What are the main causes of falls in older adults. How can seniors reduce their risk of falling. What steps can be taken to fall-proof a home. How does exercise help prevent falls in the elderly. Why is medication management important for fall prevention. What role does vision and hearing play in fall risk. How can assistive devices help prevent falls.

Understanding the Impact of Falls on Older Adults

Falls among older adults are a significant health concern, often leading to severe consequences that can drastically alter one’s quality of life. For individuals aged 65 and above, the risk of falling increases, with more than one in four experiencing a fall each year. These incidents can result in broken bones, long-term disability, and even more serious health complications.

The fear of falling itself can be debilitating, causing some seniors to limit their activities and social engagements. However, it’s crucial to understand that while the risk is real, many falls are preventable. By taking proactive measures and staying informed, older adults can maintain their independence and continue to lead active, fulfilling lives.

Identifying Common Causes of Falls in Seniors

Several factors contribute to the increased risk of falls among older adults:

• Age-related changes in vision, hearing, and reflexes
• Chronic health conditions such as diabetes, heart disease, or thyroid problems
• Cognitive impairments, including mild cognitive impairment and certain types of dementia
• Sarcopenia (age-related loss of muscle mass)
• Balance and gait issues
• Postural hypotension (a sudden drop in blood pressure when standing up)
• Foot problems and inappropriate footwear
• Medication side effects, particularly those causing dizziness or confusion
• Environmental hazards in the home or community

Understanding these risk factors is the first step in developing effective fall prevention strategies. By addressing these issues, older adults can significantly reduce their chances of experiencing a fall.

The Role of Physical Activity in Fall Prevention

Maintaining an active lifestyle is crucial for fall prevention among seniors. Regular exercise not only improves overall health but also specifically targets areas that can reduce fall risk:

Benefits of Exercise for Fall Prevention:

• Strengthens muscles and improves overall physical condition
• Enhances flexibility of joints, tendons, and ligaments
• Improves balance and coordination
• Helps maintain bone density, reducing the risk of fractures if a fall does occur

What types of exercises are most effective for fall prevention? A combination of activities that focus on strength, balance, and flexibility yields the best results. Consider incorporating the following into your routine:

1. Walking or climbing stairs (mild weight-bearing activities)
2. Yoga or tai chi for balance and core strength
3. Resistance training with weights or bands to build muscle
4. Pilates for overall body awareness and control

It’s important to consult with a healthcare professional before starting any new exercise regimen, especially if you have existing health conditions. They can help tailor a program that’s safe and effective for your individual needs.

Creating a Fall-Proof Home Environment

Many falls occur within the home, making it essential to assess and modify your living space to reduce hazards. Here are some key areas to focus on:

Lighting:

• Ensure all areas of the home are well-lit, especially stairways and hallways
• Install night lights in bedrooms, bathrooms, and along paths to these areas
• Keep a flashlight easily accessible in case of power outages

Flooring:

• Remove or secure loose rugs and mats
• Repair any uneven flooring or loose floorboards
• Keep floors clear of clutter and obstacles

Bathroom Safety:

• Install grab bars near toilets and in showers/bathtubs
• Use non-slip mats in wet areas
• Consider a shower chair or handheld showerhead for seated bathing

Stairways:

• Ensure handrails are secure on both sides of staircases
• Mark the edges of steps with contrasting colors for better visibility
• Keep stairs free of objects

By implementing these home modifications, you can significantly reduce the risk of falls within your living space. Regular assessments of your home environment can help identify new potential hazards as they arise.

The Importance of Regular Health Check-ups in Fall Prevention

Maintaining overall health is crucial in preventing falls. Regular check-ups with healthcare providers can help identify and address potential risk factors before they lead to accidents. Here are key areas to focus on:

Vision and Hearing Tests:

Even minor changes in vision or hearing can significantly increase fall risk. Annual eye exams and hearing tests are essential. If you wear glasses or hearing aids, ensure they fit properly and are worn as prescribed.

Medication Review:

Some medications can increase fall risk due to side effects like dizziness or drowsiness. How often should you review your medications with a healthcare provider? It’s recommended to do so at least annually or whenever a new medication is added to your regimen. During these reviews, discuss any side effects you’re experiencing and explore alternatives if necessary.

Bone Density Screening:

Osteoporosis, a condition that weakens bones, can increase the risk of fractures if a fall occurs. Regular bone density screenings can help detect this condition early, allowing for timely intervention and treatment.

Blood Pressure Monitoring:

Postural hypotension, a sudden drop in blood pressure when standing up, can cause dizziness and increase fall risk. Regular blood pressure checks, including measurements taken while lying down and standing, can help identify this issue.

By staying proactive with these health check-ups, you can address potential fall risks before they become problematic, ensuring better overall health and safety.

Proper Use of Assistive Devices for Fall Prevention

Assistive devices can play a crucial role in preventing falls among older adults. However, it’s essential to use these tools correctly to maximize their benefits and avoid potential risks. Here’s what you need to know about common assistive devices:

Canes:

• Ensure the cane is the correct height – your elbow should be at a comfortable 15-degree angle when holding it
• Use the cane on the opposite side of your weaker leg
• Replace worn-out rubber tips to maintain proper grip

Walkers:

• Choose between a standard walker, a rolling walker, or a rollator based on your needs and abilities
• Ensure the walker is at the correct height – your elbows should be slightly bent when gripping the handles
• For rolling walkers, check that the wheels move smoothly and brakes function properly

Other Mobility Aids:

• Consider using a wheelchair or motorized scooter for longer distances if walking is challenging
• Explore options like stairlifts or ramps for navigating stairs safely

How do you know if you need an assistive device? If you feel unsteady while walking, have difficulty rising from a seated position, or have already experienced a fall, it’s time to consult with a healthcare provider about using an assistive device. They can assess your needs and recommend the most appropriate option.

Remember, using an assistive device incorrectly can actually increase your risk of falling. Always seek proper training from a physical therapist or occupational therapist to ensure you’re using your device safely and effectively.

Nutrition and Hydration: Key Factors in Fall Prevention

While often overlooked, proper nutrition and hydration play significant roles in fall prevention for older adults. A well-balanced diet and adequate fluid intake can help maintain muscle strength, bone density, and overall health, all of which contribute to reducing fall risk.

Essential Nutrients for Fall Prevention:

• Calcium and Vitamin D: Crucial for bone health and muscle function
• Protein: Helps maintain and build muscle mass
• Vitamin B12: Important for nerve function and balance
• Omega-3 fatty acids: May help improve muscle strength and reduce inflammation

How can you ensure you’re getting these nutrients? Incorporate a variety of foods into your diet, including dairy products, leafy greens, lean meats, fish, and fortified cereals. If you’re concerned about your nutrient intake, consult with a registered dietitian or your healthcare provider about potential supplements.

The Importance of Hydration:

Dehydration can lead to dizziness, weakness, and confusion – all of which increase fall risk. Aim to drink at least 8 glasses of water per day, unless otherwise advised by your doctor. Remember that thirst sensation often decreases with age, so it’s important to drink water regularly throughout the day, even if you don’t feel thirsty.

Alcohol Consumption:

While moderate alcohol consumption may have some health benefits, excessive drinking can significantly increase fall risk. It’s important to limit alcohol intake and be aware of how it interacts with any medications you’re taking.

By paying attention to your nutrition and hydration, you can support your body’s natural abilities to maintain balance and strength, further reducing your risk of falls.

The Impact of Sleep on Fall Prevention in Older Adults

Adequate sleep is a crucial yet often underestimated factor in fall prevention among seniors. Poor sleep quality or insufficient sleep can lead to daytime drowsiness, reduced alertness, and impaired balance – all of which increase the risk of falls.

How Sleep Affects Fall Risk:

• Cognitive function: Sleep is essential for memory consolidation and cognitive processing, which are important for maintaining balance and spatial awareness.
• Reaction time: Well-rested individuals have quicker reaction times, allowing them to catch themselves or avoid obstacles more effectively.
• Muscle recovery: During sleep, the body repairs and strengthens muscles, which is crucial for maintaining strength and balance.
• Hormone regulation: Sleep helps regulate hormones that affect bone density and muscle mass.

How much sleep do older adults need? While individual needs may vary, most adults aged 65 and older should aim for 7-8 hours of sleep per night. However, it’s not just about quantity – the quality of sleep is equally important.

Tips for Improving Sleep Quality:

1. Maintain a consistent sleep schedule, going to bed and waking up at the same time each day.
2. Create a relaxing bedtime routine to help signal to your body that it’s time to sleep.
3. Ensure your bedroom is dark, quiet, and at a comfortable temperature.
4. Limit exposure to blue light from electronic devices before bedtime.
5. Avoid caffeine, large meals, and excessive fluids close to bedtime.
6. Engage in regular physical activity, but not too close to bedtime.

If you’re consistently having trouble sleeping, it’s important to discuss this with your healthcare provider. Sleep disorders such as insomnia or sleep apnea are common in older adults and can significantly impact fall risk if left untreated.

By prioritizing good sleep habits, you can improve your overall health and reduce your risk of falls, contributing to a safer and more active lifestyle in your senior years.

Falls and Fractures in Older Adults: Causes and Prevention

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A simple accident like tripping on a rug or slipping on a wet floor can change your life. If you fall, you could break a bone, which thousands of older adults experience each year. For older people, a broken bone can also be the start of more serious health problems and can lead to long-term disability.

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If you or an older adult in your life has fallen, you’re not alone. More than one in four people age 65 years or older fall each year. The risk of falling — and fall-related problems — rises with age. However, many falls can be prevented. For example, exercising, managing your medications, having your vision checked, and making your home safer are all steps you can take to prevent a fall.

Many older adults fear falling, even if they haven’t fallen before. This fear may lead them to avoid activities such as walking, shopping, or taking part in social activities. But staying active is important to keeping your body healthy and actually helps to prevent falls. So don’t let a fear of falling keep you from being active! Learn about what causes falls and how to lower your risk of falling so you can feel more comfortable with staying active.

What causes falls in older adults?

Many things can cause a fall.

• Your eyesight, hearing, and reflexes might not be as sharp as they were when you were younger.
• Certain conditions, such as diabetes, heart disease, or problems with your thyroid, nerves, feet, or blood vessels can affect your balance and lead to a fall.
• Conditions that cause rushed movement to the bathroom, such as incontinence, may also increase the chance of falling.
• Older adults with mild cognitive impairment or certain types of dementia are at higher risk of falling.
• Age-related loss of muscle mass (known as sarcopenia), problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension) are all risk factors for falling.
• Foot problems that cause pain, and unsafe footwear such as backless shoes or high heels, can also increase your risk of falling.
• Some medications can increase a person’s risk of falling because they cause side effects such as dizziness or confusion. The more medications you take, the more likely you are to fall.
• Safety hazards in the home or community environment can also cause falls.

Steps to take to prevent falls

If you take care of your overall health, you may have a lower chance of falling. Most of the time, falls and accidents don’t just happen for no reason. Here are a few tips to help lessen your risk of falls and broken bones, also known as fractures:

Read and share this infographic and help spread the word about how to help prevent falls.

• Stay physically active. Plan an exercise program that is right for you. Regular exercise improves muscles and makes you stronger. Exercise also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis, a disease that makes bones weak and more likely to break
• Try balance and strength training exercises. Yoga, Pilates, and tai chi can all improve balance and muscle strength. You can also try lifting weights or using resistance bands to build strength. Learn more about different types of exercises to improve balance and strength.
• Fall-proof your home. Check out these tips for changes you can make to your home that will help you avoid falls and ensure your safety.
• Have your eyes and hearing tested. Even small changes in sight and hearing are linked to an increased risk for falls. When you get new eyeglasses or contact lenses, take time to get used to them. Wear your glasses or contacts as your eye doctor advises. If you have a hearing aid, be sure it fits well and wear it.
• Find out about the side effects of any medicines you take. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
• Get enough sleep. If you are tired, you are more likely to fall.
• Avoid or limit alcohol. Too much alcohol can lead to balance problems and falls, which can result in hip or arm fractures and other injuries.
• Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. Get your blood pressure checked when lying and standing.
• Use an assistive device if you need help feeling steady when you walk. Using canes and walkers correctly can help prevent falls. If your doctor tells you to use a cane or walker, make sure it’s the right size for you. Walker wheels should roll smoothly. If you borrow walking support equipment from a friend, ask your health care provider to make sure the equipment is the correct size and is safe to use. This is exceptionally important when you’re walking in areas you don’t know well or where the walkways are uneven. A physical or occupational therapist can help you decide which devices might be helpful and teach you how to use them safely.
• Take extra caution when walking on wet or icy surfaces. These can be very slippery! Use an ice melt product or sand to clear icy areas by your doors and walkways.
• Keep your hands free. Use a shoulder bag, fanny pack, or backpack to leave your hands free to hold on to railings.
• Choose the right footwear. To fully support your feet, wear nonskid, rubber-soled, low-heeled shoes. Don’t walk on stairs or floors in socks or in shoes and slippers with smooth soles.
• Consider staying inside when the weather is bad. Some community services provide 24-hour delivery of prescriptions and groceries, and many take orders over the phone.
• Always tell your doctor if you have fallen since your last check-up, even if you did not feel pain when you fell. A fall can alert your doctor to a new medical problem or issues with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.

What to do if you fall

Whether you are at home or somewhere else, a sudden fall can be startling and upsetting. If you do fall, stay as calm as possible and take the following steps:

• Breathe. Take several deep breaths to try to relax. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.
• Decide if you are hurt. Getting up too quickly or in the wrong way could make an injury worse.
• Crawl to a sturdy chair. If you think you can get up safely without help, roll over onto your side. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.
• Slowly sit down in the chair. Put your hands on the chair seat and slide one foot forward so that it’s flat on the floor. Keep the other leg bent so the knee is on the floor. From this kneeling position, slowly rise and turn your body to sit in the chair.
• Get help. If you are hurt or cannot get up on your own, ask someone for help or call 911. If you are alone, try to get into a comfortable position and wait for help to arrive. Prepare for a fall by keeping a well-charged cordless or mobile phone with you at all times and arrange for daily contact with a family member or friend. Emergency response systems are another option: These systems enable you to push a button on a special necklace or bracelet to call for help. Some smartwatches also have this feature.

Keep your bones strong to prevent fall-related fractures

Having healthy bones won’t necessarily prevent a fall, but if you do fall, healthy bones may help prevent serious injury, such as breaking a hip or other bone. Bone breaks and fracture can lead to a hospital or nursing home stay, long-term disability, or even death. Getting enough calcium and vitamin D can help keep your bones strong. So can staying active. Try to get at least 150 minutes per week of physical activity.

Other ways to maintain bone health include quitting smoking and avoiding or limiting alcohol use. Tobacco and alcohol use may decrease your bone mass and increase your chance of fractures. Additionally, try to maintain a healthy weight. Being underweight increases the risk of bone loss and broken bones.

Osteoporosis is a disease that weakens bones, making them thin and brittle. For people with osteoporosis, even a minor fall may be dangerous. Talk to your doctor about osteoporosis.

Falls are a common reason for trips to the emergency room and for hospital stays among older adults. Many of these hospital visits are for fall-related fractures. You can help lower your risk of fractures by keeping your bones strong and following the tips above to avoid falls.

For more information

Centers for Disease Control and Prevention (CDC)
800-232-4636
888-232-6348 (TTY)
[email protected]
www.cdc.gov

National Resource Center on Supportive Housing and Home Modifications
213-740-1364
homemods@usc. edu
www.homemods.org

Rebuilding Together
800-473-4229
[email protected]
www.rebuildingtogether.org

National Falls Prevention Resource Center
571-527-3900
www.ncoa.org/center-for-healthy-aging/falls-resource-center/

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
September 12, 2022

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How to Prevent Falls at Home

One out of four older adults will fall this year, but fewer than half of them will talk with their doctors about it, according to the Centers for Disease Control and Prevention (CDC). Per the CDC, falls are the No. 1 cause of injuries in adults over 65, resulting in hip fractures, cuts, and even serious head and brain injuries that can be fatal.

Even when there’s no serious injury, a fall can be so frightening that people may avoid certain activities out of fear they’ll fall again. And that’s not unreasonable, because if you fall once, your chance of falling again doubles, according to the CDC.

Whether it’s slippery floors, rickety stairs, or electrical cords, some of the most common causes of falls are in the home, where you might have a false sense of security. That’s why fall prevention starts with creating a safe living space.

It doesn’t have to involve a complete house remodel. You can make your home safe from falls with just a few basic changes. Elder care experts offer the following advice for preventing falls at home.

1. Clean up clutter. The easiest way to prevent falls is to keep your home neat and tidy. Remove all clutter, such as stacks of old newspapers and magazines, especially from hallways and staircases.
2. Repair or remove tripping hazards. Sometimes home fixtures can contribute to falls, which can then lead to back pain and other injuries. Examine every room and hallway, looking for items such as loose carpet, slippery throw rugs, or wood floorboards that stick up. Then repair, remove, or replace those items for more effective fall prevention.
3. Install grab bars and handrails. If your mobility is limited, these safety devices can be crucial for going up and down stairs, getting on and off the toilet, and stepping in and out of the bathtub without injuring yourself. Gary Kaplan, DO, the founder and medical director of the Kaplan Center for Integrative Medicine in McLean, Virginia, suggests installing grab bars by toilets and bathtubs and handrails in stairways and hallways. Have a handyman or family member help with this if necessary.
4. Avoid loose clothing. You want to feel comfortable at home, but very baggy clothes can sometimes make you more likely to fall. Opt for better-fitting and properly hemmed clothing that doesn’t bunch up or drag on the ground.
5. Light it right. Inadequate lighting is another major hazard. To create a home that’s easier to navigate, install brighter light bulbs where needed, particularly in stairways and narrow hallways. Robert Bunning, MD, the associate medical director of inpatient services at MedStar National Rehabilitation Hospital in Washington, DC, recommends adding night-lights in bedrooms and bathrooms for better guidance at night.
6. Wear shoes. Socks may be comfortable, but they present a slipping risk. Preventing falls at home can be as simple as wearing shoes. You can also purchase nonslip socks that have grips on the soles of the feet if shoes are too uncomfortable.
7. Make it nonslip. Bathtubs and showers, as well as floors in kitchens, bathrooms, and porches, can become extremely dangerous when wet. To prevent falls on slick surfaces, Dr. Kaplan recommends nonslip mats.
8. Live on one level. Even with precautions like guardrails, stairs can present a significant falling hazard. “If possible, live on one level,” says Kaplan. “Otherwise, be extra careful when you negotiate stairs.” If it’s not possible to live on one level, try to limit the trips you take up and down the stairs.
9. Move more carefully. Dr. Bunning explains that many people fall at home by moving too quickly from a sitting to a standing position and vice versa. Preventing falls can be as easy as taking your time. “All you have to do is pause after going from lying down to sitting and from sitting to standing,” he says. “Also take a pause before using the railing on stairs, whether you’re going up or down.”
10. Join a preventive exercise program. Many community centers, gyms, and health systems offer exercise programs for older adults aimed at preventing falls. These exercise regimens focus on improving balance and strengthening muscles. A physical therapist can also recommend exercise programs and assistive devices, if necessary, to keep you safe.

For older adults, fall prevention means injury prevention. Ask your loved ones to help you ensure that your rooms and stairways are clutter-free and well-equipped with lighting, handrails, grab bars, and nonslip mats — all of which can go a long way toward keeping you safe in your home. In the event a fall does occur, having a proper Medicare plan can help alleviate surprise medical costs.

Additional reporting by Rachael Robertson. 

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