Fall Prevention: How To Prevent Older Adults From Falling

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Falls can be life-changing and can be prevented. They are not “just a normal part of aging.” You have the power to prevent falls by understanding your risks. 

According to the Centers for Disease Control and Prevention (CDC), the death rate from falls is increasing rapidly among those ages 65 and older. The most recent statistics show this statistic has increased by 30 percent from 2009 to 2018. 

Falls can be deadly for older adults. However, by implementing safety practices, staying active, and making simple home modifications, injury prevention is doable. 

Why Are Falls So Dangerous For Older Adults? 

Falls can be deadly and costly. They can cause serious injuries, such as hip fractures or internal bleeding. Even if it isn't serious, fall-related injuries can instill a fear of falling. Unfortunately, this can lead to a decrease in physical activity and a potential loss of mobility and strength.

Falls for older adults are common. For example, every year, over 3 million people over the age of 65 are treated in hospital Emergency Departments for falls.

  • One out of five falls causes a serious injury.
  • Death can result from complications of bleeding in the brain or from immobility. 
  • Pneumonia is a common complication of immobility. 
  • Sepsis from bedsores is another.  

2 Ways To Screen For A Fall Risk

1. Assess fall risks due to pre-existing conditions


The first step to fall prevention is to screen for the potential medical conditions and risk factors that can make your senior more likely to fall.
Conditions can lead to scenarios that contribute to falling. 

These include:

    • Common prescription and over-the-counter medications, including supplements.
      The side effects of these can affect balance and steadiness, dizziness, grogginess, lethargy, or sleepiness. Watch out if your loved one is taking:
      • Tranquilizers
      • Sedatives or sleeping pills, even those sold over-the-counter
      • Antidepressants
      • Blood pressure medications
      • Antihistamines
    • Pain relievers A Vitamin D deficiency
    • Difficulties with walking or balance
      • Due to pain, illness, or injury
      • Due to joint deterioration from wear and tear or arthritic changes
    • Vision or hearing problems can affect balance and gait or missteps
    • Lower body weakness
    • Foot, hip, or knee pain or stiffness

Discuss these fall risks with your loved one’s primary care practitioner and ask for a full fall risk analysis, such as the one recommended by the CDC, known as STEADI. Review for medication changes or adjustments with your doctor and pharmacist that can help reduce the fall risks. 

Do NOT stop taking any medications without consulting the doctor who prescribed them. Using assistive devices such as walkers or canes is not optional if recommended by a healthcare provider. These devices help you remain steady on your feet.

2. Complete a Falls Risk Analysis

    • Take an NCOA Falls Free Checkup to see where your risk is.
      This brief checkup will provide an overview of your risk for falls – and some critical next steps.

    • Receive a home health care safety evaluation.
      An evaluation typically performed by a nurse, physical therapist, or occupational therapist might be recommended, especially if there have been near falls or simple, injury-free falls. These professionals can offer tips for prevention strategies, as well as make recommendations for improving home safety.

    • Get a hearing and eye exam annually.
      Vision and hearing loss can lead to poor balance and safety issues with mobility. Bifocals, progressive lenses, or simple reading glasses can make things appear much closer and cause dizziness or unsteadiness.

      A separate pair of glasses just for distance can improve safety for older people, especially while walking outdoors. 


How Can You Prevent Falls At Home?

A well-lit, clutter-free environment that is set up for how you move in your home will help reduce the risk of falls at home. 

An occupational therapist can perform a home assessment to help you identify ways in which your home can be as safe as possible as you age in place. Home safety can be improved with a few simple home modifications. 

Let’s review a few areas of the home that can be improved to prevent falls from happening at home. 

Throughout the house:

    • Walk through the residence and observe for ways to make it safer.
    • Clear all walkways and stairs.
    • Always keep objects off the stairs and floors.
    • Make sure staircases are well-lit, and that visibility is not impeded. 
      • Ensure handrails are sturdy. Add a handrail to each side. 
      • Repair any loose or broken threads.
      • If carpeted, make sure the carpet is firmly attached or remove it.

In the main living area:

    • Make sure furniture placement allows for free and easy movement. Seniors tend to use furniture to hang onto instead of using canes or walkers. (Furniture can move unexpectedly and cause a fall.) 
      • Always use assistive devices such as grab bars which can be helpful
    • Remove throw rugs or secure them with double-sided tape or non-slip backing.
    • Clear the clutter!
      • Organize items and keep them off the floor and out of pathways.
      • Make items easily accessible for your loved one, but not in the way. If piles of newspapers or magazines are absolutely necessary, make sure they don’t impede mobility. (They can be a fire hazard as well.)
    • Coil extra length of cords and wires and secure to the wall to prevent tripping.
    • Oxygen tubing is often a trip hazard when it’s long enough to navigate the entire house.
      • Coil it on a hook on the walker or a hand-held device while walking around and uncoil as needed.

In the kitchen:

    • Keep things on the counter or on lower shelves of upper cabinets. 
      • In lower cabinets, minimize the number of objects and make them easily accessible on the top shelf.
    • If a step stool is needed, use one with only two steps and a bar to hold onto.
      • Only use the lower step, never use a chair or stool.
    • A reacher or even long tongs can be used to grab small items.

In the bedroom:

    • Make sure a light is easily accessible from the bed.
    • Keep pathways clear.
    • Use a nightlight – a motion-detecting one that is good, or one that comes on when it gets dark.
    • Remove throw rugs or anchor with underpads.
      • There are specific fall mats that can be placed securely next to the bed to soften a fall if necessary.
    • Ensure your loved one uses the bathroom before retiring and have them limit fluids before bedtime.

In the bathroom:

    • Make sure the path from other rooms is accessible and well lit. 
      • Use motion-detecting lights to light pathways and shut them off after your loved one leaves the area.
    • Use a non-slip mat or self-stick strips in the tub or shower.
    • Encourage drying off in the tub or shower.
      • A non-slip water-absorbent mat on the floor when stepping out of the bath or shower can help prevent slipping.
    • Install grab bars inside and out of the tub/shower. (Get recommendations from a professional.)
    • Install bars to assist on and off the toilet.
    • A bar next to the sink can be helpful if your loved one has trouble standing while grooming.
    • A significant number of falls occur when rushing to the bathroom.
      • Encourage a routine of toileting every 2-3 hours while they’re awake and before bedtime to reduce the number of urgencies they’ll have.     

Outside:

    • Always ensure your loved one uses assistive devices and assistance or supervision as recommended both inside and outside.
    • Keep pathways clear and in good repair.
    • Ensure paths are well-lit even in daylight.
    • Encourage your loved one to look down occasionally every 4-6 feet to check for debris, uneven walkways, or other obstacles. 
      • Otherwise, have them stand up straight and look straight ahead to keep from getting dizzy or disoriented.
      • A gait belt might also be needed for the person assisting to help prevent a fall or wandering.

 If your older family member does have a fall, make sure to seek medical care to ensure there are no repercussions. If they take blood thinners and/or hit their head, seek medical care.


Balance & Strength Exercises For Fall Prevention 

Balance and strength training can’t prevent falls but they can reduce the risk. 

Find an exercise program that fits your loved one’s needs and level of fitness. There is a range of options and classes, including many through community senior centers, as well as the YMCA.  Look for those that include strength, balance, and fitness.  

Start early – and keep moving!

The National Council on Aging (NCOA)

The National Council on Aging (NCOA) is a 60-year-old non-profit organization that delivers resources, tools, and best practices to ensure that every person can age with health and financial security.

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