Falls prevention programme in older adults

The programme begins by looking at activities that feel unsafe, such as getting out of bed, using stairs, turning in a narrow space or walking outdoors. A physiotherapist may check strength, balance, gait, footwear, vision concerns and the use of a cane or walker. Sessions can include sit-to-stand practice, controlled stepping, reaching, weight shifting and walking over simple obstacles. The plan is adapted for arthritis, previous fractures, neurological conditions and the person’s home environment.

Practise at the agreed frequency with a sturdy support within reach, and avoid doing balance drills when alone if you have a history of falling. Improve the environment by securing loose rugs, increasing lighting and keeping frequently used items easy to reach. Rise slowly if you feel light-headed. Bring a list of medicines and recent falls to the assessment; this helps the team consider factors beyond muscle strength. Regular review allows exercises to progress as movement becomes more controlled.

Seek urgent assessment after a fall with head impact, severe pain, new weakness, confusion or difficulty standing. Fainting, chest discomfort or sudden speech or vision changes also need urgent attention. Tell the clinician about repeated falls, increasing dizziness, new unsteadiness or pain that prevents practice, because these may require medical review before exercise continues.

Which daily activity should we target first? Is my walking aid fitted correctly? How can family support practice without taking over? When should my balance and strength be reassessed?