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  • Writer's pictureFit For Life

Falls, footwear and prevention for Older Adults.

What is a fall? Definitions of a fall include a fall, slip, trip or stumble.

How do falls effect Older Adults?

  • ~30% of Irish Adults who are over 65 years old and living in the community will experience at least 1 fall a year. This rises to 50% for those living in Nursing Homes or residential care (HSE, 2011).

  • 20% of Older Adults will require medical attention following a fall and 5% will experience a serious injury, such as a fracture (HSE, 2011).

  • Among Older Adults, ~40,000 fatal falls are reported in the EU annually.

  • Falls can have a significant psychological effect on Older Adults. This can lead to decreased confidence and physical activity levels, increased isolation and risk of further falls and injury.

Consequences of a fall for an Older Adult

Images below are from our Falls Risk Factors & Best Practice Interventions Training Course ©Fit For Life Ltd., 2022.

Risk factors for having a fall

To help us to understand how to try to prevent falls we must understand what the main evidence-based risk factors for falls are. The BBSE (Biological, Behavioural, Socioeconomic) model is widely recognised for Older Adults.

The following six factors alone when isolated without the influence of any other risk factors are substantial contributors to falls risk:

1. FRIDs (Falls risk increasing drugs)

2. Dementia

3. Feet and footwear

4. Visual impairment

5. Orthostatic/postural hypotension

6. Fear of falling

We will look at feet and footwear considerations briefly below.


Feet and footwear considerations

Common foot changes with ageing include bunions, hammertoes, mallet toes, claw toes, arthritis, musculoskeletal foot changes. Other foot conditions such as nail problems, corns and calluses and gout can also affect Older Adults.

Changes in foot structure due to ageing cause problems such as foot pain, decreased peripheral sensation, reduced range of motion, muscle weakness and toe deformity. This can lead to balance deficits, altered and antalgic gait pattern, impaired functional stability and increased risk of falls.

Safe footwear

Studies have shown that many Nursing Home residents prefer to wear slippers around the house. Though when compared to residents that wear fastened shoes, they have an increased risk of foot pain and falls (Mickle et al, 2007). Other studies have shown that 72-81% of Older Adults wear incorrectly fitting footwear (Burns et al, 2002; Menz & Morris, 2005; O’Rourke et al, 2020).

Choosing appropriate footwear is important in reducing the risk of falling. Appropriate shoes improve balance, gait and postural stability. Please see the image below for an example of safe footwear for Older Adults for falls prevention. And remember the footwear must be the correct size for the individual!



We find the TUMBLES acronym and images to be a great reminder for all involved in falls prevention! See the leaflet here (accessed 24/2/2022): tumbles-7-steps-falls-prevention.pdf (


Who can help with falls prevention?

  • Physiotherapist, Athletic or Physical Therapist: experienced therapists can review Functional ability, Gait/Mobility, footwear, environment, aids e.g. stick; and provide exercise programs to improve your balance and strength.

  • Occupational Therapist: can review Environment, Behavioural factors, Cognitive factors, Seating, equipment and ADL’s (activities of daily living).

  • GP/Nurse: can review Medical conditions, Medications, Falls hx and may send specialist referrals.

  • Podiatrist/chiropodist: can review Foot deformity and provide foot and nail care.

  • Orthotist & Prosthetist: can review and provide aids e.g. AFO and Prosthetics.

  • Optometrist: can review vision and provide aids e.g. glasses.

  • Dietician: can review for Diet/fluids and Supplements.

  • HCAs/care team: can assist and help to educate Older Adults and help to ensure a safe environment.

Fit For Life provide a broad range of evidenced-based falls prevention services. We provide Falls Risk Assessments and prevention programs for individual Older Adults at home or in supported living or nursing home settings. We provide Falls Prevention Training Courses for individuals and Nursing and care centre teams members. Other services we provide for Nursing Homes and Care Centres include: Falls Policy Audits, Falls Database Design & Implementation and Falls Report Creation & Methods of Dissemination.

Click here to check out our website for more information on Falls Prevention services or to book a course! And, don’t hesitate to contact one of our falls prevention specialists, physiotherapists or occupational or exercise therapists at or 01-2137915 if you have any questions!

©Fit For Life Ltd., 2022

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