Preventing Falls at Home: Small Changes That Can Make a Big Difference

A fall can happen to anyone, but as we get older, or if our mobility, strength or balance changes, the consequences can become much more serious.

For some people, the biggest impact isn't even the fall itself. It is the loss of confidence afterwards. Someone who has always been independent can suddenly become nervous about walking to the shops, using the stairs or even moving around their own home.

The important thing to remember is that falls are not simply an inevitable part of getting older.

There are often practical things we can do to reduce the risk, and many of them are surprisingly simple.

At Fen Mobility Centre, falls prevention is something we talk about regularly. Our centre is led by Occupational Therapist Sara Cunnington, who has over 17 years of NHS experience, and one of the things we always encourage is looking at the person, their environment and their everyday routine together.

There is rarely one magic solution. Instead, it is often a collection of small changes that can make everyday life safer and easier.

Start with the little trip hazards

Sometimes it isn't the big things that cause problems.

Loose rugs, trailing cables, cluttered walkways, shoes left by the door or even a small change in floor level can all create a trip hazard.

Take a walk around the home and look at the routes used most often, particularly between the bedroom and bathroom, around the kitchen, between a favourite chair and the front door, and anywhere somebody regularly carries things.

Could anything be moved or removed to create a clearer route?

Think about furniture too. A coffee table that has always been in the same place might suddenly become awkward if somebody has started using a walking frame or rollator.

It sounds simple, but creating a little more space can make a surprisingly big difference.

Think about lighting

Poor lighting can make steps, obstacles and changes in flooring much harder to see.

Hallways, stairs and bathrooms are particularly important, as is the route between the bedroom and toilet during the night.

A bedside lamp that's easy to reach, plug-in night lights or motion-activated lighting can all help. It is also worth checking whether bulbs have become too dim and whether switches are conveniently positioned.

Outside lighting matters too. A doorstep or path that feels perfectly safe during the day can be quite different on a dark winter evening.

Take another look at the stairs

Stairs can become more difficult if strength, balance or vision changes.

Make sure they are well lit and kept clear. Handrails should be secure and positioned where they can actually be used.

Try not to leave items on the stairs ready to be taken up later. Even something small can become a significant obstacle.

If somebody has started avoiding the stairs, pulling heavily on the handrail or becoming particularly tired when climbing them, it may be worth getting further advice.

A stairlift can sometimes be appropriate, but it isn't automatically the first answer. Understanding why the stairs have become difficult is important.

Getting up from a chair

If standing from a chair is becoming difficult, people can sometimes compensate by pulling on nearby furniture or pushing themselves up awkwardly.

Before assuming a rise and recline chair is needed, it's worth looking at the existing chair.

Is it too low? Is the seat too deep? Has the cushion become very soft? Are there suitable armrests to push from?

A sofa that somebody has happily used for ten years may simply no longer provide the support they need.

The right seating can make standing considerably easier and safer.

Where a rise and recline chair is appropriate, getting the correct size and movement is important. Seat height, depth and width all matter, as does the way the chair lifts.

A chair that simply tips somebody forwards isn't necessarily helping them to stand safely.

This is one of the reasons we encourage people to try different chairs rather than choosing one purely because it looks comfortable.

Getting in and out of bed

The bedroom is another area that's easily overlooked.

If a bed is too low, standing can become difficult. If it is too high, getting safely onto it can be equally awkward.

Someone who is struggling may start pulling on bedside furniture or using a radiator, windowsill or other unsuitable object for support.

Bed rails, support handles and electric adjustable beds can all have their place, but they need to be appropriate for the individual.

Sometimes simply looking at the height and position of the bed can identify an easier solution.

Grab rails can help, but put them in the right place

A strategically positioned grab rail can provide reassurance and support around steps, doorways, toilets, showers and other areas of the home.

Position matters, though.

A rail fitted where it looks convenient isn't always where somebody naturally reaches when they need support.

Think about the actual movement being made. Where does the person put their hand when stepping through the doorway? Which direction are they turning? Are they trying to pull themselves upwards or simply looking for something steady?

There are also different styles of grab rail for different situations.

The important point is not simply to cover the house in rails, but to put useful support in the places where it is genuinely needed.

Don't forget the bathroom

Bathrooms combine several potential problems: water, slippery surfaces, restricted space and the need to sit, stand and turn.

Getting into and out of the bath can become particularly difficult if strength or balance has changed.

Depending on the individual, relatively straightforward equipment such as a shower stool, bath board, toilet frame, raised toilet seat or appropriately positioned grab rail can make everyday tasks easier and safer.

Non-slip surfaces and keeping the floor clear and dry can also help.

The important thing is choosing equipment that suits the person and the bathroom rather than simply buying something because it is labelled as a bathroom aid.

Walking aids need to be right for the person

A walking stick, rollator or walking frame can provide valuable support, but only when it is appropriate and adjusted correctly.

We've seen plenty of walking sticks that are far too tall or too short for the person using them.

A stick that has been borrowed from a relative or bought years ago may never have been properly adjusted.

The same applies to walking frames and rollators. Height, stability, brakes, wheels and the way somebody walks all need consideration.

More support isn't automatically better either. The right walking aid should help someone move safely while allowing them to remain as independent as possible.

If you're unsure, ask for advice rather than guessing.

Check the ferrules and brakes

Even when somebody has the right walking aid, it needs to remain in good condition.

The rubber ferrule on the bottom of a walking stick gradually wears down. Eventually it can provide considerably less grip than it once did.

Rollator brakes can also need adjustment, particularly after plenty of use.

These are small things that are easily forgotten because the equipment still appears to work.

Every so often, give walking aids a quick check. Look at the ferrules, wheels, brakes, handles and anything that has become loose.

Footwear matters too

Slippers that have lost their shape, loose-fitting shoes and smooth soles can all increase the risk of slipping or tripping.

Well-fitting, supportive footwear with suitable soles can make a real difference, particularly for somebody who is already a little unsteady.

Watch out for slippers without proper backs, shoes that are now too large and footwear with badly worn soles.

It is also worth remembering that feet can change with age. Swelling, arthritis and other problems can mean that shoes which once fitted perfectly are no longer comfortable or supportive.

Eyesight, medication and general health

Not every fall is caused by something in the home.

Changes in eyesight can make obstacles or changes in floor level harder to see. Feeling dizzy or light-headed can affect balance. Some medications can also have side effects that affect how steady someone feels.

If somebody has started falling unexpectedly, has become noticeably less steady or regularly feels dizzy when standing, it is sensible to speak to their GP or another appropriate healthcare professional.

Regular eye tests are important too. We recommend specatular opticians.

A sudden change in mobility or balance shouldn't simply be dismissed as "getting older".

Strength and balance are important

People sometimes respond to a fall by moving less.

It's understandable. If somebody is frightened of falling again, sitting safely in a chair can feel like the sensible option.

But becoming less active can lead to reduced strength and confidence, which can make mobility even harder.

Where appropriate, maintaining activity, strength and balance can be an important part of reducing future falls.

This doesn't necessarily mean joining a gym. For some people it might simply mean continuing regular walks or following suitable exercises recommended by a physiotherapist or other healthcare professional.

The right approach will depend on the individual and their health.

Take your time

Falls don't always happen because somebody cannot walk safely. Sometimes they happen because somebody is rushing.

Getting to the telephone, answering the door, needing the toilet urgently or trying to catch

something that's falling can all lead people to move faster than they safely can.

Making everyday things easier to reach can help.

Keep frequently used items nearby. Make sure the telephone is accessible. Avoid storing everyday kitchen items on very high or very low shelves if reaching them is difficult.

Planning the home around the person can reduce some of that unnecessary rushing and stretching.

Think about outside the home too

Falls prevention doesn't stop at the front door.

Uneven paths, loose paving, steps, gravel, wet leaves and poor lighting can all make getting in and out of the house more difficult.

If somebody uses a walking aid indoors, consider what happens when they go outside. Is the same aid suitable? Can they safely negotiate the path and doorstep?

Ramps can sometimes help with access, but gradient, width and available space are important. A ramp isn't automatically safe simply because it fits over a step.

What should relatives look out for?

Sometimes changes happen gradually and the person themselves may not notice them.

If you're worried about a parent, partner or relative, look for little clues.

Are they holding onto furniture as they walk around the room? Have they stopped going upstairs unless they absolutely have to? Are they struggling to stand from their usual chair? Have they stopped going outside as often?

You might also notice unexplained bruises or hear about "little stumbles" that weren't considered serious enough to mention.

These things don't necessarily mean someone is about to have a serious fall, but they can be useful signs that something has changed.

A conversation at this stage can be much easier than waiting until after a fall.

What if someone has already fallen?

A fall, or even a near miss, can knock somebody's confidence considerably.

They may become nervous about walking outside, using the stairs or being left alone.

If somebody has started falling, feels increasingly unsteady or their mobility has noticeably changed, it's worth speaking to an appropriate healthcare professional rather than simply accepting it as part of getting older.

It can also be useful to think about what happened immediately before the fall.

Where were they?

What were they doing?

Were they rushing?

Did they trip over something?

Did they feel dizzy?

Were they getting up from a chair or bed?

Understanding what happened can help identify changes that might reduce the chance of it happening again.

Sometimes you need to look at the whole picture

There isn't one product that prevents falls.

For one person, a correctly adjusted walking stick might help. For somebody else it could be better lighting, different seating, a grab rail or simply removing a troublesome rug.

For another person, the most useful thing might be a conversation with their GP, optician or physiotherapist.

And sometimes the answer isn't a piece of equipment at all.

That's why we believe good advice should come before products.

At Fen Mobility Centre in Ely, our team can help with everything from walking sticks, rollators and grab rails to bathroom equipment, seating, wheelchairs and mobility scooters.

Our centre is led by qualified Occupational Therapist Sara Cunnington, who brings more than 17 years of NHS experience to Fen Mobility Centre. That means our approach isn't simply about finding something on a shelf. It's about understanding what somebody is finding difficult and helping them find an appropriate solution.

We have a large range of mobility equipment, daily living aids and useful gadgets available in our Ely showroom, and you're always welcome to come in for a look around and a chat.

If you're making a special journey for a particular item, please feel free to call ahead and we'll happily check whether we have it in stock.