Preventing falls in independent older adults

Falls are the leading cause of injuries for people ages 65 and up. One-third of independently living older adults fall annually, and half of their falls occur in the home. Half of all falls cause injury, and 10-20% cause serious injuries (such as fractures, traumatic brain injuries, and injuries to internal organs) that require hospitalization and transfer to a nursing home; some people who fall can never live independently again.

old man who has fallen on the floor

What are some risk factors for falling?

  • Muscle weakness, gait, and balance disorders
  • Numbness in feet
  • Decreased eyesight, hearing, reflexes
  • Tint-changing lenses or bifocals
  • Diabetes, heart disease, and problems with the thyroid, nerves, feet, and blood vessels, which decrease balance
  • Dementia, which impairs gait, balance, and hazard recognition
  • Blood pressure that drops too much when you stand (orthostatic hypotension)
  • Confusion, lack of sleep
  • Taking medications to treat anxiety, depression, psychosis, pain, and sleep disorders, such as opioids, benzodiazepines, and antidepressants
  • Taking multiple medications
  • Rushing to the bathroom
  • Being female or 85 or older
  • Having already fallen
  • Being worried about falling

elderly person walking with a cane

Because the number of risk factors you have increases your risk of falling, you can decrease your risk of falling by modifying even a few risk factors.

How can I decrease my risk of falling?

  • DO exercise—it’s the single most effective fall prevention intervention, lowering the risk of falling between 12 and 20%.
  • DO get at least 150 minutes of physical activity each week.
  • DO tell your doctor when you fall, even if you’re not injured.
  • DO find out about possible side effects of your medications and talk to your doctor if they make you dizzy or confused.
  • DO ask your doctor if it’s possible to reduce the number of medications you take.
  • DO ask your doctor about a referral to physical therapy for balance and gait training.
  • DO get your eyes and feet checked out by a doctor.
  • DO have an occupational therapist conduct an in-home safety assessment.
  • DO keep a flashlight and phone next to your bed.
  • DO make sure sofas and chairs are the right height to get out of easily.
  • DO install grab bars by the toilet and bathtub—most falls with injuries occur in the bathroom.
  • DO use a raised toilet seat, a shower chair, or a hand-held shower.
  • DO get assistance from another person with bathing.
  • DO keep cords and wires near walls and away from walking paths.
  • DO install and always use handrails on the stairs.
  • DO make sure stairs are adequately lighted, and always turn on the lights before proceeding.
  • DO have a step-free entrance to your home.
  • DO use caution when walking on wet or icy surfaces.
  • DO always wear your glasses or hearing aid.
  • DO wear nonskid, rubber-soled, low-heeled shoes.
  • DO wait for tint-changing lenses to change completely before walking.
  • DO know where your pet is when you’re walking so it doesn’t trip you.
  • DO get enough sleep.
  • DO limit alcohol.
  • DO stand slowly.
  • DO use assistive devices safely.
  • DON’T stand on chairs.
  • DON’T walk on newly washed floors.
  • DON’T use small throw rugs or keep objects on the stairs.
  • DON’T wear backless shoes or high heels.
  • DON’T walk if you’re confused–wait for your head to clear or somebody to help you.

Falls are not an inevitable part of aging. Most falls can be prevented. By reducing your risk of falling, you can remain independent and safe in your own homes for as long as possible.