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<<safety slippers / slippers | example falls project | falls project health links | slippers | buying tips

Example of a falls project

Quoted from an article on BBC.co.uk where you can search for similar recent articles. Free slipper exchanges - new for old - are sometimes held at the same time as falls prevention seminars Castle Point and Rochford Primary Care Trust recently gave out 17 pairs of slippers at a seminar in exchange for over-sized, slippery, or trodden-down pairs. The story below is about a much larger scheme:

"It is hoped the slippers will cut fall injuries among the elderly Pensioners could soon be given free slippers by a council in an effort to cut the number of injuries suffered in falls

Neath Port Talbot Council, in south Wales, is considering spending £1,500 on a scheme to provide safe slippers to elderly people, believing it could save much more by reducing injuries

Poorly-fitting footwear is among the biggest causes of accidents among elderly people Last year, 14,000 people fell and broke their hips in the UK

The NHS spends more than £1bn a year on treating fractures caused by falling. When a similar scheme was tried in England, the number of people falling was reduced by 60%

Councillor Clive Owen, Neath Port Talbot Council's Champion for Older People, said: "We've got £1,500 and we are working in conjunction with Age Concern to see who needs the slippers"

Katie Mather, of Neath Port Council, demonstrates the safe slipper: "£1,500 will buy us 150 (pairs of) slippers so we'll get them out to people as soon as possible. We are doing it as a pilot at the moment, but we are hoping that later on we can take it a little bit further They have rubber soles, which means that they are reasonably non-slip They have a good Velcro fastener on the front so they won't slip off, you have to physically take them off They have a very wide opening, so it's easy to get your foot in and out of the slipper which is good if you have restricted mobility"

The idea is part of the authority's strategy to improve life for older people.

It is also looking at internet access for centres for the elderly and at setting up a council for elderly people"

falls project & health links:

The Department of Trade and Industry's Home Safety Network has a website section on falls including research reports leaflets that they printed with the Health Education Authority. If you would like any of these reports or leaflets printed-out in colour and enclosed with a pair of slippers when you order just let us know. Using their database of hospital accident reports, the department's statistical leaflet
Falls on stairs in the home involving older people finds them on

  • staircases 62%
  • steps between rooms 17%
  • outside steps 13%
  • doorsteps or "weather bars" under outside doors 7%
  • step ladders 1% - the surprisingly small proportion reflecting the high age of admissions

Other factors mentioned at the time of the accident include

  • misjudging the bottom step 21% - often when carrying, or when eyesight or light are bad
  • visiting 12%: unfamiliar steps in care homes, hospitals and when visiting relatives
  • carrying 11%
  • loose slippers allowing tripping & stumbling 9%
  • reported alcohol 9% - the leaflet reasonably suggests under-reporting
    The researchers' booklet, below, suggests "decreased balance ability, disturbed gait, cognitive impairment, reduced strength, impaired vision, illness, and side effects from the use of medication" I imagine that these factors have a multiplied effect on one-another, along with slight depression caused by loneliness in some cases, and confusion about what exactly is going-on. For example someone with a large number of tablets to take and little idea of what they do is more likely to find unexpected interactions between tablets and between tablets & alcohol.
  • trips to loo 6% - the leaflet suggests drowsiness & sudden activity are factors
  • tripping over objects including children and pets 6%
  • poor lighting or trips with the light turned off 4%
  • poor eyesight 3% often in combination with other factors

    Anecdotally, I'm told that it takes an elderly body far longer to get its balance after a shock like a small fall than it does for a young body; the advice of sitting for a long time - like an hour or more - to get together before walking again after a stumble may be worth passing-on.

Much the same information is presented for different audiences in different leaflets:

  • Information for older people on how to avoid accidental falls in the home
  • Preventing accidental falls in and around the home - information for friends, neighbours, relatives and carers of older people
  • Guidance for professionals working with older people with book list and exhortation to draft an "awareness strategy" which sounds like good way of getting away from the clients & leaving junior staff, hired without problem-solving tests, to work unsupervised and stressed. The truth is that the senior managers sometimes aren't in an "awareness strategy" meeting at all, as they've put in the office diary, but at the employment tribunal defending their sacking of the last social worker who they hired and dropped in at the deep end without supervision.
  • Step up to safety - a point-by-point checklist about stairs, written in simple language, not just for older people but for social workers who may assess them: if one is coming, keep this leaflet and go through it with them. Some social workers aren't the brightest, and their bosses, as we have seen, are too busy with "awareness strategy" meetings to issue a screwdriver or take a phone call about how to put a screw in the wall. Social workers neither fit hand rails themselves nor know how it's done, and are asked to be strangely un-embarrassed at "assessing" with our taxpayer's money rather than helping. The ones who are embarrassed have all given-up the job. Some social workers may prove me wrong, though. If so, the department of health has published an example of an assessment flow-diagram that may be useful for training. It may be useful to send a copy to the client before assessment, with an explanation of what social services do, if anything, for people with or without savings. The example is listed on Help the Aged's Falls web site, below
  • How do older people use their stairs? is a booklet for researchers. Much of the research results in questions but there are one or two answers as well.

Help the Aged has been given a grant to continue the work above, by reprinting the leaflets with their logo on them, and by adding up-to-date information links and ideas to the healthy aging & falls section on their website. Their style of writing is repetitive, but readable.

Most of their advice could be taken as patronising. For example if you are taking lots of medicines at once, they don't suggest you look-up what they do but that you ask a "professional" to "review" them, because of course you are too stupid yourself. Where the truth about life is too messy, sad, and muddled for anyone to make much sense of it, they pretend with a kind of New Labour grin that a little bit of advice by a bossy person at tax-payer's expense with no idea about his or her own motives might do the trick. Other ideas, like bright pet collars to stop you tripping over the cat, are less obvious. The general depression and isolation that may come before a fall is not mentioned directly, but it could be that if someone is active enough to be looking-up advice and reading leaflets about fall-prevention then these practical ideas will help.

The National Institute for Clinical Excellence, a taxpayer-funded standards organisation for the health service, has a range of leaflets about falls and says that we are "expected" to follow its advice. Most of the advice in the leaflets is to seek advice: "If you have questions about the specific issues covered, talk to your nurse or doctor (or other health professional or practitioner, depending on what it is you want to know)". The most specific parts of the leaflets are about what doesn't work, according to NICE, with the implication that it should not be done and so save the NHS money. Their categories are "no evidence" and "not enough evidence":

They find no evidence to recommend

  • brisk walking for direct benefits; there is some evidence that unsupervised brisk walking can increase the risk of falling in older women who have had an upper limb fracture in the past year

They don't find enough evidence to recommend

  • light exercise and a programme to help with incontinence in people living in residential or nursing homes
  • group exercises of a general kind for direct benefits
  • educational, advice and confidence-building interventions at home
  • eye test alone
  • vitamin D, although there is evidence that many older people don't have enough of it and that this could cause muscle weakness
  • hip protectors outside nursing homes

Age Concern England's website has a fact sheet on personal alarms - for those who are worried that they might have a second fall or suffer from lack of confidence. They also own the largest supplier of personal alarms - a firm which is reticent about prices on its website - so the advice may be thin about rival suppliers. If you care for someone with Alzheimer's or other dementia, a door alarm might help alert you to wondering problems at night - these will soon available from the Care-alert.co.uk web site.

The Age Concern's Site map page also links to an information section including an order form for a booklet that gives an overview of how chiropody & voluntary-sector foot-care projects are funded and advice on setting a local one up.

The Health & Safety Executive has a slip-related injuries link on its main website - mainly about trips at work, but with more than enough information for checking your own common-sense approach to slip risk. They have a download-able leaflet of extreme measures that Health Authorities and employers take.e to prevent people falling over and going to court, and a "from experience" link to cases including the Port Neath example above

tips on ordering single pairs of slippers:
The EC has an extraordinary amount of regulation about safety boots & motorcycle boots, but none at all about slippers for the elderly, although the elderly are just as accident-prone as factory workers or motorcyclists. For example slip-resistance tests exist and are often quoted for safety boots, but Comfylux have never done them when they change sole material. Instead, like the counsellor from Port Neath in the article above, we are forced to use common sense with a kind of Blue Peter bravado Anyone with any better ideas is welcome to use our form to contact us. We think that slipping is reduced by four S-words:

  • Slip-resistance: softer sole materials have a greater grip on carpet & lino than hard ones The Comfylux company have reduced their use of rubber, so the slippers are not quite as grippy as they used to be, but they are still well above average
  • Suppleness. As we get older our extremities become a little numb, and it is harder for us to get the information needed for balance, or to tell us whether we are treading in the middle of a stair or on the edge. A suppler sole is more useful as we get older, to reduce this effect.
  • Snugness & fit. This is achieved with good stiffeners, that prevent the slipper from being trodden down. It is helped, if in doubt by velcro tops which are not stylish but do help with a good fit. The last element, in shoe industry jargon, is also called the last (other trades call it the mould): slippers should be made in UK sizes if they are for people who are used to ordering in UK sizes; they should be broad, as north Europeans tend to have broad feet and this tendency increases with age.
  • Superwide lasts: this is a speciality of Comfylux. If your feet are swollen, width is likely to be more effected than length so that a larger size of slipper is not so important as a wider size. Comfylux have commissioned a special set of superwide lasts for swollen feet.

tips on ordering slippers in bulk:

  • Ask for your choice of sizes: elderly people in particular are likely to have small feet If you can find a supplier who gives you your choice of sizes, you will save a lot of wasted slippers.
  • Don't spend all your budget on one delivery. However careful your planning, you will run-out of some sizes quicker than others and can put this right on the second order. Most suppliers can tell you a minimum order for free delivery to your address
  • Stock a minimum of style/colour combinations and offer the others to order.
  • You may have to multiply the price by 1.175 to get a price including VAT: ask your supplier
  • Save a little money for a size measuring devices - these save fitting time. You may also want to supply long-handled shoe horns
  • Set a deadline, make a decision, and tell the truth about it to anyone who asks - whether they are auditors, other suppliers, or your boss. If you are buying for the public sector, it's not so important that you look clever as that you look honest! Likewise, in business, it is important to be honest even if it is just to say that you didn't have time to do more research and picked a supplier at random.
  • Veganline.com is able to offer free delivery and the customer's choice of sizes on orders over £240 + VAT (£120 in the Leicester area) We can offer a competitive quote on large orders of Safety slippers / Slippers and stretchy shoes

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