This leaflet has been produced by NHS England, in partnership with Age UK. NHS England works with NHS staff, patients, stakeholders and the public to improve health outcomes for people in England. Age UK provide companionship, advice and support for millions of people facing life alone.
The advice in this leaflet will help improve the health and general fitness of people of any age, but it is written to be particularly relevant for people who are about 70 years or older.
People of this age, and sometimes younger, begin a 'slowing-down' process related to the effects of ageing on their body.
This is a progressive process and the advice given here will help keep you fit and independent.
Try this at home
Have you noticed it’s taking longer to get to the bus stop than it used to? Or that your weekly supermarket shop takes longer than before? These can be signs that we’ve started slowing down. If you’ve noticed you’re a little slower than you used to be, or even if you haven’t, you may want to try this simple test which will let you know if the 'slow-down' process of later life is affecting you. It is called the Walking Speed Test. You can do it easily at home and a friend or relative can help. All you need is a tape measure and a watch with a second hand or a mobile phone with a stopwatch function.
- Using a tape measure, mark out on the ground two lines 4 metres (13 feet) apart.
- Stand next to the first line.
- Your friend/helper should say "Go" and start timing you.
- Walk at your usual speed (using a walking aid if you usually use one) until a few steps past the 4-metre mark (don’t slow down as you approach the mark).
- As you pass the 4-metre mark, your friend/helper should stop timing you.
- Repeat three times, allowing sufficient time to recover between tests.
If you take more than 5 seconds, it’s likely you’re affected by the slowing down process of later life. Of course, some of us walk slowly for other reasons, such as arthritis, but the test will give you a good indication of your general fitness. If you have slowed down you may want to try some simple exercises, or see your GP or nurse to discuss things further.
Look after your feet
Your feet have been a constant fellow traveller throughout your life, but they may be showing signs of strain. Healthy feet are essential for safe walking, but the good news is there are lots of things you can do to keep them healthy.
A lot can be done to improve comfort, relieve pain and maintain mobility.
Wash your feet often
Wash your feet daily to help prevent any infections. If you leave dirt on the skin’s surface, it can become irritated and infected. Dry them well, especially between the toes to help prevent athlete's foot. If you have some hard skin, apply moisturising foot cream (not body lotion).
It can get harder to cut toenails as you get older, but keeping them short will help keep you mobile. When cutting your nails, trim them straight across, never at an angle or down the edge as this may cause an ingrown nail. You may need help with this from your chiropodist or a toenail cutting service.
Try to keep your feet as warm as possible. Warm stockings or socks can help. Avoid anything too tight which can restrict your circulation or cramp your toes. Wearing fleece-lined boots or shoes or even an extra pair of socks will also keep you warm but make sure your shoes aren't too tight as a result. Bed socks are also a good idea when the weather is particularly cold. If your feet are cold, don't try to warm them up by putting them close to a fire or on a hot radiator as this risks chilblains.
Choosing the best footwear
Shoes that fit well protect and support your feet and may improve your balance and stability. Poorly fitting shoes or slippers can easily trip you up and cause a fall.
Look for shoes with uppers made of soft leather or a stretchy man-made fabric which is also breathable. Avoid plastic 'easy clean' uppers which don't allow the foot to breathe and won't stretch to accommodate your own foot shape. Check that the heel is held firmly in place. You'll find that a lace-up or Velcro® fastening shoe will give more support than a slip-on.
Shoes should be comfortable in the shop. If they don’t fit well, they can make even minor foot problems worse. Don't buy them if they're too tight thinking you can break them in. It's a good idea to shop for shoes in the afternoon if your feet swell during the day.
Bunions, corns, chilblains and foot arthritis can cause foot pain. All can be helped in simple ways.
If your feet swell during the day, it's a good idea to put your shoes on as soon as you wake up, before your feet have had a chance to swell.
You can ask your GP to refer you to your local chiropodist for free treatment. If you’re not eligible for this or need urgent attention, you should contact a private chiropodist (see Age UK below).
Look after your eyes
Your eyes should give you a lifetime's service, but sometimes they can be affected by conditions that develop as you grow older. You can help keep your eyes healthy by:
- Not smoking - smoking damages the eye making it more likely to develop age-related macular degeneration and cataracts.
- Eating lots of fruit and vegetables.
- Protecting them from the sun by wearing sunglasses.
It's easy to neglect your eyes because they rarely hurt when there's a problem. Having an eye test will not only tell you if you need new glasses, it also checks the health of the eye and can pick up eye conditions before you may be aware of them so they can be treated early. If you have a low income, you may be eligible for help with the cost should you need glasses or contact lenses.
An eye test can pick up eye conditions, such as glaucoma and cataracts, as well as general health problems, such as diabetes and high blood pressure.
The good news is that if you’re 60 or over, you can have a free NHS eye test every two years. You can have a free test every year if you’re 70 or over.
Make your home safe
Have a look round your home and check for some simple things you can do to make your home as safe as possible:
- Consider getting and wearing a personal alarm, particularly if you live on your own. This will let you contact a 24-hour response centre at the touch of a button should you fall or become unwell. Don’t be afraid or embarrassed to push the button if you need to. The response centre will be glad to reassure you or call for help.
- Check fire and carbon monoxide alarms are installed and working correctly. The fire brigade may be able to fit and check free fire alarms.
- If you have an electric blanket, get it tested at least every three years and replace it every ten years. Check for danger signs such as frayed fabric and scorch marks. You can ask the shop where you bought it about testing and servicing, or contact the trading standards.
- It’s easy to slip in the bathroom. Consider getting a non-slip bath mat and a handrail to help you feel more stable.
- Remove any clutter on the stairs that might trip you up.
- Use plug-in nightlights that turn on automatically at night. They provide a low light so you can see your way to the bathroom or stairs.
- Make sure you have good lighting, especially on the stairs.
- Coil up any long or trailing electric leads, particularly around doorways or stairs, or tape them close to the wall.
- Don’t walk on slippery floors in socks or tights. Wear well-fitting slippers.
- Don’t wear loose-fitting, trailing clothes that might trip you up, such as a long dressing gown.
- Loose rugs and mats can be a trip hazard and should be avoided if possible. Replace frayed carpets or repair with double-sided carpet tape.
You can request a home safety assessment if you are concerned that you may need some additional equipment to make things a little easier and safer. Your GP, nurse or social care professional can arrange this for you.
It can be easy to retreat into the pleasing comfort of an armchair, particularly during the colder months. But taking life too easy can actually speed up the slowing down process of later life. It is never too late to start being more active or begin an exercise programme. Keeping active is the key to staying fit, mobile and independent. Regular exercise can help reduce the impact of several diseases - for example, osteoporosis, diabetes, high blood pressure, heart disease, and stroke. Regular exercise can also reduce arthritis-related pain, improve sleep, prevent falls and fractures and improve low mood and memory. In fact, taking regular exercise is one of the best things you can do to remain independent.
The good news is that any exercise is good for you. You don’t need to go to a gym! Try to find things that can be part of your everyday routine, such as simple chair-based exercises, or walking to the shops, or that are fun, such as dancing or playing bowls.
If you haven’t been very active, you should aim to minimise the amount of time spent sitting down for extended periods. You could do this by reducing the time you spend watching TV; taking regular walk breaks around the garden or street; or swapping a bus or car journey for walking part of the way.
Your next aim should be to increase your activity so you build up to about 30 minutes activity on three to five occasions a week. Each activity should be sufficient to raise your heart rate and make your breathe faster and feel warmer.
Examples of the sorts of activity that improve or maintain health include:
- Brisk walking.
- Ballroom dancing.
- Climbing stairs.
You should also aim to undertake activity to improve muscle strength on at least two days a week, such as:
- Carrying or moving loads such as groceries.
- Gardening jobs such as pushing a lawnmower, digging, or collecting grass and leaves.
- Activities that involve stepping and jumping such as dancing.
- Chair-based exercises.
Why not contact your local leisure or community centre to see what they’ve got on, or see if you can find an activity to do with friends such as walking or dancing?
Talk about your medicines
You may be taking several different medicines, especially if you have a condition such as diabetes or asthma. It’s important that your medicines and the doses are reviewed regularly. Your GP, nurse or pharmacist will do this for you. They may recommend alternative medicines or lower doses, or sometimes suggest the medicine is stopped altogether.
Did you know that your pharmacist can help you with queries you might have about your medicines? They are experts on medications, often have extended opening hours and no appointment is necessary.
Don’t simply stop taking a prescribed medicine if you are worried about side effects. If you think a medicine is causing side effects (perhaps dizziness, a fuzzy head, dry mouth, loss of appetite, nausea or constipation), get advice from your GP, practice nurse or pharmacist.
You should see your GP, nurse or pharmacist if you have not had your medicines reviewed for more than one year, or if you are concerned about the medications you are taking.
Get your hearing tested
Losing your hearing is a normal part of the ageing process, but because it happens gradually you may not notice any change. You may realise you need to have the TV on louder or find you can’t always follow conversations, especially in a group. Having trouble hearing can make it hard to understand and follow a doctor's advice, to respond to warnings, and to hear doorbells and alarms. This can sometimes be frustrating, embarrassing, and even dangerous.
Don’t delay in booking a hearing test. Why not book one when you book your eye test? NHS hearing tests are free and can be arranged through your GP.
It is important to identify hearing loss early as treatment is more likely to be effective the earlier problems are diagnosed. The problem may be as simple as earwax, which is very easy to treat.
To do a quick hearing check before seeing your GP, use the free hearing check provided by Action on Hearing Loss (see below). It only takes five minutes and you can do it at home either by phone or online for free. This check will indicate if you have hearing loss. If you have any concerns, speak to your GP.
Hearing aids are much smaller than ever before and will enhance your hearing.
Falls become more common as we get older, but they are not inevitable and there is much that can be done to reduce the chance of a fall, even if you have already had one. Much of what can be done is quite simple and includes the health advice described already in this guide.
Simple actions to prevent falls include:
- Looking after your feet.
- Looking after your eyes.
- Making your home safe.
- Getting your medicines reviewed.
- Staying active.
- Looking after your hearing.
If you have had a fall - even if you haven’t hurt yourself - feel unsteady, or are worried about falling, it is important to discuss this with your GP or practice nurse. They can check your balance and walking, and refer you to a falls preventions service if necessary.
Get your vaccinations
As we age, our immune system becomes less efficient at protecting us. A number of different vaccinations are available for older people. These are currently free on the NHS.
- Flu vaccination, commonly known as the flu jab, protects against influenza. Flu can be particularly serious in older people and cause complications like pneumonia. It is free to people aged 65 and over and also to carers and younger adults with conditions that make them susceptible to complications if they have flu. So ask at your GP service if you think you could be eligible for a flu jab.
- People who are aged over 65 should have a single pneumococcal vaccination which will protect them for life. This is a one-off jab.
- People who are aged 70 or 79 should be offered a single vaccine to prevent shingles, a common and painful skin disease. Talk to your GP practice for further information.
Keep warm and well
Keeping warm over the winter months can help to prevent colds, flu and serious health problems such as heart attacks, strokes, pneumonia and depression.
- Heat your bedroom to at least 18°C (65°F) and main living room to 21°C (70°F). If you can’t heat all the rooms you use, heat the living room during the day and the bedroom just before you go to sleep.
- Keep your bedroom window closed at night. Breathing in cold air is bad for your health and could put you at risk of a chest infection. Use a wheat bag or hot water bottle to keep warm.
- Make sure you are receiving any benefits you are entitled to. Your local Age UK (see below) can provide advice and even help you to fill out forms.
- Have regular hot drinks and eat at least one hot meal a day if possible. Eating regularly helps keep energy levels up during winter.
- Wear several light layers of warm clothes (rather than one chunky layer). Thermal vests can be good as a base layer.
- Wrap up warm and wear shoes with a good grip if you need to go outside on cold days.
Get ready for winter
There are practical things that you can do to prepare for winter weather, including cold, ice and snow and high winds. Remember that cold weather can start in October.
- Icy pavements and roads can be very slippery. Take extra care if you go out and wear boots or shoes with good grip on the soles. Rubber snow/ice grips that attach to outdoor shoes are very effective.
- Consider fitting a grab rail if you have steps at your front or back door.
- Have your heating system serviced during the summer.
- Have some food supplies ready if you can't go out for a few days.
- Ask your family, neighbours or friends if they could call or visit you more often if a period of cold weather stops you getting out and about.
- Keep simple cold, flu and sore throat remedies in the house.
- Speak to your friends, family or carer if you are feeling under the weather. They can help you.
- Order repeat prescriptions in plenty of time, particularly if bad weather is forecast.
- Local pharmacists also provide expert advice to help manage long-term conditions or can offer advice if you have a bad cough, trouble breathing, a cold or a sore throat. They have longer opening hours than GP practices, and most have a private consultation area. They’ll also tell you if they think you should see a doctor.
Eat well and drink plenty of fluids
Hot meals and drinks help to keep you warm, so eat at least one hot meal each day and have hot drinks during the day. Wholesome soups make a warming snack. Include a good range of foods in your diet, (for example, wholegrain cereals, milk and cheese for calcium) and aim for five portions of fruit and vegetables each day, so that you’re getting plenty of nutrients and vitamins. Remember that frozen vegetables are as good as fresh. It’s important to eat enough, especially in winter.
Having a glass of water within reach during the daytime will remind you to keep up your fluid intake. Having a hot drink before bed and keeping one in a flask by your bedside can be good ideas too.
If you’re worried about a poor appetite or losing weight, speak to your GP.
Help with bladder problems
People of all ages can experience bladder control problems - including over 2.5 million people over 60 - yet many people keep it a secret for years. Bladder problems are not an inevitable part of getting older, or something you have to put up with.
Start by talking to your GP. Bladder problems are common so there’s no need to feel embarrassed. They will assess your symptoms, identify the cause, and discuss what treatments or exercises may help. Or you could refer yourself directly to your local NHS continence service for an assessment, where a continence adviser can help you.
There are things you can try that may help improve your symptoms too:
- Drink normally, as cutting down on liquids will usually make urinary incontinence worse, not better.
- If you notice that tea, coffee and cola make your symptoms worse, cut down or try decaffeinated versions.
- Check whether any medicines you’re taking could be affecting your bladder.
Urinary infections can be serious. Consult your GP or pharmacist if you think you have a urinary infection.
Some people who are prone to repeated urinary infections can be helped by a daily glass of cranberry juice. Cranberry juice can also increase the effects of warfarin, so you should avoid drinking it regularly if you are taking warfarin.
Look after your mental well-being
We all feel down from time to time, but if you are feeling low and out of sorts for two weeks or more, you may be suffering from depression. Symptoms include:
- Loss of confidence and feeling down.
- Feeling anxious or panicky.
- Not being able to enjoy the things you usually do.
- Unexplained aches and pains.
- Avoiding people, even those you're close to.
- Sleeping badly.
- Loss of appetite.
- Feeling bad or guilty, or dwelling on things from the past.
Depression is just as significant as a physical illness, so speak to your GP and explain how you're feeling. You can then agree on the best treatment for you, such as talking to a counsellor who can help you manage your thoughts and feelings and the effect they have on you.
Caring and keeping well
Lots of older people care for a loved one: this might be helping someone to eat, get dressed, or help with getting a weekly shop. This is an important role and can be tough at times and may affect your physical or mental health. It is easy to overlook your own health needs if you are a carer. Your GP can support you as a carer and help you to look after yourself and stay well.
Ten-point action plan
Five things we recommend you do:
- Check out your walking speed.
- Stay active or become more active.
- Keep up regular chats and spending time with other people.
- Keep on top of your health (eyes, hearing, vaccinations and medicines review).
- Look after yourself (warm, safe home, good company, good food).
Five things I am going to do:
Content provided at the request of NHS England: A Practical Guide to Healthy Ageing (published January 2015). It is available as an A4 magazine-style publication which members of the public, professionals and organisations such as CCGs, pharmacists, Fire and Rescue Services and GPs can order free through Prolog, by calling 0300 123 1002, quoting reference HA2, or on-line at www.orderline.dh.gov.uk. Copyright for this leaflet is with NHS England.