According to the Centers for Disease Control and Prevention (CDC), the death rate from falls is increasing rapidly among seniors age 65 and older. The most recent statistics show this increased by 30% from 2009-2018. Falls can be deadly for older adults, but by implementing safety practices and making simple home modifications, injury prevention is doable.
Understand why falls are so dangerous to the elderly
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 in your loved one, leading them to decrease their physical activity and become very stiff, rigid, or unsteady on their feet.
- Older adult falls are common: Every year, over 3 million people over 65 are treated in Hospital Emergency Departments for falls.
- One out of five falls causes a serious injury.
- Deaths result from complications of bleeding in the brain or from immobility. Pneumonia is a common complication of immobility. Sepsis from bedsores is another.
Screen for Fall Risk
Assess risk due to pre-existing conditions
The first step to fall prevention is to screen for the potential medical conditions and risk factors that make your senior more likely to fall. Conditions and 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 and lethargy, or sleepiness. Watch out if your loved one is taking:
- Blood pressure medications
- 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
- Foot, hip or knee pain or stiffness
Discuss these fall risks with the primary care practitioner and ask for a full fall risk analysis. Review for medication changes or adjustments that can help reduce the fall risks. Do NOT stop taking any medications without consulting the doctor who prescribed them!
Get a Professional Risk Analysis
- A home health care safety evaluation from 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 improve home safety.
- Get a Hearing and Eye Exam at least once a year: 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.
Ways to Prevent Falls
Improve home safety with a few simple home modifications:
Throughout the house
- Use devices such as canes and walkers as directed. Make sure they are set at the right height and always kept within reach.
- A bed alarm or tab alarm attached to the chair can help alert caregivers of unexpected movement. A call pendant can help call for assistance if left alone or unattended.
- 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 they are lighted, and visibility is not impeded.
- Ensure handrails are sturdy. Add a handrail to each side.
- Repair any loose or broken treads.
- 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 the furniture to hang onto instead of using canes or walkers. Furniture can move unexpectedly and cause a fall. Always use assistive devices. Grab bars 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 them easily accessible, 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 2 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 the bed is big enough, so the senior isn’t too close to the edge or thrashing about all night.
- Make sure a light is easily accessible from the bed.
- Keep pathways clear.
- Use a nightlight – a motion detecting one is good, or one that comes on when it gets dark.
- Remove throw rugs. There are specific fall mats that can be placed securely next to the bed to soften a fall if necessary.
- Use the bathroom before retiring and 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 the path and shut off after leaving the area.
- Use 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 standing is an issue while grooming.
- A significant number of falls occur when rushing to the bathroom. Encourage a routine of toileting every 2-3 hours while awake and before bedtime to reduce the number of urgencies.
- Always use assistive devices and assistance or supervision as recommended.
- Keep pathways clear and in good repair.
- Ensure paths are well-lit even in daylight.
- Look down occasionally every 4-6 feet to check for debris, uneven walkways, or other obstacles. Otherwise, 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 loved one 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, medical care is an absolute.
For questions, call your loved one's healthcare providers.
TIP: Remember a well-lit, clutter free environment will help reduce the risk of falls. Using assistive devices such as walkers or canes is not optional. If the assistance of 1-2 people to ambulate safely is required, a full-time caregiver is essential. Falls can be life-changing and need to be prevented.