Resources for nursing professionals on the prevention, treatment and management of falls in older people
Older people who experience falls are frequently in contact with nurses in all sectors of health care. You can use these pages to find out about the falls guidance and resources available to you.
Falls are the number one reason older people are taken to the emergency department in a hospital.
Falls and fractures in older people are a costly and often preventable health issue. Reducing falls and fractures is important for maintaining health, wellbeing and independence among older people.
A fall is defined as an event which causes a person to, unintentionally, rest on the ground or lower level and is not a result of a major intrinsic event (such as a stroke) or overwhelming hazard. Having a fall can happen to anyone; it can be as a result of an accident, but can also be an unfortunate but normal result of human anatomy. However, as people get older, they are more likely to fall over. Falls can become recurrent and result in injuries including head injuries and hip fractures.
Falls are events resulting from the presence of risk factors. The likelihood and severity of injury from an event is often related to bone health. People with low bone mineral density are more likely to experience a fracture following a fall. One of the main reasons why people have low bone mineral density is osteoporosis.
Over 3 million people in the UK have osteoporosis and they are at much greater risk of fragility fractures. Hip fractures alone account for 1.8 million hospital bed days and £1.9 billion in hospital costs every year, excluding the high cost of social care.
Causes of falls
There are multiple causes and risk factors when it comes to having a fall. These include:
- having a history of falls
- muscle weakness
- poor balance
- visual impairment
- polypharmacy (taking multiple medicines)
- the use of certain medicines
- environmental hazards
- medical conditions.
Please see Public Health England's Falls: applying All Our Health.
COVID-19 related resources
Keep on Keep up app. This app will help to reduce the high risk of falls and physical decline in older people self-isolating during and after the COVID-19 Lockdown.
National Institute for Health and Care Excellence (NICE) guidance
NICE (2017) Falls in older people. This updated quality standard covers assessment after a fall and preventing further falls (secondary prevention) in older people living in the community and during a hospital stay.
NICE (2017) Falls in older people pathway.This pathway covers the assessment and prevention of falls in older people both in the community and during a hospital stay.
NICE. Falls: assessment and prevention in older people and people 50 and over at higher risk - In development. This updated guidance will fully update NICE (2013) Falls in older people: assessing risk and prevention.
British Geriatrics Society (2022) Falls in older people.
NHS England. The National Patient Safety Improvement Programmes.
NIHR. Falls Management Exercise (FaME) Implementation Toolkit. This toolkit provides a suite of resources that commissioners can use to plan, implement and monitor the FaME programme.
Public Health England and Centre for Ageing Better (2018) Muscle and bone strengthening and balance activities for general health benefits in adults and older adults (PDF). Summary of a rapid evidence review for the UK Chief Medical Officers’ update of the physical activity guidelines.
Royal College of Physicians. Falls and Fragility Fracture Audit Programme (FFFAP). The Falls and Fragility Fracture Audit Programme is a national clinical audit designed to audit the care that patients with fragility fractures and inpatient falls receive in hospital and to facilitate quality improvement initiatives.
Royal College of Physicians (2017) Bedside vision check for falls prevention: assessment tool. The National Audit of Inpatient Falls (NAIF) has collaborated with partners to produce a new vision assessment tool which enables ward staff to quickly assess a patient’s eyesight in order to help prevent them falling or tripping while in hospital.
Royal College of Physicians (2017) National Audit of Inpatient Falls Audit report 2017. Although prevention of inpatient falls across hospitals in England and Wales has improved slightly many patients are not receiving the required assessments which can help prevent falls in hospitals.Royal College of Physicians (2016) Falls Prevention in Hospital: a Guide for Patients, their Families and Carers. This guide is designed to help prevent serious injury and unnecessary cost to the NHS caused by older people tripping or falling when they are in hospital.
Page last updated - 01/02/2024