Stronger for Longer
Welcome to Stronger for Longer, A guide to staying steady and strong to keep you doing the things you enjoy.
What is this guide about?
All of us want to keep doing what we have been doing all our lives, whether it be shopping, socialising with friends, gardening or playing with grandchildren.
But sometimes, as we get older, we may start to notice that we are not as energetic and steady as we once were.
We may even feel worried about having a fall.
The good news is that falls are not an inevitable part of ageing.
There are lots of simple things you can do to help you stay steady, mobile and independent.
This guide helps you to find out what you can do to continue to make the most of your life.
understanding what puts us at risk
Clearly we can’t change our biological age, but by understanding what puts us at risk, we can take preventative action.
Experts believe the vast majority of falls could be prevented with some fairly modest changes to our lifestyle and homes. So take a look at the checklist below and see how many apply to you. Then read the following pages to find out why our fall risk increases as we age – and the many positive and easy steps we can all take to cut that risk and protect our freedom, whether we’re 65 or 95!
Look after yourself
- I wear bi-focals or vari-focals
- I haven’t had an eye test in the past 12 months
- I sometimes feel dizzy or lightheaded on standing or walking
- I probably do not have 6-8 drinks daily
- I have a poor appetite
- I am on more than 4 medications
- My alcohol intake sometimes makes me feel unsteady
- I often need to get up in the night to go to the toilet
- I have broken a bone in the last 2 years
- I spend a lot of time inside
Fall-proof your home
- I struggle with maintenance jobs around the house
- A bit of clutter has built up at home over the years
- I am not always that warm at home
Stay safe out and about
- I’m more cautious of my surrounding
Stay strong, stay steady
- I am probably not as active as doctors recommend (150 minutes moderate activity a week in bouts of 10 minutes)
- I sometimes struggle to get up from the chair
- I sometimes feel a bit wobbly on my feet
Never slip on a banana skin
- My slippers have that ‘lived-in’ look
- Taking care of my feet is quite difficult these days
- I often get my feet tangled up in things that could trip me such as my pets or trailing clothes
Getting up from a fall
- If I had a fall I wouldn’t know how to get up safely
Getting spcialist advice
- I have had a fall in the last year but not seen anyone about it ¨ I have a long-term condition that affects my mobility
We can’t stop the ageing process, but we can counteract some of the effects with a few gentle tweaks to our lifestyle.
It’s not just ‘old-age long sight’ that can cause vision problems. Ageing can decrease contrast sensitivity (making it harder to see the edge of steps and kerbs), alter depthperception and cause visual field disturbances – all of which make you more likely to fall.
What can I do ?
Have a sight examination yearly, even if you think you’re fine (it’s free for over-60s) as the optician is also checking for glaucoma, cataracts, macular degeneration and diabetic retinopathy. Don’t rely on supermarket reading glasses long-term: it’s rare for both eyes to require identical correction.
The older we get, the more likely we are to be prescribed medications for several different health conditions; it’s estimated that 36% of people over 75 are on four or more different drugs. Some common ones are associated with dizziness, drops in blood pressure when you stand up, or sleepiness – all of which can raise the risk of falling. Talk to your GP if you are experiencing any of these problems and ask whether your medication should be adjusted.
What can I do ?
Never stop taking any prescribed medication suddenly. If you suspect one or more of your medications is making you dizzy or faint, see your GP or Pharmacist – and make sure the GP reviews your prescriptions every 12 months. (That’s every six months if you are over 75 or taking four or more medications.) Watch out for alcohol intake: you may find you can’t drink the same quantity you used to without feeling dizzy or ill, and it may interact with prescribed medications.
As we get older we are more vulnerable to dehydration. This may be because we experience a reduced sensation of thirst - meaning we don’t realize we need a drink. Or we may be taking some medicines such as diuretics and laxatives that may increase the likelihood of dehydration. Some of us with incontinence might even limit our fluid intake.
What can I do ?
Ensuring good hydration not only prevents falls, it also improves the mood, stimulates the appetite and reduces restlessness and disrupted sleep patterns. Try to drink six to eight cups of fluid each day, which includes fruit juice, tea and coffee, milky drinks and water. Wet foods like jelly, blancmange and soup are also a good source of water.
Rushing for the toilet
If you hurry, especially in the dark at night, it can make falls more likely. And 3-6 million people over 60 in the UK have urinary incontinence problems
What can I do ?
Incontinence can be improved and sometimes cured – talk to your GP. Some continence medications can also make you dizzy – let them know. Read this web page for more information about incontinence
Ageing can lower the body’s tolerance for alcohol. As we get older, we generally experience the effects of alcohol more quickly than when we were younger. This means we are more likely to experience unsteadiness after drinking alcohol, and so are more susceptible to falls.
What can I do ?
- Drink less than 14 units per week
- Spread drinking over 3 days or more
- If you want to cut down, try having 2 or more drink free days per week
If you are taking medications:
- Check the sideeffects listed on your medication
- Avoid drinking altogether if advised
- If you are concerned, speak to your pharmacist
To find out more how alcohol can affect you as you get older take a look at the Drink Wise Age Well website.
Bones naturally become more brittle as we age, which makes a fracture more likely if we do fall. This is true for both men and women, but is especially true in post-menopausal women.
What can I do ?
- Eat a calcium rich diet. Try eating 3-4 servings daily of milk, yoghurt, and cheese, soy milk with added calcium, sardines and salmon with bones. (1 serving is equal to 250ml of milk, 200g of yoghurt, 40g of cheese or 100g of tinned salmon or sardines).
- Get enough Vitamin D. Vitamin D is important for muscle strength and helps the body use calcium. The best source is sunlight acting on our skin or a daily vitamin D supplement (10 micrograms). Sunlight exposure without sunscreen should be limited to 10 mins per day on the arms and face between May and September but NO burning!
- Weight-bearing activities are also great for maintaining strong bones (See the content under the ????? heading below page 12 – Stay strong, stay steady)
Six out of ten falls happen in the home or garden.
This is not surprising, as homes get old too: carpets get worn, clutter builds up and we may not stay on top of maintenance as we once did.
Often we don’t notice problems because we’ve lived with them so long. But clutter can present a very real risk for falls. So take a few minutes to look round your home with a critical eye, using the points below.
- Did you know that 60-year-old eyes need three times more light than 20-year-old eyes? Keep each area of your home well lit and use nightlights – especially if you need to get up at night. Sensor lights can be a big help too, as they react to movement
- Avoid trailing cables from lamps that could trip you.
- Consider installing two-way switches on the landing/hall and/or extra stair lighting. Wire in a smoke alarm at the same time – one more hazard sorted!
- Always use your bedside light when getting up at night; if the switch is not easily accessible keep a good torch by the bed.
- Never walk about in the dark: if you regularly get up for the toilet, keep a landing light on.
- Check all rugs have a non-slip underlay and replace worn ones. Consider replacing frayed carpets, or ask someone to tack them down.
- Cable tidies and/or boxes will organise jumbled wires by the TV, computer or music centre. Tape any trailing extension leads to skirting boards.
- Clear away clutter, especially in the hall/landing and doorways.
- Never store items on the stairs!
- A surprising number of people trip over their pets. Buy them a bright collar, and a bell to alert you to their presence.
- Continually reaching up for things? Rearrange cupboards so that frequently used items are within easy reach.
- Clear up spills straight away.
- Always use a non-slip mat in the bath/shower
- Consider installing grab rails in the bathroom.
- Keep paths free of moss and leaves. Repair any cracks in paving.
- Ensure your back/front doors and garage are well-lit.
- Consider installing safety rails on your steps.
Help is available
Peterborough Home Service Delivery Team can help you live safely and independently at home for longer. They can help if your home needs repairs or adaptations, or if you need equipment (including Technology Enabled Care) to help with everyday living.
Tel 01733 747474 option 4
Or take a look at our Staying independent (Adults) webpage under the Home Services Delivery Team heading.
You can also view the Home Services Delivery Information Sheet.
Any form of exercise will help to improve overall fitness and health but to reduce your chance of falling and maintain strong bones, you need to do specific exercises which challenge both your strength and balance.
The benefits of strength training
Strength training, also called resistance training, involves exercises using some form of
extra resistance to challenge the muscles. This resistance can come from weights/heavy objects, elastic resistance bands, or even your own body weight. Each exercise should be performed with the maximum resistance you can lift 8-12 times. When you can do the exercise more times, the resistance should be increased rather than doing more repetitions.
These activities done at least twice a week will give the greatest benefit:
- Strength and balance exercises – starting with the ‘super six’
- T’ai Chi
- Strength training*
- Nordic walking
- And for the fitter and more able: dancing, cycling, and playing racquet sports or ball games - walking football and netball count
Sociable and quality assured strength and balance classes are available in Peterborough. View our Stay Stronger for Longer (Adults) web page for more details.
Managing your fears
Some people get so worried about falls that they restrict their movement and spend long periods sitting down. This harms balance, body strength and mobility, which in turn makes a fall even more likely. It’s a vicious circle that damages confidence and independence. If this is you, set yourself small, gradual goals taking the steps in this booklet. Get friends/ relatives to help, stay positive, and practise relaxation exercises for anxious moments. Speak to your local falls service for advice.
There are two falls prevention services available in Peterborough for people over 65 years old.
Healthy Peterborough Falls Prevention Service
The NHS approved, free and friendly Healthy Peterborough Falls Prevention Service is for people who are able to manage activities of daily living such as washing, feeding, toileting, dressing, and functional mobility/ transferring.
Self-referrals and referrals from professionals are accepted.
To self-refer telephone 01733 894 540 or visit healthypeterborough.co.uk
Cambridgeshire and Peterborough NHS Trust (CPFT) service
The Cambridgeshire and Peterborough NHS Trust (CPFT) service is for people who are not able to manage activities of daily living. Referrals to this service are through a professional only.
Talk to your GP to request a referral to this service.
Try these six simple exercises two or three times a week – every day if you like – and you should soon notice improvements to your co-ordination and balance.
- MAKE SURE THE CHAIR YOU USE IS STURDY
- WEAR SUPPORTIVE SHOES
- IF YOU EXPERIENCE CHEST PAIN, DIZZINESS OR SEVERE SHORTNESS OF BREATH, STOP AND CALL YOUR GP OR CALL 111
- A SLIGHT SORENESS THE DAY AFTER IS QUITE NORMAL
Stand tall, holding the back of a sturdy kitchen-type chair or kitchen sink, then lift your heels off the floor, taking your weight onto your big toes. Hold for three seconds, then lower with control. Repeat 10 times.
Stand tall holding the same support, then raise your toes – taking your weight on your heels. Don’t stick your bottom out. Hold for three seconds, then lower with control. Repeat 10 times
Sit to Stand
Sit tall near the front of a chair with your feet slightly back. Lean forwards slightly and stand up (with hands on the chair if needed). Step back until your legs touch the chair then slowly lower yourself back into the chair. Repeat 10 times.
Stand tall, with one hand on your support. Put one foot directly in front of the other to make a straight line. Look ahead, take your hand off the support and balance for 10 seconds. Take the front foot back to hip width apart. Then place the other foot in front and balance for 10 seconds.
Stand close to your support and hold it with one hand. Balance on one leg, keeping the support knee soft and your posture upright. Hold the position for 10 seconds. Repeat on the other leg.
There’s no reason to curtail your activities away from home because you are worried about falling, but it makes sense to take some simple precautions.
In the street
- Take your time and don’t rush. Scan an area for trip hazards – cracked pavements, obstacles and uneven surfaces – before walking.
- If you need to carry a bag, think about your balance. Choose the best way to carry your shopping bag for you. Try and make sure you can always see the path beneath your feet.
- Watch out for shop entrances with ‘lipped’ door frames, especially if you’re stepping inside out of bright light; give your eyes time to adjust to the darker conditions.
- Watch out for subtle changes of gradient, especially near pedestrian crossings.
- Keep your bus pass/money near to hand so you don’t have to root around in your bag. That way you’ll stand a better chance of boarding safely.
- Don’t be afraid to ask the bus driver to wait until you’re seated before moving off.
- Don’t worry if you think you’re being slow and inconveniencing others: staying safe is more important. Chances are that no one has noticed anyway.
Don’t be embarrassed to use a walking aid if it helps you stay steady. It’s important a stick is the right length: level with your wrist crease when your arm is down by your side. It should also have a rubber end (‘ferrule’) to stop it slipping; replace wornout ones promptly. If a stick is no longer quite enough, talk to your GP about getting a walking frame or rollator (wheeled frame).
NRS Safe and Well
NRS Safe and Well provide information and advice on daily living equipment.
Telephone 01480 415 719
It’s only cartoon characters who slip on banana skins – that risk is rather obvious to the rest of us. But how many other common slipping and tripping risks do we ignore?
Here’s our top five:
1. Badly fitting shoes.
Our feet change shape as we age and lose some feeling and flexibility, so a well-fitted shoe is vital; what fitted 10 years ago may not be right any more.
2. Trailing clothes.
Always take time to tie belts or cords on clothes and dressing gowns – or remove them altogether. Hem trousers that are too long.
3. ‘Shuffly’ walking.
It’s easy to get into the habit of not lifting your foot as high as you used to when walking, but it increases your chance of tripping. The exercises on page 14-15 will help.
4. Worn-out slippers.
They may be like old friends, but it’s time to say goodbye to your slippers if they have holes in their soles, frayed uppers, broken-down backs or the fit is ‘sloppy’. Slippers should fasten, stay on and provide grip.
5. Walking in socks/tights on hard floors.
Never, ever do it (wear the new slippers instead!).
Taking care of your feet
See your GP if you have painful, swollen or tingling feet that are hampering mobility; it’s possible something can be done to help. Trim toenails regularly (straight across only) and keep your feet well-moisturised to avoid painful cracking. Use a pumice stone on hard skin. If footcare is becoming tricky, see a podiatrist.
How to choose shoes
Soles should be thin enough for you to feel and ‘read’ the ground under your feet, but have enough cushioning for shock-absorption, as well as tread for gripping.
Heels should be low and broad for maximum stability.
Choose a round or square-toed style to give your toes more space – and enough depth so you can wriggle them inside.
Shoes should be long enough so your toes don’t touch the end and should provide support around the middle part of your foot.
Go for styles with fastenings such as laces to give support. Avoid ballet pumps and flip-flops!
Don’t buy shoes in the morning – they may feel tight in the afternoon when your feet have swollen a bit.
If you should fall, lie still for a minute, stay calm and check for injuries. If you are unhurt and think you can get up, follow the steps opposite (rest between each one if you need to). If you know you can’t get up, or feel pain in your hips or back if you move, see
overleaf for ways to summon help.
1. Roll on to your side, then push up on to your elbows.
2. Use your arms to push yourself on to your hands and knees.
3. Crawl to a very stable piece of furniture (a sturdy chair or bed) and hold on to it for support
4. Slide or raise the foot of your stronger leg forwards so it‘s flat on the floor.
5. Lean forwards and push up using your arms and front leg, slowly rising to standing position.
6. Turn around and sit down. Sit for a minute or two to rest.
If you can’t get on to all fours, bottom-shuffle or roll to a low surface like the bottom stair or sofa. Sit with your back to it, put your arms behind you on to the surface and push up with your hands and feet, lifting your bottom onto the surface. If using the stairs, go up to the next step before standing up.
Follow these steps – and they will be a lot easier if you’ve already done a bit of forward planning
To get help
- Use your LifeLine if you have one or call nearby neighbours on your phone – put them on speed dial now.
- Use your phone to call 999.
- Bang on the wall, radiator or floor.
- Stay warm. Cover yourself with anything you can find – tablecloth, blanket, rug or coat. lifelin
- Put a cushion under your head or roll up an item of clothing.
- Keep moving. Roll from side to side and move your limbs as pain allows to help keep you warm and maintain circulation.
- Keep your fluids up if you can reach a drink.
It makes sense to prepare yourself and your home just in case the worst happens. Then you can get on with enjoying life, knowing that you’ve done the groundwork.
- Make sure you’ve read pages 10-11 of this guide and made your house as fall-proof as possible.
- Place cushions and blankets around the house at floor level so that, if you do fall, you can keep warm and comfortable while waiting for help.
- Use your common sense on placement: they need to be easily accessible but should be stored so they don’t cause a hazard in themselves!
- Put a bottle of water with the cushions so you can stay hydrated while waiting.
- If you have a cordless landline phone, carry it in your pocket.
- Get a mobile phone if you don’t already have one and keep it (switched on) in your pocket or on a belt. Programme in the phone numbers of neighbours or friends/relatives nearby who could help if you fell.
- Consider getting a LifeLine. You wear it like a pendant, or on your wrist, and when you press a button the control centre will telephone your nominated key holder(s) so they can check on you
Falls aren’t an inevitable part of ageing. Most can be prevented – without you having to stay indoors or cut back on your normal activities.
Ageing affects balance, muscle strength and bones – it’s the same for everyone. But we can all protect our independence for longer by taking simple steps.
A few regular exercises and stepping up daily activity helps balance and muscle strength.
Fall-proofing your home needn’t be costly; it’s mostly about spotting small risks that can be easily and quickly sorted out.
Practising how to get up from the floor if you do fall could turn out to be a life-saver.
Worry less and enjoy life more by taking these few simple preventative measures!
I’ll do it today
- Make a GP appointment to review my medication (if it hasn’t been done for 12 months) or to talk about my dizziness or unsteadiness.
- Make an eye-test appointment.
- Put a torch by the bed, keep landing/hall lights on at night.
- Remove/tape down frayed carpet, replace worn-out slippers and clear clutter, especially in passageways, bedroom and round doorways.
I’ll do it today and every day
- Keep my mobile phone on me, charged and switched on.
- Increase exercise levels – and get up and walk/stretch every 20 minutes while sitting.
- Tear out the p14-15 exercises, stick them on the fridge, and do them!
- Aim for 2-3 servings of calcium-rich food a day.
- Ask my pharmacist about vitamin D supplements and get 10 minutes in the sun from May-September.
- Think: do I need to cut down on how much alcohol I drink?
- Tell my GP if I fall
I’ll investigate now, and aim to complete this month using the contacts list
- Get properly fitting shoes.
- Reorganise kitchen cupboards to avoid reaching up so often.
- Get a bell and/or bright collar for my cat or dog.
- See the GP about any urinary incontinence problems.
- Find a podiatrist and book an appointment if necessary.
- Locate a strength and balance class or activity nearby.
- Make a fall plan, cushions and blankets in key locations.
- Buy non-slip mats for the bathroom.
- Think: is my home warm enough? If not, request a LEAP home visit
- Find a qualified electrician if I need to change lighting. Plus a local approved handyman for odd jobs such as changing bulbs and fitting rails etc.
- Investigate walking aids and other helpful equipment as appropriate. (Age UK and the Citizens Advice Bureau have information on financial help.)
Previous falls (with or without injury) are one of the biggest independent risk factors for falling again; guidelines recommend that if you have had a fall you should get yourself reviewed.
If you have had a fall in the last year you will be eligible to access a falls prevention service. A competent professional will complete a multi-factorial falls risk assessment to understand the reasons why you may have fallen and put an action plan in place to help reduce your risk of another fall in the future.
There are two falls prevention services available in Peterborough for people over 65 years old.
1. The NHS approved, free and friendly Healthy Peterborough Falls Prevention Service is for people who are able to manage activities of daily living such as washing, feeding, toileting, dressing, and functional mobility/ transferring. Self-referrals and referrals from professionals are accepted. To self-refer telephone 01733 894 540 or visit healthypeterborough.co.uk
2. The Cambridgeshire and Peterborough NHS Trust (CPFT) service is for people who are not able to manage activities of daily living. Referrals to this service are through a professional only. Talk to your GP to request a referral to this service.
Podiatrist or pharmacist
Find your nearest at www.nhs.uk/service-search
A register of local recommended traders who have been vetted and approved. www.safelocaltrades.com
Small repairs and assistance to maintain independent living Tel: 01733 863860 or email firstname.lastname@example.org
Local Energy Advice Programme (LEAP)
Free in-home visit to offer energy and money saving advice. www.applyforleap.org.uk or Tel: 0800 060 7567
First Time Central Heating
Installation of first time central heating in eligible homes. www.warmerhomes.org.uk or Tel: 0800 038 5737
Peterborough’s Home Service Delivery Team for independent living
‘One stop shop’ approach which looks at both your ability to carry out activities of daily living and physical home environment. Tel: 01733 747474 option 4. www.peterborough.gov.uk/pin
Information and advice for independent living
Age UK Cambridgeshire and Peterborough provide friendship clubs, home support and much more. Tel: 0300 6669860 or www.ageukcap.org.uk
Strength and balance home programmes Provided by Healthy Peterborough. Tel: 01733 894 540 or healthypeterborough.co.uk/
www.parkinsons.org.uk Helpline: 0808 800 0303
For advice on improving the lighting in your home. www.rnib.org.uk Helpline: 0303 123 9999
Peterborough SMART Flat
View a range of Technology Enabled Care products in a home environment. Email: email@example.com or Tel: 01733 747474
Safe and well home visits
Fire and Rescue Service (CFRS) home safety checks - includes falls prevention. www.cambsfire.gov.uk/homesafety/safe-and-well-visit/ or Tel: 0800 917 9994.