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What I Wish I Knew About Dementia is a community engagement project developed by Alzheimer’s Society to create a safe and welcoming space for people to share experiences, ask questions and reflect on what they wish they had known about dementia earlier.

At the heart of the project are reflection boards, which invite people to contribute thoughts, questions, advice and lived experiences. The boards encourage open conversations and capture the voices of people affected by dementia, including people living with the condition, carers, family members, professionals and community members who want to learn more. By sharing real stories and perspectives, the project helps make dementia more human, relatable and better understood. People can engage in whatever way feels comfortable to them, whether by adding a reflection, reading others’ contributions or simply learning more about the topic.

The project concludes with a community event featuring lived experience speakers and local support organisations. These events provide opportunities for learning, discussion and signposting to services available in the local area. By bringing people together to share experiences and learn from one another, What I Wish I Knew About Dementia helps raise awareness, challenge misconceptions and support the development of more dementia-friendly communities.

For more information or to get involved contact Devna Vickerman, Alzheimer's Society

Email: Devna.Vickerman@Alzheimers.org.uk

Charlotte Toal, Alzheimer’s Society

Email: Charlotte.Toal@Alzheimers.org.uk

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What I Wish I Knew About Dementia Overview

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Email to promote the Age and Dementia Friendly business 5-step pledge

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Email to promote the Age and Dementia Friendly business 5-step pledge

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Please use this email to promote the Age and Dementia Friendly business 5-step pledge

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RE Help your business grow and support our community

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Women’s Brain Health A practical guide for every stage of life

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Women’s Brain Health A practical guide for every stage of life

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Women’s Brain Health - A practical guide for every stage of life

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A checklist to help you make a note of symptoms before you talk to your GP.

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A checklist to help you make a note of symptoms before you talk to your GP.

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Check out the dementia symptoms checklist to make a note of symptoms you are experiencing. This checklist can help you discuss your concerns with your GP, healthcare professional or a trusted individual.

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A checklist to help you make a note of symptoms before you talk to your GP.

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Sleep is closely linked to physical health, cognitive function and mental wellbeing. Poor sleep increases the risk of cardiovascular disease, metabolic conditions and dementia. This report by International Longevity Centre sets out why sleep should be treated as a core pillar of healthy longevity.

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Brain health Scotland: Your brain is amazing. Let's keep it that way.

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Brain health Scotland: Your brain is amazing. Let's keep it that way.

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At Brain Health Scotland our mission is to inspire and empower you to protect your brain health and reduce your risk of diseases that lead to dementia.

YOUR BRAIN IS WHO YOU ARE. IT IS YOUR THOUGHTS AND FEELINGS AND MEMORIES.

IT IS CURIOUS AND CREATIVE, AND IT NEEDS TO BE PROTECTED .

Take regular exercise that

gets your heart pumping

Don't smoke and don't drink alcohol to excess

Eat a balanced, mediterranean-style diet

Learn new skills

throughout life

Enjoy time with

other people

Manage stress, look after mental health and get plenty of sleep

DEVELOPED IN PARTNERSHIP WITH ALZHEIMER SCOTLAND,

Brain Health Scotland has been established with the singular objective of reducing the incidence of dementia over the next 10 years.

Brain Health Engagement:

Brain Health Services:

We are developing Scotland's first brain health clinics, at which patients will access the information and interventions they need to protect their brain.

We also provide opportunities to join research programmes, so everyone can join the effort to better

understand brain health and disease.

Taking part in brain health research is for everyone and is one of the greatest ways to impact future success: Join Dementia Research

We run a free online learning course all about Understanding Brain Health. Visit the course onFutureLearn

are keen embed brain health in your work, school or community, w e would love to hear from you. Discover ways your organisation can support our work

Register interest and sign up for alerts so we can let you know when we are looking for skills.

All Brain Health Scotland data is held on the principle of open access, if you would like to know

more please contact us

Subscribe to keep up to date with our latest news and discover opportunities to join brain health initiatives near you

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At Brain Health Scotland our mission is to inspire and empower you to protect your brain health and reduce your risk of diseases that lead to dementia. YOUR BRAIN IS WHO YOU ARE. IT IS YOUR THOUGHTS AND FEELINGS AND MEMORIES. IT IS CURIOUS AND CREATIVE, AND IT NEEDS TO BE PROTECTED .

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Winter weather has arrived, and with it comes a surge in 999 calls from older and vulnerable people who have fallen and cannot get back up. This is why the Association of Ambulance Chief Executives (AACE), speaking on behalf of all UK ambulance services, has joined forces with the Royal College of Emergency Medicine (RCEM) and the British Geriatrics Society (BGS) to issue important advice: know what to do if you fall, and take simple steps to stay steady on your feet.

Anna Parry, Managing Director of AACE, said:

Every winter we see thousands of older people who have fallen and struggled to get back up, often spending some time on the floor as a result. Many of these 'long lies' could be prevented.

A mobile phone in your pocket, a pendant alarm around your neck or wrist, or practising how to get up from the floor while you're well could make a real difference.

One in three people over 65 who live at home will fall at least once this year; for those over 80 the risk rises to one in two.
The key advice is:

If you do fall - stay calm: Take a moment to check yourself before moving.

If you can get up safely: Roll onto your side, push up to hands and knees, shuffle to a sturdy chair or sofa, place one foot flat and slowly stand.

If you cannot get up: Use your phone or pendant alarm immediately, shout or bang to attract attention, keep warm, and move a little every half hour to protect circulation.

Call 999 at once if you, or the person who has fallen:

* Cannot get up, even with help
* Is confused, not fully awake, drowsy or vomiting
* Has injured their head, neck, back or hip
* Has severe bleeding

This advice is now available in a downloadable PDF that can be printed off by members of the public here. For less urgent concerns after a fall, patients or their family or carers are being urged to call 111 or visit www.111.nhs.uk
Dr Ian Higginson, RCEM President, said:

Falls are a common reason that older people find themselves in emergency departments (ED), and can lead to significant injury, particularly when someone is frail. We know that older people will be worried that there are often very long waits in our departments, and that they are more likely than those who are younger to endure these waits. We worry that this will put them off calling an ambulance. No one wants to wait a long time in an ED corridor, especially due to something which can often be prevented.

We expect our departments to be extremely busy this winter. Be assured that despite the difficulties we face providing the service we would like for our patients, we will be open and there to look after you if you need help. We support this advice which could prevent the need for a stay in an A&E.

Professor Jugdeep Dhesi, President of the BGS, said:

A fall doesn't have to mean the beginning of the end of independent living. Many older people recover quickly if they avoid a 'long lie' on the floor and get prompt help.

Simple strength and balance exercises twice a week, good footwear, removing trip hazards in the home and a review with your GP can dramatically cut your risk.

Top tips to prevent falls this winter

Carry a mobile phone or wear a pendant alarm.

Have a key-safe or give a spare key to someone trusted.

Wear well-fitting slippers with grip.

Keep paths clear of clutter and trailing wires.

Stay active - even gentle movement helps.

Eat regularly and keep hydrated and don't drink too much alcohol, especially if you feel unsteady.

Get your eyes and hearing checked.

Never rush when standing up.

Download our Winter Falls advice here. More help is available from NHS Inform (Prevent falls by identifying hazards at home | NHS inform), the Chartered Society of Physiotherapy's free "Get Up and Go" guide, and from Age UK on 0800 678 1602.

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'Don't let a fall ruin your winter' - Ambulance chiefs, emergency doctors and geriatricians urge older people to prepare now

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Winter weather has arrived, and with it comes a surge in 999 calls from older and vulnerable people who have fallen and cannot get back up.

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Inclusive involvement practice – involving Black, African and Caribbean communities

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Inclusive involvement practice – involving Black, African and Caribbean communities

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Inclusive involvement practice – involving Black, African and Caribbean communities

Alzheimer’s Society’s is commited to community engagement and inclusive involvement practices. They have developed an involvement toolkit created with full input from people affected by dementia.

Key learnings were tailoring approaches to foster safe and effective involvement, particularly focusing on increasing the representation and voices of Black, African, and Caribbean communities, groups historically underrepresented in sharing their lived experiences.

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Tackling loneliness and social

isolation in older people:

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Free resources for those working with older people and people living with dementia

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Free resources for those working with older people and people living with dementia

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Explore the Good Practice Mentor’s collection of resources for those working with older people and people living with dementia on the Alliance Padlet. These inlcude:

Community Group Toolkit

Resident Engagement in Sheltered Housing

Don’t Call Me Old – engaging younger older adults

Working with Older Men

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Read the attached Good Practice Mentor (GPM) training slides which covers how to promote a community event and check out their other amazing free training, including Creating a Co-production Culture, Ageism in Yourself and Others and Finding & engaging those perceived as 'harder to reach': The Good Practice Mentor Team Events - 11 Upcoming Activities and Tickets | Eventbrite. The GPM programme is an innovative project that brings together legacy, learning and resources from Ageing Better, a seven year Test & Learn project that worked to reduce social isolation and loneliness in people aged over 50.

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DEEP Network's Knowledge is Power booklet – Handy hints that might help make life a little easier after diagnosis

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Dementia UK's ‘Living with dementia’ guide is here to help people through the daily challenges of dementia. It’s packed with expert advice from their specialist nurses on everything from getting a diagnosis to coping with changes in behaviour and planning for the future, along with practical tips from people living with dementia and their families.

Dementia UK also has other amazing resources and leaflets.

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Welcome to the Living with Dementia Toolkit for people with dementia and their carers. This set of resources is based on research, and the expert experiences of people with dementia and their carers. If you would like to learn more about how we developed them click here. These resources are here to:

give you hope for the future

inspire you through examples of real-life experiences

offer ideas to help you live your life as you choose

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Set of resources based on research, and the expert experiences of people with dementia and carers.

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'This is me' is a simple leaflet for anyone receiving professional care who is living with dementia or experiencing delirium or other communication difficulties.

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My Choice - information for people living with dementia to help them to live well

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My Choice - information for people living with dementia to help them to live well

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My Choice information resource for people living with dementia to give them the information they need to help them live well.

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A growing database of funding directories and funding opportunities.

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My Life, My Goals is a self-help guide designed to help people living with dementia, step by step, try to achieve their goals.

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Find out how faith can play a vital role in the lives and wellbeing of people living with and affected by dementia Dementia-friendly faith groups | Alzheimer's Society

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Find out how faith can play a vital role in the lives and wellbeing of people living with and affected by dementia.

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Mindfulness and dementia: Learning to live with what is. This spring, Sussex Mindfulness Centre, ran its first eight-week mindfulness course for people living with dementia and their loved ones in Brighton & Hove. Read their short report

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Mindfulness and dementia: Learning to live with what is - Sussex Mindfulness Centre

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Julia Powell shares an insight into running a mindfulness course for people living with dementia. We learn that dementia doesn’t diminish the capacity for connection, calm, and joy.

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Powerful film from NHS Scotland, information and resources.

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Home Instead Home Truths YouTube channel

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Home Instead Home Truths YouTube channel

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There is a new Home Instead Home Truths YouTube channel as a great new resource for those supporting anyone on a dementia journey (115) Home Instead UK | Personalised Home Care - YouTube

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Home Instead UK | Personalised Home Care

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Home Instead UK | Personalised Home Care

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As a leading UK home care provider, we deliver personalised, high-quality care that helps people live independently in the comfort of their own homes. Our mission is to share expert advice, inspiring stories, and practical tips to support ageing adults and their loved ones. From dementia care insights to heartwarming real-life moments, our videos aim to inform, support, and connect. Enquire about home care today by calling 0330 0531671. Our lines are open: Monday to Friday: 8 am – 7 pm
Saturday: 9 am – 4 pm
Sunday: 10 am – 3 pm.

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Stay Active at Home - Strength and balance exercises for older adults

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Stay Active at Home - Strength and balance exercises for older adults

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Stay Active at Home - Strength and balance exercises for older adults

Short fillm (131) Stay Active at Home - Strength and balance exercises for older adults - YouTube

Booklet get_up_and_go_0.pdf

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Stay Active at Home - Strength and balance exercises for older adults

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Intercultural dementia care guide aims to help health and social care workers provide dementia care, which corresponds to the needs and wishes of people from a wide range of ethnic groups, especially minority ethnic groups. https://www.england.nhs.uk/publication/intercultural-dementia-care-guide/

Dementia care activity booklets are culturally competent activity booklets for use in care settings; one tailored for South Asian communities and one tailored to Black Caribbean/African communities – for health and care professionals https://www.england.nhs.uk/publication/dementia-care-activity-booklets/

Complete the new free e-learning module to support increased knowledge of how care can be improved for people from ethnic minority communities throughout the dementia care pathway: https://elearninghub.rcpsych.ac.uk/products/NHSE_Dementia

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This film ' Finding Patience was made to raise awareness of the need for families to talk about dementia and to realise that it might affect them - it was particularly aimed at Afro-Caribbean people, to encourage people to start to think ahead about how they might get help and support if and when they need it.

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NHS England Workforce, Training and Education

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DEEP is a network of groups of people with dementia all across the UK. Amazing resources and information. DEEP (dementiavoices.org.uk)

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Dementia Care Pathway for Professionals Poster

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Dementia Care Pathway for Professionals Poster

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Here is the Dementia Care Pathway printable A3 poster for professionals. Online information can be found here: Dementia care information for professionals (brighton-hove.gov.uk)

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Age and Dementia Friendly What's On Guide

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Age and Dementia Friendly What's On Guide

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Hello Everyone, here is the Age and Dementia Friendly What's On Guide to promote everything that is going on inthe city for older people and people living with dementia and to signpost to key services, including Ageing Well and the Healthy Lifestyles Team.

If you would like to order printed copies please contact Davina.DeLaszlo@brighton-hove.gov.uk. Online information can be found here: Directories - Ageing Well Thank you, Davina

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Time for Dementia - Visiting Families

Time for Dementia - Visiting Families (youtube.com)

Bring Dementia Out Innovation January to February 2019

Bring Dementia Out Innovation January to February 2019 (youtube.com)

Moving Sounds

Doorstep Music in Lockdown (youtube.com)

"Music is the wonder of life" (youtube.com)

Ageing Well Festival

Ageing Well Festival 2023 (youtube.com)

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Dementia Care Pathway for Residents booklet

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Dementia Care Pathway for Residents booklet

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Hello Everyone, here is the dementia care pathway booklet for residents. This booklet aimed to have all the support information for people living with dementia in one place. If you would like to order printed copies please contact Davina.DeLaszlo@brighton-hove.gov.uk. Online information can be found here: Dementia support in Brighton & Hove (brighton-hove.gov.uk) Thank you, Davina

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Free Your Guide to the Menopause has been thoughtfully created with and for Black, Asian and minoritized ethnic women, offering culturally relevant and empowering information about navigating menopause. Your guide to Menopause - BHA for Equality

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Your guide to Menopause - BHA for Equality

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Your guide to the Menopause is a comprehensive guide on the Menopause designed in collaboration with minoritised ethnic communities. This guide aims to provide you with the necessary information about menopause, empowering you to make informed decisions and access the support you deserve. Launch event: Join BHA on Wednesday 5th March for the launch […]

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Dementia Tip Share

Home - Dementia Tip-Share

Dementia Creatives

Home - Dementia Creatives

Dementia Diaries

Dementia Diaries

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As Wendy Mitchell says: I treat dementia as a game. It throws me a challenge and I solve it to try and keep one step ahead... But that's what dementia is all about, a life of adapting.

Are you living with a diagnosis of dementia, or think you may have it?

If you want to learn from and share with others 'in the same boat', you're in the right place!

The Tip-Share website is bursting with Tips, work-arounds and short cuts. All from people with dementia themselves. And these will grow and grow.

The website aims to be clear, easy to use, searchable and informative. We'd love you to use it, contribute - and even become a Tip-Sharer yourself!

You can go to the ' Our Tips ' page to look through all the topics we have covered so far. Or if you have a specific issue that you'd like to find a Tip for, try using the search box below...

We have tried to make this website as accessible as possible. You can increase the size of the words, or if you prefer, you can listen instead of reading (click on tabs at top right of any page). To get back to the Home Page, just click on the Back to Home arrow at the top left of the pages, and to get back to the top of the page, just click on the box at the bottom right of the page.

We need to know which Tips people are finding most useful. So, if you like a Tip, please click on the 'Like this Tip' icon.

This is where you will find all sorts of Tips which we hope can help you live with your dementia more easily. There is a whole range of topics covered, such as 'Tips for Life at Home', 'Tips for Money and Legal Matters', 'Tips for Connecting and Communication'... and many more. There are even Tips for coping with the Coronavirus situation.

We're sure that many of you out there will have lots more great Tips and examples of things you do to manage your day-to-day life more easily. Use this page to tell us about them so we can add them to the site.

Contributing will really make a difference to how Tip-Share grows and helps others. So we really hope you'll join in, get involved and become part of the Tip-Sharer community.

If you aren't able to find a 'Tip' on the site that relates to the specific issue you are looking for, then the Tip-Share Community may be able to help. Just give us the details which we will pass on to our Tip-Sharers and wider resource team. Hopefully they will be able to highlight an existing solution or possibly even come up with a new idea or approach.

Meet (and hopefully join) our ever-expanding community of people who contribute Tips, work-arounds and short-cuts. These can help to make a real positive difference in the lives of those of us who live with dementia.

The Listen Button lets you listen instead of reading (just click on the button at the top right of any page). You can find out more about this function by clicking here.

By clicking on one of the three letter A's that appear at the top of each page you are able to increase (or decrease) the size of the text on any page.

The content of this website is solely and intentionally made up of Tips shared by people with dementia themselves. Innovations in Dementia is not able to take any responsibility for these, or to give 'professional' advice, information or sign-posting ourselves.

Twitter

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Tips for people with dementia: to help you to keep living as well as you can. From people with dementia, for people with dementia.

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Here is the Wellbeing in Retirement booklet. If you would like to order printed copies please contact Davina.DeLaszlo@brighton-hove.gov.uk.

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Staying Steady and Independent with Dementia booklet

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Staying Steady and Independent with Dementia booklet

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The new Staying Steady and Independent with Dementia. To order copies email Davina.DeLaszlo@brighton-hove.gov.uk.

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Care UK has developed a number of very useful guides, including Eating as we age, Communicating with people living with dementia and As easy as ABC

a resurce to ensure an older loved one stays active and engaged with our guide, packed with 100 ideas for maintaining hobbies, interests and activities.

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From keeping active and independent in older age to dealing with the symptoms of dementia, our guides are here to help you and your loved one.

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Toolkit to support South Asian communities and film

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Toolkit to support South Asian communities and film

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People living with dementia from South Asian communities will benefit from improved culturally sensitive support, thanks to a new online toolkit launched by universities and charities.

The toolkit hosted by the Race Equality Foundation will provide enhanced care for members of South Asian communities – many of whom receive significantly less effective dementia care from statutory services compared to their counterparts from White British communities. ADAPT South Asian Dementia Pathway – An online toolkit of enhanced interventions (raceequalityfoundation.org.uk)

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An online toolkit of enhanced interventions

Overview of the issue

Roughly 25,000 people from ethnic minority communities live with dementia in the UK. The largest single grouping are people whose origins are South Asian countries. People from these communities are at greater risk of developing dementia. However, they are less likely to access support at all points of the dementia care pathway, so are more likely to seek help in a crisis or at a later stage in the condition.

There are also differences in how people from South Asian communities use dementia services. Symptoms of dementia are more likely to be missed or misinterpreted by NHS and other services; As South Asian people are more likely to receive a diagnosis at a later stage of their illness, this limits their access to NICE recommended treatment. People from South Asian communities are also more likely to seek support from local community organisations they are familiar with than from NHS and statutory services.

The differences in access to help can mean that, compared with white British people, South Asian people living with dementia and their carers are potentially disadvantaged.

The following film was produced as a representation of some of the challenges faced by South Asian carers. The content of this film has been informed by real life events that were shared as part of the ADAPT study. Warning: Some viewers may find parts of this film upsetting

The ADAPT Study

This project set out to create a set of online resources of culturally appropriate assessments and interventions which support people from South Asian communities at various stages across the dementia care pathway. We believe that this website will help statutory and voluntary sector organisations provide more equitable services.

...

By working with South Asian families, statutory (e.g. the NHS) and voluntary organisations, this project brought together evidence based resources and examples of good practice to facilitate equitable service provision. The study aimed to identify toolkit elements that can be drawn upon by commissioners, clinicians, and care teams to meet the needs of people from South Asian communities living with dementia (including family carers).

Use of language

The work presented on this website arose from conversations the research team had with a wide range of individuals. This included people who are living with dementia or who are caring for them, as well as people who are working within the voluntary and statutory services. We are very conscious of the different language, cultures and experiences of all those who have been kind enough to talk with us while we gathered this information. As a result, we have tried to take into account the suggestions from those we have spoken to about the best best words to use when referring to the customs, approaches and cultural perspectives of people from South Asian communities. We hope that you find this appropriate here.

The views and opinions expressed by speakers in the videos are based on their personal and professional experiences.

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An online toolkit of enhanced interventions Overview of the issue Roughly 25,000 people from ethnic minority communities live with dementia in the UK. The largest single grouping are people whose origins are South Asian countries. People from these communities are at greater risk of developing dementia.

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The titles from the Reading Well for dementia booklist can be borrowed from Brighton & Hove Libraries.

The titles have been selected and recommended by health professionals, people with lived experience and their families and carers, as being helpful with reliable information and advice.

The booklist is intended for people living with dementia and their families and carers. It includes titles to help young children understand more about dementia.

The booklist and more information about the recommended titles can be found at Reading Well for dementia - The Reading Agency

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Guided walks for people living with dementia and/or their carers. Wakehurst invites people living with dementia on an accessible guided walk to explore the gardens through sight, smell and touch. Led by our expert volunteers, you will learn about the wonderful plants, people and places that make up Wakehurst. Walks last one hour and are open to those with dementia symptoms plus their families, friends and carers. When: Last Tuesday of every month, 11am – 12pm Where: Tours start by the Plant Centre, outside the front of the Visitor Centre main entrance. A Wakehurst staff member will meet you there. How to register: Free entry and parking. Register by emailing wakehurstcommunity@kew.org or calling 01444 894066 (ask for the Participation team)

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Alzheimer's Society Carers Information and Support Programme

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Alzheimer's Society Carers Information and Support Programme

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Alzheimer's Society & Dementia UK resources

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Alzheimer's Society & Dementia UK resources

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Publications and factsheets from Alzehimers Society Publications and factsheets | Alzheimer's Society and Resources - Dementia UK

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We produce a wide range of publications and factsheets designed to support and inform anyone affected by dementia.

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Check out Old School Anti-Ageism Clearinghouse https://oldschool.info/about​

Watch Ashton Applewhite’s TED Talk on Ageism (www.ted.com/talks/ashton_applewhite_let_s_end_ageism?subtitle=en) ​

Watch Power of Oldness (humanrights.gov.au) (www.youtube.com/watch?v=ks8P9ZTdmhY)

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Old School educates people about ageism and connects people who are working to end it.

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Examples | The Social Guarantee The Social Guarantee released a paper showcasing 12 examples of innovative local public service providers around the UK. These services cover areas like adult social care, housing and transport.

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Examples of The Social Guarantee in practice

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The preventative shift: how can we embed prevention and achieve long term missions  

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The preventative shift: how can we embed prevention and achieve long term missions  

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This briefing looks at how to shift the culture of public bodies to think ‘prevention first’ and target spending at activities which are value for money and improve outcomes.  The preventative shift: how can we embed prevention and achieve long term missions | The Health Foundation

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The preventative shift: how can we embed prevention and achieve long term missions

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Published in collaboration with Demos, this briefing looks at how to shift the culture of public bodies to think 'prevention first' and target spending at activities which are value for money and improve outcomes.

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Social prescribing for older people facing financial hardship  

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Social prescribing for older people facing financial hardship  

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The National Academy for Social Prescribing explored ways to support older people struggling financially by integrating financial wellbeing into community-led social prescribing initiatives. This report details the two pilot programmes and a national training programme they led to gain valuable insights into improving financial stability. Older People Social Prescribing- National Academy for Social Prescribing | NASP

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Older People Social Prescribing- National Academy for Social Prescribing

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NASP is here to support healthy ageing through social prescribing. Access resources, case studies, evidence and more

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London: Precarious Lives- Financial and material hardship among older LGBTQ+ people in London      

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London: Precarious Lives- Financial and material hardship among older LGBTQ+ people in London      

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Tonic Housing published a study exploring discrimination, social isolation, long-term health conditions and financial stress among LGBTQ+ people in London aged 50 and above. Precarious Lives — Tonic Housing

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It is becoming increasingly evident that many LGBTQ+ people face financial and material problems in later life. Despite this, there has been little research to date as to why these problems are so prevalent.

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Digital Inclusion Action Plan- First Steps

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Digital Inclusion Action Plan- First Steps

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The Department for Science, Innovation and Technology released this document outlining their plan to address the digital divide by opening up opportunities through skills, tackling data and device poverty, breaking down barriers to digital services, and building confidence. Digital Inclusion Action Plan: First Steps - GOV.UK

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Department for Science, Innovation and Technology

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Digital Inclusion Action Plan: First Steps

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Presented to Parliament by the Secretary of State for Department for Science, Innovation and Technology by Command of His Majesty.

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Falls and fractures in older people are often preventable. Reducing falls and fractures is important for maintaining the health, wellbeing and independence of older people.

The causes of having a fall are multifactorial – a fall is the result of the interplay of multiple risk factors. These include:

muscle weakness

poor balance

visual impairment

polypharmacy – and the use of certain medicines

environmental hazards

some specific medical conditions, which might make a person more likely to fall

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The Public Health England team leading this policy transitioned into the Office for Health Improvement and Disparities (OHID) on 1 October 2021.

Introduction

Falls and fractures in older people are often preventable. Reducing falls and fractures is important for maintaining the health, wellbeing and independence of 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 is 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.

The causes of having a fall are multifactorial - a fall is the result of the interplay of multiple risk factors. These include:

muscle weakness

poor balance

visual impairment

polypharmacy - and the use of certain medicines

environmental hazards

some specific medical conditions, which might make a person more likely to fall

Falls are events resulting from the presence of risk factors. The likelihood and severity of injury resulting from an event is related to a number of possible factors including bone health, risk of falls, frailty and low weight. Strong bones are important for your health. People with low bone mineral density are more likely to experience a fracture following a fall. Osteoporosis is one of the reasons why people have low bone mineral density.

Over 3 million people in the UK have osteoporosis and they are at much greater risk of fragility fractures. Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture, known as low-level (or 'low energy') trauma. The World Health Organization ( WHO) has quantified this as 'forces equivalent to a fall from a standing height or less'. Hip fractures alone account for 1.8 million hospital bed days and £1.1 billion in hospital costs every year, excluding the high cost of social care.

Fragility fractures are most common in bones of the spine, wrists and hips. The risk of osteoporosis starts to increase in women after the menopause because their ovaries no longer produce oestrogen, which helps to protect the bones. People may also be at increased risk of osteoporosis because it runs in their family or because of the side effects of some medications such as steroid tablets or injections. Therapies and treatments are available to help prevent fractures in people with osteoporosis. Other factors can also put a person at risk of fractures: low body weight ( BMI <19), diet lacking in calcium and vitamin D, poor mobility, smoking, alcohol, diabetes, certain long term medications, especially corticosteroids.

Focusing on falls in your professional practice

Falls and fractures are a common and serious health issue faced by older people in England. People aged 65 and older have the highest risk of falling; around a third of people aged 65 and over, and around half of people aged 80 and over, fall at least once a year. Falling is a cause of distress, pain, injury, loss of confidence, loss of independence and mortality.

For health services, they are both high volume and costly.

In terms of annual activity and cost:

the Public Health Outcomes Framework (PHOF) reported that in 2017 to 2018 there were around 220,160 emergency hospital admissions related to falls among patients aged 65 and over, with around 146,665 (66.6%) of these patients aged 80 and over

falls were the ninth highest cause of disability-adjusted life years (DALYs) in England in 2013 and the leading cause of injury

unaddressed fall hazards in the home are estimated to cost the NHS in England £435 million

the total annual cost of fragility fractures to the UK has been estimated at £4.4 billion which includes £1.1 billion for social care; hip fractures account for around £2 billion of this sum

short and long-term outlooks for patients are generally poor following a hip fracture, with an increased one-year mortality of between 18% and 33% and negative effects on daily living activities such as shopping and walking

a review of long-term disability found that around 20% of hip fracture patients entered long-term care in the first year after fracture

falls in hospitals are the most commonly reported patient safety incident with more than 240,000 reported in acute hospitals and mental health trusts in England and Wales

Core principles for health and care professionals

In general health and care professionals should:

make themselves aware of the range of needs of individuals, communities and the population and the services available in the localities in which they work

think about the variety of resources available in health and wellbeing systems, including people, data, written, and digital

understand specific activities which can prevent, protect and promote in the areas of falls and fractures

Taking action

The National Falls Prevention Coordination Group's Falls and fracture consensus statement advocates a whole system approach to prevention, which includes:

risk factor reduction across the life-course

case finding and risk assessment

strength and balance exercise programmes

healthy homes

high-risk care environments

fracture liaison services

collaborative care for severe injury

Interventions can take place at population, community and individual levels.

If you're a front-line health and care professional

Health and care professionals can have an impact on an individual level by:

routinely asking older people about falls

observing for deficits in gait and balance

knowing how to recognise the signs of potential risk

assessing potential risks, including medical conditions which might predispose a person to fall

understanding the referral pathway to local services, that reduce fall risks

reassuring individuals and their carers or families, that help is available to reduce the risk of falling

supporting healthy ageing, including reducing exposure to risk factors such as physical inactivity and visual impairment, making every contact count and signposting eligible patients to NHS health checks

providing up-to-date patient information on falls, such as Get up and go: a guide to staying steady from the Chartered Society of Physiotherapists

If you're a team leader or manager

Community health and care professionals, and providers of specialist services can have an impact by:

considering their role in primary falls prevention and the messages given out about health behaviours

encouraging people to stay active, get socially connected and get their eyes and ears checked regularly

eat a healthy balanced diet, reduce alcohol intake and stay well hydrated to reduce the risk of falling - and improve outcomes if a fall happens

developing links with local community providers

displaying information in workplaces promoting physical activity benefits for adults and older adults

promoting the importance of strength and balance exercise

encouraging people to drink enough water, especially in hot weather to avoid dehydration

ensuring that inpatient care is in line with national falls and fracture clinical guidelines and quality standards

If you're a senior or strategic leader

Senior or strategic leaders should be aware of interventions at population level, which can include:

understanding the local population - considering the proportion of older people, frailty prevalence, and the number of falls in the population

reviewing the capacity and makeup of falls prevention services

influencing relevant parties to support the development of local services - ensuring that falls prevention is a local health priority

encouraging the use of established tools, such as those from Chartered Society of Physiotherapy (CSP)

considering the training needs of the workforce, and what action is needed to give all health and care professionals the knowledge and skills to identify the risk of falls for older people

ensuring the promotion of physical activity is prominent within commissioned services

exploring the intensity of exercise programmes

promoting the importance and influencing the evaluation of strength and balance exercise programmes

ensuring alignment of falls and fracture services with related services such as frailty

Understanding local needs

The Public Health Outcomes Framework ( PHOF) focuses on 2 high-level outcomes:

1. increased healthy life expectancy

2. reduced differences in life expectancy and healthy life expectancy between communities

The PHOF includes indicators on emergency hospital admissions and hip fractures due to falls in people aged 65 and over.

Emergency hospital admissions due to falls:

C29i - aged 65 and over

C29ii - aged 65 to 79

C29iii - aged 80 and over

Indicators on hip fractures in people aged 65 and over include:

E13i - aged 65 and over

E13ii - aged 65 to 79

E13iii - aged 80 and over

Mortality rates from accidental falls can be found in the Health and Social Care Information Centre Indicator Portal.

The Sport England Active Lives Survey includes information on the activity levels of older adults. Between November 2019 and November 2020, including during the COVID-19 pandemic, older adults aged 75 and over became less physically active, especially those with multimorbidity, due to the government requirement to stay at home and to shield.

Wider impacts of COVID 19 on physical activity, deconditioning and falls in older adults, published on August 2021, includes an estimation of the impacts of COVID-19 on physical activity and falls in older adults, and recommendations to mitigate these effects.

Measuring impact

As a health and care professional, there are a range of reasons why it makes sense to measure your impact and demonstrate the value of your contribution.

This could be about sharing what has worked well in order to benefit your colleagues and local people, or help you with your professional development.

The Everyday Interactions measuring public health impact toolkit provides a quick, straightforward and easy way for health and care professionals to record and measure their public health impact in a uniform and comparable way.

The falls impact pathway is recommended for health and care professionals to record and measure actions undertaken as part of routine care which impact on falls prevention.

Further reading, resources and good practice

Advice for patients and the public

The NHS website has information and advice on falls prevention.

The CSP's Get up and go - a guide to staying steady is a 32-page guide for the public and patients on how to prevent falls, produced by Saga in partnership with the CSP and the Office for Health Improvement and Disparities ( OHID).

Age UK provides information and advice on falls prevention. RoSPA provides advice on how to make the home a safer environment. NHS Rightcare Falls and Fragility Fractures pathway (2017) NICE Impact Falls and Fractures. Royal Osteoporosis Society Clinical Guidance 'A Safe Home' provides information on preventing falls at home developed by NHS 24's Scottish Centre for Telehealth and Telecare (SCTT). Spot the Hazard is a game about spotting falls hazards in the home.

The Active at Home booklet, updated in August 2021, provides practical guidance to older adults on home-based activities to maintain their strength and balance. It follows concerns that low levels of physical activity in older adults will lead to reduced fitness, resulting in loss of independence and need for care in the future.

The Keeping Well at Home guide, published in 2020, was produced by University of Manchester. It has been recently been updated to Keeping Well this Winter with tips and advice on keeping active and connected, staying safe and well, and managing our money and home.

The 'Talking about Keeping Well this Winter' film was made by older adults with tips on opening up a positive conversation on the doorstep or over the phone.
Watch the Talking about Keeping Well this Winter film
Better Health on the NHS website provides advice on healthy changes with free tools and support.

Professional resources and tools

OHID and the National Falls Prevention Coordination Group member organisations have produced a Falls and fracture consensus statement detailing key interventions, approaches to commissioning and the commitment to national support. It is accompanied by a resource pack which details resources relating to the key interventions and contains an additional section on frailty.

Specific guidance includes:

Falls FAQs poster (PDF, 760KB), developed by the National Falls Prevention Coordination Group (NFPCG), is for care and residential homes to support staff to manage a fall that may require an ambulance.

Newcastle University has developed a free online falls prevention training course.

Strength and balance quality markers: supporting improvement (published July 2019) details the 7 quality markers for strength and balance exercise, suitable for use by local areas as criteria to help them carry out self-audits.

Quality standards

Cochrane systematic reviews

The Raising the bar on strength and balance: The importance of community-based provision report from the Centre for Ageing explains the models of delivery, issues and barriers of community 'strength and balance' programmes.

Good practice examples

The CSP's Get up and go - a guide to staying steady is a 32-page guide for the public and patients on how to prevent falls, produced by Saga in partnership with the CSP and OHID.

OHID's Everybody active, every day: an evidence-based approach to physical activity, published in 2014, is a physical activity strategy co-produced with over 1,000 partners including health and professionals, local authorities, research specialists, educationalists, charities and fitness experts.

The Royal College of Physicians' National audit of inpatient falls, published in 2021, contains recommendations and resources aimed at reducing inpatient falls

Raising the Bar on Strength and Balance, Centre for Ageing Better, 2019.
Falls Management Exercise (FaME) toolkit (2020)

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The Public Health England team leading this policy transitioned into the Office for Health Improvement and Disparities (OHID) on 1 October 2021. Falls and fractures in older people are often preventable. Reducing falls and fractures is important for maintaining the health, wellbeing and independence of older people.

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Resource: Working to improve employment support for over 50s across Greater Manchester 

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Resource: Working to improve employment support for over 50s across Greater Manchester 

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This report gives an overview of how the Centre for Ageing Better has worked in partnership with the Greater Manchester Combined Authority to develop new approaches to employment support.

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Commissioning Differently: Working in partnership to improve support for residents aged over 50 across Greater Manchester

# data[].attributes.attachment_link.description
This report gives an overview of our work in developing new approaches to employment support and helping to engage people who want to move closer to work.

# data[].attributes.headline
Resource: Working to improve employment support for over 50s across Greater Manchester 

# data[].attributes.subject
Resource: Working to improve employment support for over 50s across Greater Manchester 

# data[].attributes.body
This report gives an overview of how the Centre for Ageing Better has worked in partnership with the Greater Manchester Combined Authority to develop new approaches to employment support.

# data[].attributes.attachment_link.title
Commissioning Differently: Working in partnership to improve support for residents aged over 50 across Greater Manchester

# data[].attributes.attachment_link.description
This report gives an overview of our work in developing new approaches to employment support and helping to engage people who want to move closer to work.