Fall Prevention - What Makes Older Adults at Risk?

In our practice, we see many clients who are experiencing falls. Whether they are at home, in assisted living communities or nursing homes, their age, lifestyle and the progression of multiple types of disease states contribute to their fall risk. What we are told by geriatricians is that if an older adult has multiple falls, they are at grave risk for a catastrophic fall that will change their life. In our work as Care Managers, we are very focused on our client’s goals. We collaborate with our client’s families, Physical and Occupational Therapists, our client’s physicians, specialists, and private caregivers to put in place a plan to proactively support our client’s safety in their home and prevent these major events from happening. During the holidays, be especially mindful about fatigue as well as boxes and “stuff” from celebrations changing your loved one’s environment creating tripping hazards. Although falls can still happen even with the best laid plans, let us look at this very informative article from the National Institute on Aging at the National Institute of Health to help you learn the causes of falls and what we can do to prevent them.

NIA/NIH: Falls and Fractures in Older Adults

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 do not just happen for no reason. Here are a few tips to help lessen your risk of falls and broken bones, also known as fractures:

  • 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 is 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 are walking in areas you do not 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. Do not 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. 

nia.nih.gov