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Tackling the fear of falling

It's an alarming statistic that one in three people over 65 will have a fall this year.  While our risk of falling increases with age, it's by no means inevitable and experts believe the majority of falls could be prevented with some fairly modest changes to our lifestyle or home.  Keeping strong, eating well and wearing the right footwear all help.  Sadly, even when an older person makes a complete recovery following a fall, the experience can seriously affect the confidence they have in their own mobility and can lead them to limit getting out and about.  This can be harmful not only to their physical welfare but their mental health too. So, it's really important to try and prevent falls happening in the first place or to try and make sure someone who has had a fall doesn't have another.

Falls 2019

A falls service from County Durham and Darlington NHS Foundation Trust is tackling the problem head on by offering a specially devised twelve week programme of one hour weekly sessions for people who have either had a fall or who are considered at increased risk of falling.  The programme runs at five of the Trust's hospitals, led by physiotherapists and occupational therapists.  

Physiotherapist Natalie Gutteridge and occupational therapist, Clare Regan, run the clinic at The Richardson Hospital, Barnard Castle.  Natalie explains, "Patients are referred to us mainly by GPs, hospital based colleagues and district nurses, who see people in their own homes.

"We work with small groups so each person gets a lot of personal attention.  An initial assessment looks at strength, balance and general walking ability, before creating an individual exercise programme.  This might include spending time on our exercise bike or even using our Wii Fit - plus a few exercises to do at home.  At the end of the 12 weeks, a reassessment often produces amazing results and many people tell us they feel transformed both physically and in confidence It's all done gently and gradually, there's no pressure.  Although many of our patients are in the older age group, we also work with younger people. 

Brian Wilkins, from Winston, who has first-hand experience of the falls service, said, "I had a serious hip fracture following a fall about five years ago.  The care I received from the orthopaedic team at Darlington Memorial Hospital, then at The Richardson Hospital, where I went to begin my recovery was wonderful.  But I think the injury affected my gait and possibly even my balance.  I've had care subsequently from physiotherapists, which has been helpful, but I've been really impressed with the falls clinic.  Having an individualised programme of exercises, coming back every week and having exercises to do at home, give a real focus.   

"There are about 4-6 of us there each week, all at different stages and it's great watching people improve. We all get lots of individual attention.  I'm practicing walking backwards, sideways and as though I'm on a tightrope, which has helped my balance and muscle strength.  I'm 82 but still very competitive and they have to tell me to slow down - I try to beat my previous times on some of the equipment!"

Vicki Hird, occupational therapist, who is helping lead the Trust's focus on falls prevention, said, "Each day, across the country, 500 people are admitted to hospital following a fall. Of those 500, very sadly, 33 never return home, so it's really important that we identify those at risk of falling and offer them the support they need to reduce their risk. This could be a programme such as the one Brian has found so useful, some equipment at home or lifestyle advice.  As well as older people and those who have already had a fall we also work with people who have long term conditions such as Parkinson's, or who have had a stroke.

"Through our Trust Charity, we have also funded the production of  'Get Up and Go - a guide to staying steady', which has useful advice on maintaining balance, exercises for improving strength plus other hints and tips all of us could benefit from.  You can also download a copy of this from the Chartered Society of Physiotherapy website:

"Patients falling whilst in hospital is also a problem across the NHS and we've been working with ward teams to minimise this risk.  Being generally unwell, changes in medication, standing up suddenly, all increase the risk of dizziness which can lead to a fall, particularly in the frail or elderly.  Being in unfamiliar surroundings is also a risk, especially at night when going to the toilet.  On admission, our patients have their blood pressure checked when they're standing and lying down, looking for any concerns.  We've also produced a falls prevention leaflet which is given to all patients or their families.  This stresses simple steps they can take such as making sure they're wearing supportive shoes or slippers, drinking plenty and making sure they have their walking aid with them from home if they use one.  Following an initial assessment, we ask some patients to call for assistance before walking, so we can help them and we've also produced posters for all our toilets reminding patients not to hesitate to ring for assistance rather than risking a fall. 

"When a patient falls in hospital there's quite a high risk they'll sustain an injury so we're pleased that the measures we've introduced have already reduced inpatient falls by almost 10%."




Published 21st March 2019

'Care received was fantastic and I was very well looked after and very impressed.'

Patient, Day Surgery, Darlington Memorial Hospital