Falls are one of the most significant concerns in long-term care facilities, affecting both the quality of life and physical health of residents. As a podiatrist for more than 30 years, I know how essential it is to reduce fall risks in long term care facilities. I also know that it takes a multifaceted approach, including proper footwear, strengthening exercises and staff training. Below, is an outline of how appropriate footwear and some simple balance exercises can improve mobility and reduce the risk of falls.

1. Why Footwear Matters in Fall Prevention

Appropriate footwear is often an overlooked element of fall prevention in long-term care settings. Shoes that fit poorly, lack support, or have slippery soles can easily lead to loss of balance. Here’s why the right footwear is so essential:

  • Support and Stability: Supportive shoes keep the foot and ankle in proper alignment, improving balance and reducing strain on joints.
  • Reduced Slip Risks: Non-slip soles improve traction on a variety of surfaces, minimizing the chance of a resident slipping.
  • Shock Absorption: Shoes with adequate cushioning reduce the impact on joints, enhancing comfort during walking and standing.

2. Choosing the Right Footwear for Residents

When selecting shoes for long-term care residents, consider the following features:

  • Non-Slip Soles: Look for shoes with rubber or textured soles for better traction, especially on smooth or wet surfaces.
  • Proper Fit: Shoes should be wide enough to accommodate foot deformities, such as bunions or hammertoes, while remaining snug enough to provide support and fit of the heel.
  • Low, Wide Heels: High heels and narrow heel bases destabilize the foot. To enhance stability, it is preferable to opt for shoes with a broad, low heel.
  • Secure Closures: Velcro straps or laces ensure the shoe remains firmly in place. Slip-on shoes, while convenient, may not provide sufficient stability.
  • Supportive Arch and Cushioning: Look for shoes with a cushioned insole and good arch support to reduce joint strain and improve comfort.

Tip: Avoid slippers or overly flexible shoes. While they might feel comfortable, they lack the necessary structure to support safe walking.

3. Simple Exercises to Improve Balance and Strength (Disclaimer: These exercises should be based on a medical assessment of the resident’s mental and physical status and under direct supervision)

In addition to proper footwear, balance exercises are vital in fall prevention for long-term care residents. Incorporate these easy-to-perform exercises into their daily routine to boost strength, flexibility, and stability:

a) Heel and Toe Raises

  • Instructions: Stand with feet hip-width apart, holding onto a sturdy surface for support. Slowly rise up onto the toes, then back down. Next, rock back on the heels, lifting the toes off the ground.
  • Repetitions: 10-15 times, twice daily.
  • Benefits: Strengthens calf and shin muscles, improving ankle stability and balance.

b) Marching in Place

  • Instructions: Holding onto a support, march in place, lifting knees as high as possible.
  • Repetitions: 20-30 marches, once daily.
  • Benefits: Enhances leg strength, coordination, and flexibility.

c)  Seated Leg Extensions

  • Instructions: Sit with your feet flat on the floor. Extend one leg out straight, then slowly lower it back down.
  • Repetitions: 10 times per leg, once daily.
  • Benefits: Builds quadricep strength, essential for stability while standing and walking.

4. Ongoing Assessment and Monitoring

Once residents have appropriate footwear and balance exercises in place, it’s essential to assess both regularly. Monitor footwear for wear and tear, particularly on the soles, which may wear down and become slippery over time. Regularly check that residents are able to complete their balance exercises without discomfort.

How Quality Podiatry Group can help.

Staff training is the third critical step in the multi-faceted approach to fall prevention. We offer our contracted facilities the benefit of our expertise through staff training on the subject of their choice. Fall prevention is a popular topic, but we have a range of other topics to offer.

Click HERE to discuss the full range of topics.

By providing residents with supportive, non-slip footwear, encouraging simple balance exercises, and providing staff training, long-term care facilities can significantly reduce fall risks and enhance mobility. Educating residents, their families, and staff on these practices is key to creating a safer, more stable environment for everyone involved. Remember, the goal is to keep residents moving safely—protecting both their health and independence and reducing your liability.

We are experts at providing care to residents at long term care facilities. Call 786-975-2090 (Florida) or 773-321-2681 (Illinois) or email me at sweiser@qualitypodiatry.com

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