You’d be forgiven for thinking that falls are a part of ageing, something that ‘just happens’ as you get older. Most people do.

And it’s not surprising when they happen so often, around a third of over 65s and half of those over 80s will fall every year. But there are many simple things that older people can do to prevent falls, and their potentially devastating consequences, if only we can get the message across.

Through local events and national media coverage, Falls Awareness Week offers an opportunity for older people, relatives and carers to find out more about falls and take part in the local classes and services that can help to prevent them.

This year’s falls awareness week theme is ‘Keeping Feet Healthy’.

Keeping feet healthy is fundamental to maintaining mobility and independence. As we get older, we’re much more likely to suffer from foot conditions and complaints, such as bunions and stiffness in toe joints and ankles. These problems, along with the foot pain they can cause, all affect our balance and walking and reduce sensation in our feet, which often leads to falls.

In addition to these risk factors, studies have shown that some types of footwear and going barefoot indoors can also contribute to falling.

Foot-related risk factors for falls:

• Foot pain
• Stiffness in toes and ankles
• Foot and toe weakness and deformities such as bunions and claw toes
• Toenail disorders
• Unsuitable or loose-fitting footwear

Exercise

It is well known that exercise plays a vital role in falls prevention. There are a number of research trials that show exactly how effective a programme of strength and balance can be in reducing risk, both for primary and secondary

prevention of falls. While these programmes focus on building leg strength, emerging evidence has highlighted that exercises to improve toe and ankle strength can also significantly improve balance and functional ability, and thereby reduce falls.

Older people should be encouraged to carryout regular exercises to improve toe and ankle strength at home. These can also be incorporated into existing falls prevention exercise classes for maximum benefit.

Footwear

Some footwear can increase the risk of slips, trips and falls in a number of ways. As well as influencing balance, poor footwear can act as a barrier and make it difficult to judge surface

friction and distance from the floor. Other shoe characteristics, such as the height of the back of the shoe that goes over the heel, sole hardness and tread can also affect balance and gait.

Older people should therefore be advised about the importance of wearing well-fitting shoes to reduce the risk of falls, and particularly about the shoe characteristics that can aid walking and gait. These include:

• a high back or ‘collar’ to support the ankle
• a hard, slip-resistant sole
• heel height lower than one inch

It is also recommended that older people wear shoes or well-fitted, slip-resistant slippers indoors, rather than walking barefoot or in socks or tights, as this has also been shown to be a risk factor for falling.

Foot care

Taking care of feet is an essential part of falls prevention. Foot conditions, such as bunions, claw toes and ingrown toe nails, can all cause problems with gait and balance, as can foot pain, which is an independent risk factor for falls.

Older people should be advised to check their feet regularly and speak to their GP, podiatrist or chiropodist if they notice any problems, have any reduction in foot sensation, or develop foot pain. This message is especially important when it comes to pain, which is often regarded as part of getting old and therefore ignored.

Following a foot care routine can further help reduce the risk of falls by preventing some of the conditions that can cause pain and problems with balance. This includes:

• washing and drying feet daily to prevent infection
• applying moisturiser to keep skin healthy
• cutting toenails regularly
• regular podiatry for management of foot

During Falls Awareness Week we are holding a drop in session at our practice on Tuesday 18^th June from 9.00 – 12.00 where we will answer any questions relating to falls and your feet. All visitors will receive advice on footwear, free foot measurement, home based exercise leaflet for feet and ankles, a free tube of cream and the chance to enter our word search competition draw to win a free routine podiatry treatment.

So Drop In for a cup of tea and a biscuit and bring a friend!