Fall Prevention for Older Adults

08/11/23 10:03 PM PST

Nurse helping a senior woman walking the stairs

Falls are common, preventable, and deadly. Every second of every day, an older adult (age 65+) suffers a fall in the United States. Falls are the leading cause of injury and/or death among those 65+, and more than 95% of hip fractures are a result of a fall. Many of these falls are caused by environmental or lifestyle habits that can be modified to keep older adults safe.

Lifestyle habits that reduce the risk of falls include scheduling regular visits to a healthcare professional, prioritizing overall health as we age, and incorporating strength-building and balance-building exercises into our weekly routines. Modest modifications to our home environment can also reduce fall risk.

Learn more about these fall prevention measures below.

Why should older adults visit their doctor regularly?

Early detection of health changes can make a life-changing difference. Older adults should visit their doctor routinely so that doctors are up to date on any health concerns and can detect health changes as early as possible. In each visit, tell your doctor about any concerns you have, even small concerns you might otherwise consider too insignificant to mention. Below are some examples of things to report to the doctor at routine visits.

1. Unreported Falls. Have you or a loved one fallen around the house and not needed medical care? Make sure to inform your doctor about any falls at home. Falling once doubles your chances of falling again.

2. Medication Management. Are you managing medication side effects? Speak to your doctors or pharmacist if you or a loved one are experiencing any side effects from medications, such as dizziness and/or sleepiness.

3. Vision Changes. Have you noticed any change in vision? Our vision changes as we age, but not all eye change is normal. Get your eyes checked regularly for vision changes that might increase your fall risk. Some vision changes, such as cataracts, are correctable with minor surgery.

4. Unexplained Dizziness. Have you noticed any balance issues or vertigo? There are many causes of dizziness in seniors, including age-related spine degeneration, or benign paroxysmal positional vertigo (BPPV) which can come from dislodged crystals in your ear. Vertigo increases your risk of falls and should always be addressed with your doctor.

5. Foot Issues. Have you had problems with your feet? High blood sugar can lead to restricted blood flow, which can reduce foot sensation and increase risk of falls. Have your feet checked regularly to ensure foot health, particularly if you are managing high blood sugar.

6. Osteoporosis. Do you have a family history of osteoporosis? Osteoporosis is not only associated with a higher risk of falls due to muscle weakness, spine kyphosis, and decreased postural control, but it can also increase fear of falls. Speak to your doctor about preventive dietary recommendations. Getting enough Calcium and Vitamin D for your individual needs will help keep your bones strong.

7. Walking in General. Has walking become more difficult? If you have trouble walking in general, your doctor or physical therapist may be able to recommend an assistive device.

How does overall health impact fall prevention?

Maintaining overall health is important for decreasing risk of falls. Most of the time, there is a contributing reason for falls. By paying attention to overall health and pursuing healthy habits, individuals can reduce fall risk.

Below are a few tips to maintain overall health.

Prioritize sleep. Lack of sleep, or having poor quality sleep, can impair balance, reduce reaction time, affect memory and attention span, and increase fall risk. Medication that causes sleepiness can also increase fall risk.
Limit alcohol use. Even moderate alcohol consumption can contribute to mobility issues. Alcohol affects the area of the brain that controls movement and balance, making it easy to trip or fall. Alcohol is dehydrating, which can affect inner ear fluid and cause vertigo. Alcohol is also a depressant, slowing down the brain and affecting the body’s responses. When it comes to alcohol and aging, less is better.
Stand up slowly. Getting up too quickly can cause your blood pressure to drop, increasing fall risk. This can be a particular issue for individuals with lower blood pressure. Stand up slowly when getting up from a sitting or lying position to allow blood pressure to equalize and help maintain your balance.

Why is it important to exercise?

Exercise can strengthen legs, improve balance, and make older adults more flexible. These factors can help reduce the chances of falling. Below are some specific exercises and movements you can do to build strength, balance, and flexibility.

Tai Chi. Tai Chi, an ancient Chinese mind-body practice, is a type of graceful, physical exercise that gives the appearance of martial arts performed in slow motion. It involves a series of slow, gentle movements and physical postures, a meditative state of mind, and controlled breathing. Many gyms, senior centers, and community centers have group Tai Chi classes available both indoors and outdoors.
Standing on one foot. This exercise can be practiced nearly anywhere at almost any time. With abs tightened, two hands braced on a sturdy table or chair, and with feet shoulder-width apart, lift one leg at a time and hold for ten seconds. Repeating this the exercise 10-15 times per day can increase overall balance in individuals of any age.
Heel-to-toe walk. The heel-to-toe walk, sometimes called the tandem walk, can be practiced anywhere an individual has room to travel backward and forward for 4-8 consecutive steps. With a hand on a wall or counter to begin with (as balance is developed, the individual can move to an open space with arms extended from the shoulders for balance), pretend to walk on a tightrope by placing one foot directly in front of the other, touching your heel to the toes of the foot directly behind. After 4-8 steps forward, repeat the sequence backward. Practice multiple times a day to improve balance.
Calf stretches and raises. Calf flexibility and strength can improve ankle and knee movement, and help older adults to walk on uneven ground. To do a calf stretch, stand arm-length away from a wall and place your hands on the wall. Step forward with one foot. Lean your hips toward the wall, keeping your back leg straight and heel on the floor. Hold position for 20-30 seconds and repeat with the other leg. To do a calf raise, place your hands on a sturdy chair, table or counter for balance. Stand straight and rise up onto your toes as high as possible, keeping heels of the ground, then slowly lower to your normal position. Repeat 10 times.
Yoga. Yoga is an ancient practice rooted in Indian philosophy that involves physical poses, concentration, and deep breathing. It has been shown to improve balance, flexibility, strength, endurance, and mental clarity in older adults. With regular practice, yoga can also reduce stress, increase bone density, and lower blood pressure. Many gyms, senior centers, and community centers have group yoga classes available both indoors and outdoors.

While a minimum of 150 minutes of total physical activity each week is ideal, any exercise is beneficial.

Modify your home environment

Tripping hazards are common at home, making the home environment one of the biggest causes of falls. To clear your house of these hazards, review our room-by-room home safety tips below.

Bathroom

Add handlebars between the shower/tub and the toilet to help maneuver more easily.
Invest in non-slip mats for outside and inside the shower/tub.
Attach a hand-held shower head to help wash hard-to-reach areas.
Install a shower bench as a resting place for those who find it difficult to stand for an extended amount of time.

Stairways

Install night lights near the top and bottom of stairwells to keep stairs clearly visible during the night.
Remove any objects sitting on the stairs or blocking access to the steps.
If steps have torn carpet, either reattach the loose carpet or remove carpeting completely. For non-carpeted steps, add non-slip safety tread or safety tape along the stair edge.
Add full-length handrails to both sides of the stairs.

Floor

Rearrange furniture to create a straight path through each room.
If your home has loose area rugs, remove them. If removal is not an option, attach them securely to the floor with double-sided tape, Velcro rug anchors, a felt rug pad or other securing methods.
Remove loose wires, or coil and tape them snugly to the nearest wall.
Remove any loose objects on the floor. Loose objects – even in piles – cause a tripping hazard.

Kitchen

Some household falls result from trying to reach objects while in an insecure position. Use pull-out shelves or a “Lazy Susan” to easily access dishes kept in those hard-to-reach cabinets.
Consider using plastic dishware rather than breakable dishes to avoid any foot injuries or slipping caused by broken pieces of dishware.
For seniors with pets, consider feeding the pets on a more easily accessible low table rather than the floor.