What are the main causes of falls in older adults. How can seniors prevent falls and fractures. What role does exercise play in fall prevention. How can home modifications reduce fall risk. Why is medication management crucial for fall prevention. How do vision and hearing impact fall risk in seniors. What are the best assistive devices for preventing falls in older adults.

Understanding the Prevalence and Impact of Falls in Older Adults

Falls represent a significant health concern for older adults, with more than one in four individuals aged 65 and over experiencing a fall each year. This statistic underscores the importance of fall prevention strategies for maintaining independence and quality of life in seniors. As the risk of falling increases with age, it’s crucial to understand the potential consequences and take proactive measures to mitigate this risk.

Falls can have severe repercussions for older adults, often resulting in broken bones and potentially leading to long-term disability. The impact of a fall extends beyond physical injuries, affecting an individual’s confidence and willingness to engage in daily activities. Many seniors develop a fear of falling, which can lead to self-imposed restrictions on their mobility and social interactions.

The Psychological Impact of Falls

Fear of falling is a common psychological consequence that can significantly impact an older adult’s quality of life. This fear may cause seniors to avoid activities such as walking, shopping, or participating in social events. However, it’s important to recognize that maintaining an active lifestyle is crucial for overall health and can actually help prevent falls. Addressing this fear and encouraging continued engagement in daily activities is an essential aspect of fall prevention strategies.

Identifying Key Risk Factors for Falls in Seniors

Understanding the various factors that contribute to falls in older adults is crucial for developing effective prevention strategies. These risk factors can be broadly categorized into physical, medical, and environmental causes.

Physical and Sensory Changes

• Declining eyesight and hearing
• Reduced reflexes and reaction time
• Age-related loss of muscle mass (sarcopenia)
• Balance and gait problems

As we age, our sensory abilities and physical capabilities naturally decline. These changes can significantly impact an individual’s ability to navigate their environment safely and respond quickly to potential hazards.

Medical Conditions and Medications

• Chronic conditions like diabetes, heart disease, and thyroid problems
• Mild cognitive impairment and certain types of dementia
• Postural hypotension (sudden drop in blood pressure when standing)
• Side effects from medications

Various medical conditions can increase the risk of falls by affecting balance, coordination, and overall physical function. Additionally, the side effects of certain medications, such as dizziness or confusion, can contribute to fall risk.

Environmental Hazards

• Cluttered living spaces
• Poor lighting
• Loose rugs or uneven flooring
• Lack of handrails or grab bars

The home environment plays a significant role in fall prevention. Identifying and addressing potential hazards can greatly reduce the risk of falls for older adults.

Effective Exercise Strategies for Fall Prevention

Regular physical activity is one of the most effective ways to reduce fall risk in older adults. Exercise not only improves muscle strength and flexibility but also enhances balance and coordination. What types of exercises are most beneficial for fall prevention?

Balance and Strength Training

Incorporating balance and strength training exercises into a regular routine can significantly improve stability and reduce fall risk. Activities such as yoga, Pilates, and tai chi are excellent options for improving balance and building core strength. Additionally, resistance training using weights or resistance bands can help maintain and build muscle mass, which is crucial for maintaining stability and preventing falls.

Weight-Bearing Activities

Engaging in mild weight-bearing activities, such as walking or climbing stairs, offers dual benefits for older adults. These exercises not only improve overall fitness and coordination but also help slow bone loss associated with osteoporosis. By maintaining bone density, seniors can reduce the risk of fractures in the event of a fall.

How often should older adults exercise for optimal fall prevention benefits? Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, combined with muscle-strengthening activities at least two days a week. Always consult with a healthcare provider before starting a new exercise regimen to ensure it’s appropriate for your individual needs and health status.

Creating a Fall-Proof Home Environment

Modifying the home environment is a crucial step in reducing fall risk for older adults. By identifying and addressing potential hazards, seniors can create a safer living space that supports their independence and well-being. What are some key strategies for fall-proofing a home?

Lighting and Visibility

• Ensure adequate lighting throughout the home, especially in hallways and stairwells
• Install night lights in bedrooms, bathrooms, and along nighttime paths
• Use high-contrast colors to make edges of steps and transitions between rooms more visible

Flooring and Furniture Arrangement

• Remove or secure loose rugs and mats
• Keep walkways clear of clutter and electrical cords
• Arrange furniture to create clear pathways
• Consider installing non-slip flooring in bathrooms and kitchens

Bathroom Safety

• Install grab bars near toilets and in showers or bathtubs
• Use non-slip mats in showers and bathtubs
• Consider a raised toilet seat or shower chair for added stability

Stairway Safety

• Ensure handrails are secure on both sides of staircases
• Mark the edges of steps with bright, contrasting tape
• Keep stairs well-lit and free of clutter

By implementing these home modifications, older adults can significantly reduce their risk of falls and create a living environment that supports their safety and independence.

The Role of Regular Health Check-ups in Fall Prevention

Regular health check-ups play a crucial role in fall prevention for older adults. These assessments allow healthcare providers to identify and address potential risk factors before they lead to falls. What specific health checks are important for fall prevention?

Vision and Hearing Tests

Regular vision and hearing tests are essential for fall prevention. Even small changes in sensory perception can significantly increase fall risk. Ensure that eyeglass prescriptions are up-to-date and that hearing aids, if used, fit properly and are worn consistently.

Medication Reviews

Comprehensive medication reviews are crucial for identifying potential side effects or interactions that could increase fall risk. Healthcare providers should regularly assess all medications, including over-the-counter drugs and supplements, to ensure they are necessary and not contributing to fall risk.

Balance and Gait Assessments

Regular assessments of balance and gait can help identify early signs of instability. Healthcare providers may recommend specific exercises or physical therapy to address any identified issues and improve overall stability.

Bone Density Screenings

For older adults, particularly those at risk for osteoporosis, regular bone density screenings are important. These tests can help identify individuals who may benefit from interventions to improve bone strength and reduce fracture risk in the event of a fall.

The Importance of Proper Footwear and Assistive Devices

Proper footwear and the correct use of assistive devices play a significant role in fall prevention for older adults. How can seniors choose the right shoes and mobility aids to enhance their stability and reduce fall risk?

Selecting Appropriate Footwear

• Choose shoes with non-slip soles and good traction
• Opt for shoes that fit well and provide adequate support
• Avoid backless shoes, high heels, and shoes with slippery soles
• Consider orthopedic shoes or custom orthotics if recommended by a healthcare provider

Using Assistive Devices Correctly

Assistive devices such as canes and walkers can provide valuable support and stability when used correctly. It’s essential to work with a healthcare provider or physical therapist to select the right device and learn how to use it properly. Key considerations include:

• Ensuring the device is the correct size and height for the individual
• Learning proper techniques for using the device on different surfaces and in various situations
• Regularly inspecting the device for wear and tear, especially walker wheels and rubber tips on canes
• Considering additional features like built-in seats on walkers for rest breaks

By choosing appropriate footwear and using assistive devices correctly, older adults can significantly enhance their stability and reduce their risk of falls.

Nutrition and Hydration: Often Overlooked Factors in Fall Prevention

While exercise and environmental modifications are often emphasized in fall prevention strategies, the role of nutrition and hydration is equally important but sometimes overlooked. How do diet and fluid intake impact fall risk in older adults?

The Impact of Nutrition on Fall Risk

Proper nutrition plays a crucial role in maintaining muscle strength, bone density, and overall health, all of which contribute to fall prevention. Key nutritional considerations include:

• Adequate protein intake to support muscle mass and strength
• Sufficient calcium and vitamin D for bone health
• A balanced diet rich in fruits, vegetables, and whole grains for overall health and energy
• Monitoring and addressing any unexplained weight loss, which can lead to muscle weakness and increased fall risk

The Role of Hydration in Fall Prevention

Proper hydration is essential for maintaining balance and preventing dizziness, which can lead to falls. Dehydration can cause a drop in blood pressure, leading to lightheadedness and increased fall risk. Older adults should:

• Aim to drink adequate fluids throughout the day, even if not feeling thirsty
• Be aware that some medications can increase fluid needs or contribute to dehydration
• Consider setting reminders or using apps to track fluid intake
• Consume water-rich foods like fruits and vegetables to supplement fluid intake

By paying attention to nutrition and hydration, older adults can further reduce their fall risk and support overall health and well-being.

Addressing Cognitive Factors in Fall Prevention

Cognitive health plays a significant role in fall prevention for older adults. Mild cognitive impairment and certain types of dementia can increase fall risk by affecting judgment, spatial awareness, and reaction time. How can cognitive factors be addressed to reduce fall risk?

Cognitive Training and Mental Stimulation

Engaging in activities that challenge the mind can help maintain cognitive function and potentially reduce fall risk. These activities may include:

• Puzzles and brain games
• Learning new skills or hobbies
• Reading and engaging in stimulating conversations
• Participating in social activities and community events

Addressing Cognitive Impairment in Fall Prevention Strategies

For older adults with cognitive impairment, fall prevention strategies may need to be adapted. Consider the following approaches:

• Simplifying the home environment to reduce confusion and clutter
• Using visual cues and reminders for safety practices
• Implementing structured routines to promote familiarity and reduce anxiety
• Ensuring caregivers are trained in fall prevention techniques specific to individuals with cognitive impairment

By addressing cognitive factors alongside physical and environmental considerations, a more comprehensive approach to fall prevention can be achieved, supporting the safety and well-being of older adults across the cognitive spectrum.

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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