Fall precautions: Expert tips to reduce risks for older adults

If you’re an older person or care for a senior, falls and fall precautions are probably on your mind — and for good reason. Every year, one in four people over the age of 65 experiences a fall, and falls are the leading cause of injury for seniors, according to the Centers for Disease Control and Prevention (CDC).

“Falls are dangerous for anyone, but specifically for seniors,” says Shauna Buchmoyer, occupational therapist and certified fall prevention specialist at United Disabilities Services Foundation (UDSF). This is due to older people’s slower rates of healing and recovery, as well as the long term impacts that falls can have on their bodies, Buchmoyer adds.

The good news, though, is that many falls in seniors can be prevented by simple measures, including strength and balance training, medication management and home safety precautions. Here, we’ll take a look at the causes of falls in seniors, the impacts of these falls and most importantly, how to prevent seniors from falling.

Why do seniors fall?

“As we age, our bodies go through a series of changes, including [differences in] vision, sensory, strength, balance, endurance and cognitive change,” Buchmoyer says. “Some of these changes lead to an increase in falls.”

James Mortensen, a physical therapist and regional director of FYZICAL Therapy and Balance Centers in Las Vegas, says there are several experiences common to the senior population that can make them more vulnerable to falling. These include:

• A decrease in muscle strength that comes with aging.
• Changes in balance and gait (walking).
• Changes in vision, such as cataracts or macular degeneration.
• Chronic conditions that affect mobility, such as arthritis, diabetes and Parkinson’s disease.
• Medications that cause dizziness or lower blood pressure.
• Cognitive issues, including dementia, which can affect coordination and judgment.

While the risk of falling is a concern for all older individuals, there are certain factors that can increase that risk, says Buchmoyer. In addition to the body changes listed above, seniors are at higher risk of a fall if they:

• Are aged 60 and older.
• Have been hospitalized in the last 12 months.
• Have three or more coexisting chronic diagnoses.
• Have a prior history of falling in the last three months.
• Live in a space with environmental hazards.
• Wear unsupportive footwear.
• Experience incontinence.
• Are on four or more prescription medications.

Why are falls so dangerous for seniors?

One reason falls are especially dangerous for seniors is because it can take them longer to recover, says Buchmoyer. “For areas of injury to heal, they need adequate blood circulation, which is more difficult as people age,” she explains. “Oftentimes, skin is much more fragile and thinner, which makes cuts, bumps and bruises more likely and highly impactful.”

But it’s not just bumps, bruises and broken bones that are concerning. “Some seniors are at a higher risk for bleeding due to medications they are on, which opens them up to the potential for many other injuries, such as brain bleeds, abdominal bleeding and large contusions,” Buchmoyer adds. 

Falls can also have domino effects in older people, Mortensen adds, leading to other serious health conditions, such as:

• Fractures, especially of the hip, wrist and spine.
• Head injuries that are serious or life-threatening.
• Immobility that leads to complications like blood clots, bedsores and pneumonia
• Psychological issues, increased anxiety and depression.
• Reduction in physical activity, which can further decrease balance and strength.

Serious or chronic health conditions can potentially lead to a loss of independence for seniors, resulting in the need for assistance with daily activities or even long-term care. In turn, this can result in a reduced quality of life.

“For areas of injury to heal, they need adequate blood circulation, which is more difficult as people age.”

—Shauna Buchmoyer, occupational therapist and certified fall prevention specialist

Fall precautions for seniors and caregivers

As worrisome as falls are, we are not powerless over them. There are concrete steps seniors, their caregivers and their loved ones can take to prevent falls. Here are some fall prevention tips Mortensen says to keep in mind both at home and when out and about, as well as lifestyle improvements that can help reduce the risk of falling.

Fall precautions at home

• Clear away excess clutter.
• Secure any loose rugs.
• Make sure there is good lighting, especially on stairs and in narrow hallways.
• Install safety devices, such as grab bars in bathrooms, handrails on stairs and non-slip mats in bathtubs. 
• Move lamps and appliances to minimize cords stretching across rooms and walkways.
• Keep everyday items at arm- or waist-level to prevent bending and reaching.

It’s a good idea to implement preventative safety practices, such as bathing with assistance if needed or getting help with certain household chores and tasks, to eliminate dangerous situations.

Additionally, consider rearranging the living space so seniors live in one main area or on one floor (moving bedroom furniture downstairs in a two-story home, for example). Since stairs are a top place for people to fall, it’s better to eliminate or avoid them before a mobility problem arises.

Fall prevention for seniors when out and about

• Be mindful of surfaces, like uneven sidewalks, curbs or wet/slippery surfaces.
• Wear appropriate footwear, which include shoes with non-slip soles and adequate support.
• Plan your routes ahead to avoid risky areas.
• Ensure there will be good lighting if you plan to be out in the evening.

Assistive devices, such as canes, walkers or other mobility aids, may be helpful for stability. Check with a physical therapist first to determine if one is necessary, to have it properly fitted and to learn how to use the device correctly. If a walker or cane is too tall or too short, it can present a fall risk on its own.

Lifestyle modifications to prevent seniors from falling

• Engage in regular exercise that promotes balance, strength and flexibility, such as yoga, Tai Chi or Pilates.
• Work with a physical or occupational therapist to improve balance and mobility.
• Regularly review medications with a healthcare provider to minimize side effects that increase the risk of falling.
• Get regular vision and hearing checks, and use corrective lenses and hearing aides when needed.
• Stay active in your community to promote physical and psychological well-being.

The bottom line 

The prospect of you or a loved one experiencing a fall can be difficult to consider, but it’s not something you can ignore. Preventing falls in seniors is vital. 

There are simple steps you can take to reduce these risks, such as doing strength and balance exercises, removing hazards in the home and reviewing your routes for safety before leaving the house. Still, you may still have lingering questions or concerns. Reach out to your healthcare team with any questions or concerns. You may also consider consulting your local Agency on Aging for support.