Mobility-supporting balance exercises for older adults

Balance exercises to support mobility

Older adults tend to struggle with mobility loss and balance issues, so creating a routine involving regular, safe balance exercises to support mobility can help to maintain health and quality of life. Here, we are taking a look at why these exercises are so important, some common ones that could help depending on ability, tips for practicing these safely at home, and how families and home care services could help to encourage and support older adults with these exercises. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about mobility loss, we can help.

What are the most common balance issues experienced by older adults?

Balancing is possible when the brain utilises information from the vestibular system (balance functions, like the inner ear), visual system (eyes) and proprioceptive system (muscles and joints) to gauge where the body and head are in relation to nearby objects. The brain then enables the eyes to keep vision stable, allowing us to walk and move without falling over. As people age, these systems begin to deteriorate for a number of reasons, leading to balance problems that can be exacerbated when combined with other health issues. For example: 

• Muscle Weakness – Muscle deterioration (sarcopenia) is common in older adults, and loss of muscle mass throughout the body can lead to difficulties with strength, mobility and balance. One 2024 study found age-related muscle weakness, decreased joint mobility and changes in bone density all contribute to balance issues. 
• Inner Ear Issues – The inner ear includes a part of the ear called the labyrinth which manages our balance. Problems with the inner ear may include things like Ménière’s disease or labyrinthitis, both of which could cause dizziness, or the feeling of the room spinning or objects moving.
• Blood Pressure Issues – When blood pressure changes quickly, such as when a person stands up too quickly, this can cause balance problems known as postural hypotension. 
• Medications – Certain medications can cause symptoms that include balance issues, such as anti-epileptic drugs, sedatives, tranquilizers, beta blockers, blood pressure medications and more. If you suspect you are experiencing balance issues after taking a new medication, speak to your GP about alternative options. 
• Other Medical Conditions – Some other medical conditions can lead to balance issues, like stroke, diabetes, heart disease, thyroid issues and more. Speak to your GP if you suspect an underlying health condition could be to blame.
• Vision Problems – For older adults with impaired vision, balance can be affected which makes it more difficult to safely navigate their environment. As a result, they may move with more caution.
• Dehydration – Dehydration can cause balance issues in older adults due to its effect on circulation, the volume of blood in the body, blood pressure, cognitive function and other factors. This may cause symptoms like dizziness or lightheadedness. 

Neurological or Cognitive Issues – Sometimes neurological or cognitive disorders (such as Parkinson’s disease) can affect the nervous system and interrupt signals to the brain which impact balance.

What are some of the best balance exercises for older people?

After a fall or a near-miss, many older adults experience a fear of falling again, which can lead to reduced movement and low confidence. This fear can quickly become a barrier to staying active and social, so incorporating regular, supported balance exercises with help and encouragement from family or carers can rebuild their confidence, reduce any anxiety they feel, and help older people regain trust in their bodies. 

Depending on ability, doing the below exercises on a regular basis could help to improve balance over time. Remember, when beginning any balance exercise, maintain focus on a fixed point ahead of you to remain steady. 

Beginner-friendly (for those with very limited mobility)

1. Weight shifts – Stand with feet hip-width apart, and shift your weight onto your right foot, raising your left foot slightly off the ground as you do. Hold this for as long as you can, working up to 30 seconds, then bring your foot back down to distribute your weight evenly between both feet. Next, shift your weight to the left foot and do the same on the other side. Try to do this 3 times on each side. 
2. Heel raises – Start with your feet flat on the ground, and raise your heels up so you are standing only on your toes. Do this 1-3 times, have a rest and then continue, aiming to complete 10 sets of these. Stand next to a chair for balance, and ensure you are wearing sturdy footwear while doing this exercise. 
3. Sit to Stand – Start by sitting in a sturdy chair with arms. Rise up to a standing position using the arms for leverage, and repeat several times. If this is possible for you, try to make it more challenging by standing several times without using the arms to help you.  

Intermediate (for those with limited mobility) 

1. Marching – Stand with your weight evenly distributed across both feet, then lift your right knee up to a 45 degree angle. Lower it back to the ground, then do the same with the left knee. Repeat this movement to create a marching motion, taking it as slow as you need to in order to maintain balance. Do this within reach of a solid piece of furniture so you can steady yourself if you lose balance. If you usually use a walker, you can try this while gripping the frame for added support. One 2021 study found an 8-week program of marching exercises for 65-75 year olds led to improved balance, lower limb muscle strength, quality of life and a reduced fear of falling.
2. Tightrope Walking – Otherwise known as ‘heel-to-toe walking’, lift your arms out to your sides to balance, and focus on a fixed point on the floor in front of you. Walk in a straight line putting one foot in front of the other, like you are maintaining your balance on a tightrope. Try to pause for 2-3 seconds every time you raise your foot to take another step. You can do this within reach of a wall or solid piece of furniture to give you something to steady yourself against. 
3. Seated Leg Lifts – Start by sitting in a sturdy chair with arms, and place both feet flat on the floor in front of you. Brace your core, roll your shoulders back and grip the arms of the chair, then lift both legs off the ground as high as you can with your knees and ankles together. If you need to work up to this, start by lifting one leg at a time. Exhale as you do so, and hold at the top before lowering your feet to the floor. Aim to do 10 to 12 repetitions of this exercise between 3 and 5 times. 

Advanced (for those with full mobility)

1. Flamingo Stand – Shift your weight onto your right foot, lifting your left foot off the ground and extending it out in front of you. Hold the position for 10-15 seconds. To make this more challenging, you can try to extend your arms out in front of you while you balance. Return to a neutral position, and do the same with the other leg. Repeat this 3 times. Do this within reach of a wall so you have a balance aid if needed. A 2024 study of people aged 50+ found the ability to balance on one leg is an accurate measure of health, as the length of time tends to decrease with age. 
2. Modified Plank – This yoga-style exercise is great to build core strength. Make sure you are wearing non-slip shoes, and place a sturdy chair by a wall to stabilise it, with the back of the chair to the wall. Place your hands shoulder-width apart on the seat, brace your core, and step backwards so your body forms a straight diagonal line from your head to your heels. Keep arms straight and hips in line with the knees and shoulders. Hold this position for around 10 seconds, working up to a longer length of time if this is not challenging. Do this three times, maintaining proper form each time.
3. Tai Chi – For those more confident in their physical ability, beginning a regular tai chi practice or group class could help to improve balance with age. It is a combination of fluid movements that build muscle strength and stamina as you balance, and a 2017 review of studies found tai chi helped reduce falls by up to 50%. If falling is a worry for you, a regular tai chi practice could put your mind at ease. 

How can home care services help?

A 2019 study found older adults experience a decline in balance and gait as their age increases, as well as an associated increased risk of falls. For this reason, taking steps to improve balance can help with everything from reducing fall risk to improving the confidence older adults have to go out and socialise. Home care services can help with this by: 

• Assisting with prescribed activities from doctors or physical therapists
• Facilitating visits from healthcare professionals like physical therapists 
• Encouraging consistency with exercise to strengthen muscles and improve balance
• Ensuring safety and monitoring health while undergoing physical exercise
• Providing general care such as personal care to assist with bathing and dressing 

• Taking overhousework and home maintenance that could pose a fall risk 
• Moving and arranging furniture to support balance exercises and prevent falls
• Helping to arrange any necessary mobility aids and home adaptations
• Providinglive-in supportif care needs become more demanding

Support from a dedicated carer can be invaluable for older adults with mobility or balance issues to improve their abilities and confidence, reduce fall risk, and increase their independence while living at home. Our highly trained Care Professionals are experienced in helping older adults who struggle with balance and mobility, by providing everything from general companionship to more specialised, complex care needs and more. Whatever support you need, reach out to your local Home Instead office to discuss your options.

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.