It is often a combination of foot problems and unsafe footwear that increase an older adult’s risk of falling.
As the only direct source of contact with the ground, footwear can affect an individual’s posture, stability, balance, and walking pattern, influencing the risk of falls. In addition to footwear, between 20-45% of older adults experience foot-related problems, with research findings indicating that foot-related problems such as foot pain, reduced range of motion, toe weakness, and toe deformity are risk factors for falls.
Characteristics of safe footwear:
Studies have shown that high heels can make you less stable and unbalanced when walking. A safe heel should be broad, with a round shape and a height less than 2cm. The more surface area of the sole that is in contact with the ground, the more stable the shoe.
Foam material is used in the middle sole area of shoes to provide comfort. A good shoe will have cushioning, but not too much that the foot is not stable and can’t feel the ground.
The slip resistance of the outer sole of a shoe is important to prevent slipping. The amount of tread a shoe has can increase the likelihood of tripping. Too much tread can cause the shoe to grab the ground, while a smooth slippery sole will make the shoe slip; both of which increase your risk of falling.
A rounded heel improves slip resistance by increasing the surface contact area of the shoe as the heel strikes the floor; this may help lessen slip-related falls.
Heel collar height:
A firm, supportive heel is recommended.
How can I assist older adults to wear safe footwear?
There are three key factors to consider when assessing an older adult’s risk of falling in relation to footwear and foot problems:
- Footwear – Do the older adult’s shoes fit well and are they safe?
- Foot problems – Does the older person have foot pain or a different foot problem?
- Referring – Do you need to refer the older adult to a podiatrist who may be able to assess these problems further and make recommendations for footwear?
Consider using the Stay On Your Feet® Shoe Safety Checklist with older adults to start the conversation about their shoe safety.
Who can help?
There are a number of Podiatrists and other organisations who can assist with assessment or interventions for foot conditions. Podiatrists can provide advice on which footwear is suitable for an older adult and can make recommendations that they can take with them when purchasing new shoes.
The following sites can assist you in finding a local Podiatrist:
- Podiatry WA: Find Podiatrist
- Department of Health and public funded podiatry services WA Metro and Rural
- Moorditj Djena is a Podiatry and diabetes education program for Aboriginal and Torres Strait Islander people in the Perth metropolitan area.
People with diabetes may be at an increased risk of falling due to damage to the foot’s nerves and blood supply. For more information about the link between diabetes and foot health, please refer to Diabetes Australia and Diabetes WA.
Find out more about falls prevention for Podiatrists, including the role of podiatry in falls prevention, falls assessment and screening tools, falls referral pathways in WA and Podiatry interventions. Download the Falls Prevention for Podiatrists Resource.