Elderly relatives, falls, and the importance of well-fitting footwear
In our ageing population, falls are a common but often overlooked cause of injury. Approximately one-third of adults over 65 who live at home, will have at least one fall a year, with half of these falling frequently. More worryingly, when one's age reaches over 75, falls become the most common cause of injury-related death in the UK (1).
So why do falls happen?
Well, whilst we are young and healthy we take our ability to stay upright for granted. When we stumble, we can usually catch ourselves before we actually fall. As people get older, however, they typically start to suffer from balance problems, muscle weakness, and poor vision, as well as long term conditions such as heart disease, dementia, and problems with blood pressure that can cause dizziness.
The consequences of falls?
With each fall there is the risk of breaking bones, especially so when you consider the higher incidence of osteoporosis (brittle bones) in the elderly. We also shouldn't forget that there is the risk that a fall can cause a person to lose confidence, become withdrawn, and feel as if they have lost their independence. It won’t surprise you to learn that a decrease in physical activity in the elderly has been linked to depression, anxiety and an overall decline in health and quality of life.
“a fall can cause a person to lose confidence, become withdrawn, and feel as if they have lost their independence”
What can you do?
Below are several simple measures that can help prevent falls in the home.
Remove clutter
Mop up spills immediately
Ensure all rooms, passages and staircases are well lit
Use non-slip mats in the bathroom
Help out with any lifting or moving of items
Spoiler alert: Poor Footwear causes falls
Did you know that a very significant but often overlooked factor is footwear? Your elderly relatives also experience changes in the size and shape of their feet, as well as suffering from deformities like bunions, toenail malformations, callusing, and ‘flat feet’. Most would not even think to change their shoe size when they have probably worn the same size of shoe all of their adult lives. Those that do get re-measured would likely struggle to fit properly into an ‘off the shelf’ shoe, however, because their feet are no longer a regular ‘off the shelf’ size.
“Most of those individuals wearing ill-fitting shoes suffered, among other things, from depression, loss of balance and falls”
Confirming this, a study done in 2015 (2) analysed the footwear of elderly people and found that 83% did not use the correct size and, on occasion, found cases where individuals should have been using a different size shoe for each foot. The study went on to further demonstrate the negative implications that ill-fitting footwear had, on not only pain and foot function, but general health, physical activity, social capacity, vitality and even nutrition. They too also found that most of those individuals wearing ill-fitting shoes suffered, among other things, from depression, loss of balance and falls.
Ultimately, the use of supportive and well-fitting footwear would help to better stabilize the feet and accommodate deformities, thus reducing the risk of a falls, pain and the other negative effects outlined above (3). It is also advisable for an elderly person to wear the same shoes inside the home whenever possible and further minimise the risk of falling.
Replace Grandma’s shoes before it’s too late.
The next time you’re visiting an elderly relative, be sure to check their footwear.
Here’s a checklist...
Make sure there are no sore areas on the skin
The heels should fit snugly and not slip when walking
There should be about the width of a finger between the longest toe and the end of the shoe when they are stood up.
Either side of the ball of the foot should not push through the shoe
The toes should not push through the top of the shoe
The shoe should resemble the shape of the foot.
They should feel firm and supportive around the heel.
The sole and heel should be at least as wide as the shoe, with good grip.
Lace or velcro fastening to allow an adjustable and secure fit.
If your relative is Diabetic or has any problem affecting wound healing or sensation, it is extremely important to follow this advice immediately.
What can we do?
In order to capture the unique size and shape of a foot that no longer fits safely into an ‘off the shelf’ shoe, you should consult an Orthotist.
Orthotists are professional clinicians that specialise in (amongst other things), assessing for and measuring for supportive, well fitting, bespoke footwear that will provide stability and confidence to an aging relative.
Please enter your email if you are interested to find out more about our bespoke and semi-bespoke footwear. Alternatively you can book a home assessment today.
References
NHS.uk. (2018). Falls. [online] Available at: https://www.nhs.uk/conditions/falls/ [Accessed 14 Nov. 2018].
López López, D., Losa Iglesias, M., Becerro de Bengoa Vallejo, R., Palomo López, P., Morales Ponce, Á., Soriano Medrano, A. and Alonso Tajes, F. (2015). Optimal choice of footwear in the elderly population. Geriatric Nursing, 36(6), pp.458-461.
Ikpeze, T., Omar, A. and Elfar, J. (2015). Evaluating Problems With Footwear in the Geriatric Population. Geriatric Orthopaedic Surgery & Rehabilitation, 6(4), pp.338-340.
