiness or the thought of the possibleinjuries from a fall.Where you can find more helpor advice:People who are worried about falling tendto restrict their activity, gradually doingless and less. For some people this canmean less social activity. As discussed inthe ‘Keeping yourself mobile’ section (seepage 7), this can lead to an increased risk offalling over time.What you can do:R Talk to your doctor about your feelingsor concerns about falling.R Talk to a physiotherapist about whethersocial worker or counsellor can also helpyou regain your confidence, particularlyif your fear is very strong or you arelonely or isolated. CommonwealthCarelink, for counselling,physiotherapy and clinical psychologyservices in your area Yourlocal hospital or Community HealthCentre may have physiotherapists andpsychologists on staff AustralianPsychological Society AustralianAssociation of Social WorkersSee page 29 for a list of support servicesfor older people.you need a walking aid, such as a stickor frame. This can make you morestable and improve confidence whenwalking. You may only need an aid fora while until you get stronger and feelsteadier.page 11

Fall-proofing your surroundingsReducing yourEnvironmentalRisk FactorsMaking your home and surroundings assafe as possible is another important thingthat can be done to reduce the likelihood ofa fall.Making these areas safer not only reducesthe number of falls and accidents, but canmake it easier for you to manage your dailyactivities as you get older.page 12In this section we look at common hazardsthat increase your chance of a fall, both inand around your home and in public places.We also talk about planning ahead whenbuilding or renovating. On page 31 thereis a Notes page for you to jot down thingsyou can do to make your surroundings safer.

Your home and gardenDid you know that 60% of falls happenin and around the home?Some of the problem lies with us, and somewith our houses and gardens.As we get older our abilities change,increasing the chances of us slipping andtripping.And our homes age too, through general‘wear and tear’ or lack of maintenance,making them less safe. Often we don’tnotice this because we have lived there formany years without any problems.It is important to check your surroundingsand take steps to make them safer.Safe and unsafe ways todo things.Apart from hazards in the surroundings,some of the dangers can result from theway you choose to do things.For example, climbing onto a kitchen chairto reach into a high cupboard puts you indanger. Instead, you could: Asksomeone else to reach up for you, orAvoid climbing. Arrange help for jobs thatare at heightYou can also increase the risk of falls bywearing clothes or dressing gowns that aretoo long and loose and can catch on things.Think about different and safer ways ofdoing things. Use your head to save yourselfa possible injury!Smooth paths make it easy to keep on the go Keepthe item in a place that is easier toreach.Another example is not turning the light onso you can see clearly where you are goingand what you are doing.These things may have been fine when youwere younger, but are no longer safe.page 13

How to be safer in yourhome and surroundingsThe following section lists some commonchanges to your surroundings that will helpincrease safety. When you are checking yourhome for these, it is a good idea to get helpfrom somebody who has not seen yourhome before. They may spot problems thatyou may not notice, having lived with themfor so long.What you can do:R Increase the amount of light, particularlyin frequently used areas and at night.Don’t forget to turn lights on before youwalk around. (Low energy light globeswill help to keep the power cost down.)R At night, leave lights on in the passageway and other places you might walk.R Light switches should be easy to reach.Two way light switches can help incorridors or rooms where there is morethan one entry, and on stairs.Remove general hazardsGeneral hazards are things like an electriccord across a walkway. They are dangerousfor young and old. Removing generalhazards will benefit all people who use thatarea, not only you.Common problem areas are lighting,tripping, slipping and structural hazards.1) LightingChanges to our eyesight with age werediscussed earlier in the booklet (page 9).These changes mean that it is important tomake it easy for your eyes to do their best.R Decrease daytime glare with netcurtains or blinds in your windows.RMake obstacles or hazards stand out.For example, highlight the edges ofsteps with brightly coloured tape orpaint; have your furniture a contrastingcolour to the walls and floor (forexample dark blue chairs, off-whitewall, and light blue floor).R Avoid heavily patterned floor coveringsas they can make it hard to see smallobstacles or the edges of steps, becausethey ‘blend in’.R Outside, try to remove anything thatthrows shadows across paths.Where you can find help or advice: Commonwealth AnCarelinkoccupational therapist (OT) VisionAustralia Independent TheLiving CentreDepartment of Veterans’ AffairsSee page 29 for contact details.Good lighting is important throughout the housepage 14

R Non-skid tape is very useful both forhighlighting edges, and providing extragrip on steps and stairs.R Remove mats and rugs or make surethey have either non-slip backing or aresecured with double sided tape.R Keep outside paths clear of moss, slimeand fallen leaves.R Make sure the walking surfaces inand around the home have non-slipsurfaces.2) SlippingWhere you can find help or adviceSlipping can be caused by: Look unsafefootwear, such as loose slippers ornarrow heels slipperysurfaces such as wet or polishedfloor, or spills of fat or foodWhat you can do:R Wear safe shoes (refer to page 10).R Use non-slip mats in wet areas, such asthe shower and bathroom.in the Yellow Pages under ‘FloorTreatment Products’ Non-slippaint and backing is availablefrom hardware stores Contactthe Independent Living Centre Talkto an occupational therapist (OT) TheDepartment of Veterans’ AffairsSee page 29 for contact details.R For larger wet areas it may be betterto have the whole floor/bath/showertreated to make it non-slip, or replacethe floor with non-slip material.R Use a hand rail or a seat in the showeror bath.R void talcum powder on tiles, vinyl orAwooden floors - it makes them veryslippery.R In the kitchen or eating areas, pick updropped food and mop up spills as soonas they happen.R Do not polish floors.page 15

3) TrippingAs we lose the ‘spring in our step’ we don’tpick up our feet as much when movingaround, so we are more inclined to trip overeven small things.What you can do:R Keep walkways clear – remove clutter.R Tuck electric cords under furniture oraround skirting boards. Tape themdown. A power board can reduce thenumber of long cords around a room.R Fit a ‘draught excluder’ to the bottomof the door, rather than use a ‘doorsausage’ that can be tripped over.R Remove, or mark, even small changesin floor level with contrasting colour ortape so they are easily seen.R Check outdoor paths for cracks anduneven areas.R Make sure quilts, bed-spreads andcurtains do not fall across the floor.page 16R Remove mats and rugs, or have themwell secured. Get rid of mats that curlor fold over easily.R Remove or repair torn orstretched carpet.R Choose outside door mats withsloping edges.R Don’t leave things lying around thegarden – roll up the hose.R Dogs and cats like to be close. Checkwhere your pet is before you move.

4) Change structural hazardsThese are built-in features of the home thatcan be a danger. An example is a step atthe entrance to the shower that you have tostep over with wet feet when getting out ofthe shower.Other structural hazards develop becausethe house is not maintained, for example abroken step.T hink about changes or additions to thestructure of the house that may make itsafer and easier to manage.What you can do:R Plan to keep your home wellmaintained.R Think about the safest and mostconvenient place in your home foreach thing you do. For example it maybe better to move the bedroom to thespare room so that it is nearer to thetoilet for when you get up at night, orconsider a commode chair.R Consult an occupational therapist abouteliminating the “hob” or step into theshower if possible.R Talk to an occupational therapist aboutequipment that may make things easierand safer. For example, using a bathboard or bath seat if your shower isover the bath, or using blocks to raisethe bed height.Where you can find help or advice Yourlocal council may be able to assistyou with home maintenance througha Home and Community Care (HACC)program The AnIndependent Living Centreoccupational therapist (OT) Geta home safety checklistfrom an occupational therapistSee page 29 for a list of supportservices for older people.Another example is to have all the itemsyou need to make a cup of tea or coffeenear the kettle and in a convenientplace between waist and shoulderheight.R Re-hang the bathroom and toilet doorsso that they open outwards (if you fall,someone can reach you).R Install rails in the bathroom and toilet,and near front and back door andany steps.R Have soap holders recessed so thatyou will not hit them if you slip in theshower/bath.page 17

Enjoy your shopping, go when it is not so busy5) Remove personal hazardsApart from general hazards that are

Fall-proofing yourself Reducing your Personal Risk Factors 4 Health problems 5 Keeping yourself mobile 7 Medicines 8 Making the most of your eyesight 9 Falls prevention from the ground up - feet and footwear 10 Managing worries about falling 11 Fall-proofing your surroundings