Falls are the leading cause of injury and accident-related death for adults over 65. The Centers for Disease Control and Prevention says that one in four adults in this age group fall annually. Many falls are never reported, and the biggest predictor of falling is a previous fall. Thankfully, we can take steps to prevent falls and the injuries they cause. Here, we explore factors contributing to falls and provide fall prevention strategies for seniors.

Why do older adults fall?

Many facets of aging contribute to the increased risk of falling in later life. Some are tied to physical changes in the body or the effects of illnesses, chronic conditions, and medications. Our home environments and lifestyle choices also play a part. Let’s take a look at some causes of falls.

Physical changes

• Muscle and joint pain: The rate at which adults lose muscle strength can double after age 60. Shifts in posture and center of gravity happen as muscles weaken, which can cause instability. Arthritis creates inflammation and pain in joints like the spine, hips, and knees, leading to difficulty turning, transitioning, and managing steps.
• Nerves: Often tied to diabetes, neuropathy gives rise to numbness in the hands and feet. Poor sensation makes holding or gripping surfaces challenging, which in turn causes difficulty with walking or using assistive devices.
• Vision and hearing changes: Eye conditions that happen with age include cataracts, glaucoma, and macular degeneration. These limit a person’s visual field and depth perception, often resulting in missteps. Hearing loss is also common in later life. Because it is disorienting and affects balance, people with hearing loss are at higher risk of falling.
• Cognitive decline: Dementia can make safely navigating the environment hazardous due to symptoms like confusion, anxiety, and impulsive behavior.

Environmental hazards

Our surroundings can support our safety or present hazards. Some issues contributing to falls in our environment and home include:

• Obstructed walking paths in the home: Walkways in rooms may not be clear, with area rugs or furniture in the way.
• Poor lighting: Dim lighting may be a safety hazard for older adults with impaired vision.
• Entrances to the home: Outdoor weather can produce slippery conditions, and steps may be difficult for adults with pain or mobility issues to manage. 

Medications

Many medications that improve health issues also produce side effects like drowsiness or dizziness, which can lead to falls. As effective as they are, drugs that lower blood pressure, pain, or anxiety can be culprits.

Lifestyle

• Dehydration: In late life, our sense of thirst diminishes, so many older adults don’t drink enough fluid. Faintness, dizziness, and even confusion result from dehydration.
• Alcohol and other recreational drugs: Mental clarity and physical abilities are hindered by sedating drugs, including alcohol — the effects are even greater with advancing age.
• Weight and activity: Being overweight, underweight, or sedentary is tied to a greater likelihood of falls. 

Fall prevention strategies for seniors

Despite these contributing factors, older adults can take steps to prevent falls. Whether they are simple home changes, lifestyle choices promoting physical health, or regular visits to medical professionals, let’s explore these fall prevention strategies for seniors.

Exercise and activity

The importance of remaining active to prevent falls cannot be overstated. Maintaining strength, flexibility, and balance is key to healthy aging. Tendons and ligaments stabilize our joints but stiffen if unused. This stiffening limits flexibility and makes us more vulnerable to falls and lasting injuries.

• Flexibility: The key to flexibility is to stretch. Stretching exercises allow joints to warm up and operate smoothly. Standing or seated yoga with a trained teacher is a great option. 
• Strength: Strength training supports proper alignment, posture, and locomotion. Weights, resistance bands, and calisthenics, like push-ups, are examples of muscle-building activities. If push-ups are not possible, even bodyweight exercises can be helpful. Experts recommend strength training twice a week.
• Balance: If an older adult cannot sit or stand safely, balance training can help prevent falls. Seeking instruction from a trainer or physical therapist is best in this case.

Assistive devices

Weakness, injury, or a chronic health condition may warrant using an assistive device. A physical or occupational therapist can instruct someone on using new equipment and ensure correct body positioning.

• Transfer devices: Transfers are moves from one position or area to another. Examples include going from sitting to standing or from the bed to a chair. Helpful assistive devices include grab bars, transfer boards, electric recliners, and mechanical lifts.
• Mobility aids: Canes, walkers, and wheelchairs are examples of durable medical equipment (DME) and help preserve the independence of many older people. DME often requires a doctor’s prescription and can potentially be covered by Medicare.
• Seating support: Elevated commode seats with armrests are available to make toileting easier and safer. Tub benches fit over the lip of the basin, allowing people to sit and scoot into the shower area rather than standing and stepping into the tub.

Safety measures in the home environment

You can make adjustments in your living area and surrounding environment to help prevent falls. While some home modifications can be costly, many solutions are free and require simply rearranging items or ensuring good lighting. 

• Furniture and walkways: Items in the center of the room can be obstacles. If you have a coffee table, ensure it’s far enough from your sofa to walk between them comfortably. If you use a walker or other mobility device, make sure it fits. Keep walkways clear of wires, pet toys, and other items.
• Area rugs: Area rugs can be major trip hazards. Remove them from walkways and rooms like the bedroom to decrease the risk of tripping, especially at night when it is harder to see.  
• Ensure proper lighting: Make sure there are enough easily accessible lights in all areas of the home, including closets.
• Entrances/steps: These areas must be illuminated and well-maintained through different weather conditions. Consider installing a ramp, nonskid pads, bright tape, or sturdier handrails.
• Footwear: Ill-fitting shoes or those with worn treads are a concern. Make sure you have nonslip shoes in the correct size.

[Read More: How to Make Each Room Safe to Age in Place]

Routine health checks can prevent falls

Regular health checkups can help prevent falls. Generally, the sooner an abnormality is identified and addressed, the less likely it is to generate a bigger problem.

• Physicals: Medicare annual wellness visits include memory assessments, balance checks, and fall screening. Patients with vision and hearing trouble can be referred to specialists at these visits.
• Blood work: Routine blood work may uncover early signs of a disorder, such as an electrolyte imbalance or anemia. Either of these conditions can lead to a fall if not corrected.
• Medication reviews: Clinicians, including pharmacists, review medications and determine what is appropriate and safe. They can advise if certain medications might increase the risk of falling.

Some falls do not result in significant injury, even in older adults, yet research demonstrates that older adults who repeatedly fall are at higher risk of dying from issues like hip fractures and brain injuries. It’s possible to address the causes of falls in older adults and prevent many of them with these tips. Placing safety and prevention at the forefront of our minds supports healthy, successful aging.