Issue: Condition linked mobility loss such as Multiple Sclerosis, post-Stroke weakness or paralysis or

ABI.Solution: Physiotherapy and occupational therapy exercises that support rehabilitation of mobility. These should be completed in accordance with the registered AHP the individual is under, however, smaller exercise plans are accessible on the internet via reputable sources.

Issue: Vision decline and Dementia related changes in visual perception and spatial awareness.

Solution: Optician assessment to determine if vision is OK with necessary solutions i.e. glasses. Improve lighting to ensure doors and pathways are well-lit. Ensure glare and shadows are reduced to prevent unnecessary reactions that cause subsequent imbalance.

Issue: Changes in gait caused by tremors in conditions such as Parkinson’s.

Solution: People with Parkinson’s disease will need more appropriate footwear to support the change in gait, irrespective of medication regime, however advancement in medication and treatments are supportive of reduction in tremors.

Issue: Trip hazards: Rugs, loose floor boards or lino, worn carpet, wires or clutter on the floor, raised door thresholds.

Solution: Undertake an environmental risk assessment and where possible replace or mend as firmly as possible all issues identified within it. Most care providers will conduct a risk assessment as part of the care planning process, however care providers will happily complete risk assessments as a stand alone service to support with improvements in community living.

Issue: Poorly managed medical conditions such as High Blood Pressure, Anaemia, Diabetes, Substance Misuse, etc.

Solution: Closer commitment to self-care management of own conditions, a health management plan drawn up and agreed with the medical practitioners involved with the individual.

Issue: Poor diet and/ or malnutrition and dehydration will cause weakness in general and specifically will prevent regeneration of muscle as part of natural wastage in older adults. In turn as the body works harder with less fuel fatigue is an obvious complication which results in imbalance.

Solution: Look at dietary options that improve intake, agree a meal planner and look at how monitoring of food and fluid intake can be undertaken.

Issue: Disturbances of the inner ear are a common cause of feeling dizzy or unsteady as if surroundings are in motion.

Solution: In most cases episodes are temporary with the most useful suggestion being rest. Ongoing events should be supported by a medical practitioner. Practical options are ensuring clearer access routes throughout the property to prevent trip risks. Similarly improved lighting may support removal of distracting glares or shadows that cause the individual to react to, in turn causing a risk of imbalance.

Issue: Certain medications – Some medications have side-effects that can cause vision problems, dizziness, light-headedness, drowsiness and impaired alertness or judgement. Some can even damage the inner ear[1]. Older adults are especially vulnerable in regards to medications side-effects because drugs are absorbed and broken down differently as people age. Sometimes the problem isn’t a single drug but a combination of medications being taken that cause an issue. Some commonly prescribed medications that can affect balance include:

  • Antidepressants

  • Anti-anxiety drugs

  • Antihistamines (allergy relief)

  • Blood pressure and some heart medications

  • Pain relievers

  • Sleep aids

  • Psychotropic medications

Solution: Clearer pathways in the home to support ability to right oneself without tripping. Handgrips and handrails to act as physical support aids throughout the home. Potential use of walking frames or rollators that are adjustable to height – be aware that some frames may impact on balance initially as individuals become used to them, as they get used to moving with their head down, before they feel confident enough to look forward only.

Issue: As muscle wastage occurs as part of old age as a consequence the natural ability to right yourself and re-balance becomes impacted.

Solution: Eating protein and calcium to support maintaining and re-building ligaments, tendon and muscle that are impacted by muscle wastage as part of the natural ageing process. Exercise classes for strength conditioning and balance training classes are accessible throughout the country in people’s own local community or commercially via gym membership. There are lots of easily accessible video resources video on YouTube.

Issue: Poor footwear such as “Sloppy Slippers” or Novelty slippers, inappropriate shoes or socks without grips.

Solution: Old slippers which have become flat and slack on the sides, loose fitting, trodden down at the back or have a worn out sole are a contributor to people falling via slips and trips. As can novelty footwear that offer little to no support. Well fitting slippers, which support the ankles and have a good grip on the bottom can be bought anywhere from high street stores to online specialist such as The Online Slipper Shop. Sensible supportive slippers will help to maintain safe walking indoors and should help to prevent falls. So much so in fact that there is a Slipper Exchange Programme run via the NHS. Socks without grips on worn surfaces such as stone steps, tiled flooring or even worn carpet can cause trips and slips that result in falls. There are socks that have have grips on the soles that whilst keeping the feet warm offer an opportunity to gain friction and prevent slips.


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