Natalie Home Physio Talks With Us About Fall Prevention At Home

From your perspective, what are the most common causes of falls in older adults?

“A lot of causes of falls i see are people tripping over or over reaching but i do also see people seeing due to their blood pressure. Most falls could’ve been prevented by wearing supportive footwear, or removing rugs, and making sure people stay well hydrated.”

What are the long-term risks if a fall is not properly addressed or prevented?

"People often think the biggest issues with falls is bothering their families or carers, but there are huge risks associated with falls. There are the obvious ones such as fracturing a bone, but if you are unable to get up from the floor then you can develop pressure ulcers or suffer dehydration, as well as developing a fear of falling causing people to become bed bound. Other long term risks include immobility, by which i mean people stop doing the things that they would normally do, such as going out with family and friends, showering, or walking to the toilet.

Falls can have such a wide impact on someone’s life. It can lead to social isolation and self-neglect, all of which can be addressed by keeping active for as long as possible.”

What are some key things carers or families should look out for in the home that might increase fall risk?

“You need to make sure someone is wearing good supportive slippers. If their feet swell, getting one's with velcro on the top or around the heels, that can be a really easy thing to help prevent falls.

Other things can be looking at the furniture. We see quite a lot of people that have slipped off the edge of the bed due to the bed being too high, or slipped out of their chair because it’s too big or small for them so they can’t relax properly. There are many causes of falls in the environment which is why having a falls risk assessment can be really helpful by highlighting any risks and helping to prevent further falls.”

How important is the environment in preventing falls, and what are some simple changes that can make a big difference?

“A cluttered environment can be a really big risk, so you should ensure carpets are well fitted and that there are no rugs as well as checking the threshold between different floorings are smooth as you can catch your toes or zimmer frames on them. Looking at the layout of the home, as change can be difficult for lots of people so discussing how they can remain in their own home safely for as long as possible can be really helpful for managing expectations.

There are some simple things that you can do: like having a commode, or urine bottles for men in the bedroom so that they don’t have to navigate getting to the toilet in the dark, getting a second banister rail on the stairs, or even simply just moving furniture so there is space to walk around easily.”

What kind of exercises or movements can help improve balance and strength for people in home care?

“As you age your goals become slightly different as you exercise to try to maintain the status quo instead of trying to make fast improvements in ability. If you think about any stage of your life, if you were able to run as fast at 40 as you are at 20, you would be really proud of yourself, so the same goes for an older adult being able to achieve what they could at 70 when they’re 90 is still a big success when it comes to physiotherapy.

I have two favourite exercises that I like to give to nearly everyone I see. The first is standing on one leg holding onto the kitchen worktop, starting off with 2 hands for support then slowly reducing the support and increasing the length of time.

There was a campaign in 2023 called ‘The Flamingo Challenge’ which highlighted the importance of strength and balance. The study showed in the over 80’s, the average amount of time they could stand on one leg was 5 seconds, and people in their 70’s could stand for around 18 seconds, and those in their 60’s could stand for around 30 seconds, which are some good targets to aim for if you are practising this exercise.

The second exercise I like to give is standing up and sitting back down. I recommend doing this every 20-30 minutes this could be during the ad breaks if you’re watching TV as this exercise is really good for keeping you strong.

Other exercises that are great for someone who is lacking in a bit of confidence they may need their carers to support with is just generally walking, marching on the spot, and also going up and down the stairs if you have them.

The more you move, the stronger your muscles will remain which is really important as it’s where we get our energy from when we’re unwell.”

How can physiotherapy help someone regain confidence after a fall?

“A lot of people associate physiotherapy with sore backs or knees, or for a massage, but physiotherapists have a wealth of knowledge that can help keep you safe and regain your confidence. We have experience working with people that have fallen so we can help adapt your environment whilst you build your strength back up, we can assess your strength and balance to create a personalised exercise programme.

Sometimes even a short period of physiotherapy will help you find ways to complete your daily routine safely which then gives you the confidence to progress to more challenging exercises.

I find that I like to do some exercises and do some tasks that are a bit tricky but easy to progress with, which is why I often give the standing on one leg exercise, as it just gives you that boost in confidence that actually you can improve things and that will give you more motivation to do more challenging things like walking up and down the stairs or walking outside.”

If you could give just one piece of advice to someone worried about a loved one falling, what would it be?

“Other than the obvious advice from a physiotherapist to keep active as much as possible, I would say to take advantage of technology! There are lots of fall detectors out there or if you don’t want to pay for something like a lifeline, there are watches you can buy to detect falls. There are often a solution to most things these days. Some of them can be fairly inexpensive such as chair raises, but if you think you need more expensive items to get in touch with your local occupational therapist they usually have a solution.

In Hampshire, our first port of call is the adult social care occupational therapists and they can find wonderful pieces of technology to help detect falls.”

Why is early intervention so important when it comes to falls?

“If you or a loved one have started having near misses or stumbles, I would say now is the time to start taking action. Falls cost the NHS billions but any physiotherapist will tell you that is not why we care. The impact that a fall can have on someone and their families is massive. There’s hip fractures, head injuries or even the fear of falling can be so profound that they stop walking. The sooner a falls risk assessment can be completed, the more chances there is of preventing life changing events and the right tools can be given to prevent any further falls.

Alongside physiotherapy, there are other things you can do to help reduce the falls. Having a medication review as the more tablets you take the higher your risk of falls, yearly eye tests things like varifocals can increase your risk of falls, having a hearing test as your ears and your vestibular system play a big part in your balance, also checking your blood pressure. If your blood pressure drops when you stand up this can cause dizziness and can increase your risk of falls.”

To watch the full interview with Natalie Home Physio, find the video on our YouTube!

If you are in Hampshire, take a look at Natalie’s website for any physio needs you or a loved one may have https://www.nataliehomephysio.co.uk/

To speak with Homelium about any home care needs, please call us on

0333 3448 677 or email hello@homelium.com