- Falls are the leading cause of fatal and non-fatal injuries for older Americans
- The first step to preventing falls is understanding your fall risk through a handful of simple assessments and fitness tests
- Safety-proof your home, increase strength, balance and mobility, and get regular health check-ups to reduce the risk of falling
Falls are the leading cause of fatal and non-fatal injuries for older Americans, significantly affecting their quality of life. Every 11 seconds, an older adult is treated in the emergency room for a fall, resulting in 2.8 million older adults being treated in emergency departments every year, according to the National Council of Aging.
The key to preventing a potentially dangerous fall is to assess your risk level, safety-proof your home, build your balance and mobility, and make sure to get regular health check ups.
Why Do Older Adults Fall More Often?
In older adults, increased risk of falls is usually caused by a combination of multiple factors, including:
- Physical changes: As we age, we experience a natural decline in muscle strength and bone density, known as sarcopenia. Joint stiffness, slower reflexes, and a drop in blood pressure when you get up — all things that are common as we age — also contribute to increased fall risk. Additionally, age-related vision and hearing impairments reduce the ability to respond to potential hazards.
- Chronic health conditions: Conditions such as arthritis, diabetes, Parkinson’s disease, and severe foot problems can affect balance and mobility. Cognitive impairments, including dementia, also make it harder for individuals to navigate their environment safely.
- Medications: Some medications can have side effects like dizziness, drowsiness, low blood pressure, or impaired coordination — all of which increase the likelihood of falls. The more medications an individual takes, the higher the risk of a fall, especially if they take more than four medications.
- Environmental hazards: Uneven flooring, poor lighting, and obstacles like loose rugs, cords, or clutter and slippery surfaces in the home lead to an increased risk of falls.
The Impact of Frequent Falls
While falls are a common part of aging, frequent falls can have serious long-term ramifications, such as:
- Physical injuries: Falls are a leading cause of fractures (particularly hip fractures) among older adults, resulting in long-term pain, decreased mobility, and the need for long-term medical treatment.
- Psychological effects: Experiencing a fall can lead to fear and anxiety about falling again. This fear can restrict an individual’s activities and social interactions, leading to isolation and depression. It can also further increase the risk of falling.
- Loss of independence: Frequent falls can diminish an individual’s confidence and ability to live independently.
- Financial burden: Treating fall-related injuries can lead to medical bills piling up, causing a heavy financial burden. And non-fatal falls among people ages 65 and up cost the United States over $50 billion annually in medical costs.
How to Assess If You Are at High Risk for Falling
The good news is that there are several ways to minimize the risk of falling. The first step is to assess if you or your loved one are at a high fall risk. There are a couple of ways to evaluate this risk:
- Take this brief assessment: Answer a few short questions about you or your loved one to understand their risk level.
- Try this 30-second fitness test: A personal trainer who specializes in balance & mobility, shares the “sit-to-stand” test to assess your physical fitness.
- Take this checkup recommended by the CDC: This 12-question checkup provides a deeper understanding of the factors contributing to your fall risk.
Monitor Emergency Room and Hospital Visits
Keeping track of how many visits your loved one has made to the emergency room or hospital over the past few years is a helpful marker of potential decline, even if the visits weren’t related to a fall.
Similarly, you should also keep track of falls even if they don’t result in an ER visit to identify recurring patterns.
Monitor and record as many details as possible — noting whether or not the falls are minor or major, what the resulting injury is, what other ailment led someone to the ER, and anything else you think may be important.
If you’re looking to identify patterns in a loved one who is living in an assisted living facility, it’s likely that the facility is keeping track of falls and other health-related concerns. You can ask them for this information to keep with other data points you’ve collected.
Looking at patterns over time can indicate many different things, and you should discuss the findings with your doctor or your loved one’s doctor. For example, you may find that additional support is required to help with daily activities, or that there is something that needs to be monitored or changed. This could be environmental, like a trip hazard in their home, or something like a recent change in medication.
Strategies for Fall Prevention
Preventing falls involves a combination of lifestyle changes, environmental modifications, and medical interventions. Here are some effective strategies:
1. Fall-proof your home:
- There are dozens of ways to make your home safer, and we recommend starting with a home safety assessment. Medicare will often cover these assessments as long as they’re ordered by your primary care physician, so the first step is to speak to them. The agency that performs the assessment will bill Medicare and your Part B benefits will pay for the assessment.
- If you aren’t able to get an assessment covered, you can use the CDC’s guide.
- Here are some essential elements to consider:
- Remove hazards: Secure loose rugs, clear out clutter, and ensure that all cords and cables are out of the way.
- Improve lighting: Make sure that all areas of the home are well-lit, including stairways and hallways. Use night lights in bedrooms and bathrooms, add motion sensors to dark outdoor areas, and glow-in-the-dark tape is a great quick fix in areas where adding permanent lighting is difficult.
- Install grab bars and handrails: Installing grab bars in the bathroom near the toilet and in the shower or tub and placing handrails on both sides of staircases can also provide additional support.
- Secure the bathroom: Consider adding a non-slip rug, a toilet seat extender, or a shower chair when necessary.
2. Exercise and physical activity:
- Having good mobility, balance, and core strength are some of the best ways to prevent a fall. Here are some tips on how to improve yours:
- Strength and balance training: Engage in regular exercise that focuses on balance, and flexibility can help improve stability. Strength train, lift weights or do resistance-based exercises to help strengthen bones. Programs like Tai Chi or gentle yoga are beneficial for enhancing balance and coordination.
- Maintain bone health: Getting adequate intake of calcium and vitamin D in your diet is essential to supporting bone health.
- Daily mobility training: Mobility training helps improve your range of motion and helps prevent falls.
- Get your steps in: Regular walking builds muscle strength and endurance and helps prevent falls.
3. Regular health check-ups:
- Vision and hearing exams: Schedule annual eye and hearing exams and make sure to correct any impairments caused by aging.
- Review medications: Consult with a primary healthcare provider to review and manage medications, and see if there are any available alternatives to medications that may cause dizziness or confusion.
4. Assistive devices:
- Use canes and walkers: Use canes or walkers when needed for additional support — like this adjustable walker — and make sure they are properly fitted!
- Footwear: Wear shoes that are well-fitting, supportive, and non-slip. Avoid walking in socks or slippers that can cause slips.
5. Community support:
- Fall prevention resources: Find local community-based fall prevention programs or workshops near you. These programs often provide valuable information on preventing falls and can offer practical solutions tailored to individual needs. The NCOA has a directory detailing local resources by state.
- Family and caregiver involvement: Educate family members and caregivers about fall risks and prevention strategies. Their support can be instrumental in creating a safer environment.
Frequent falls among the elderly are one of the most common issues as we age, and they can have severe physical, emotional, and financial implications. Thankfully, implementing effective prevention strategies make it possible to reduce the risk of falling and enhance quality of life.
Addressing the risk of falls requires a multifaceted effort involving individuals, their families, healthcare providers, and community support. By working together, we can create safer environments and better care for our loved ones.
