Preventing Falls in Older Adults
By Mark Speechley, PhD
First, the good news: everybody falls – it’s normal – ask any toddler or hockey player! And fortunately, most falls do not cause serious injury.
Now, the not so good news: as we age, about one third of us start to fall in situations where we would not have fallen when we were younger. Suddenly, we slip on a floor or trip over a doorsill that we’ve used safely for decades. This is a warning sign. When older adults fall, they are about two and a half times more likely to fall again in the next year.
The consequences of falls can be major – a broken wrist, leg, hip, even a head injury. And, it usually takes older adults longer to recover. Injuries to bones, muscles, and joints can restrict your movements and keep you from living as independently as you would like.
But, back to the good news: an unexplained fall can be a great opportunity for you to start taking back control. Excellent research on thousands of people has shown clearly that many falls can be prevented.
Why do we fall?
Most falls happen for more than one reason. Normal, age-related changes in our body combine with things in our environment to cause a fall. For example, cataracts in our eyes reduce our ability to see in dim light, and it is normal for our legs to become weaker with age. These factors can come together and make us trip over something because we didn’t see it, or couldn’t recover our balance in time.
The best approach to fall prevention is to use strategies that adapt your body to your environment, and adapt the environment to your body.
Adapting your body to the environment
Your balance system is an amazingly complex machine that usually works automatically. With proper maintenance, it can be kept in good operating condition. The research evidence is overwhelming that regular physical activity is good for you in many ways, including preventing falls. The most helpful exercise programs involve walking, lifting weights, yoga, swimming, or Tai chi.
Leg strength is very important to our balance system, and it can be maintained through regular walking. You can increase grip strength in your hands by squeezing a small rubber ball, even while you watch television. Get regular eye checkups to keep your eyeglass prescription up to date. Take care of your feet, because corns and calluses can impair balance.
Dizziness is a common complaint in older adults. Certain medications can impair balance. Be sure to mention any problems with dizziness to your doctor, especially after starting a new medication. Keep an up-to-date list of all your prescription and over-the-counter medications. Show it to the doctor, nurse practitioner, or pharmacist before starting any new medication.
Some falls occur when people are in a rush and not paying full attention. Perhaps everyone would be a bit healthier if we could just slow down a bit!
Adapting your environment to your body
Here are some tips on fall-proofing your environment:
- Install brighter lights in dimly lit areas, especially staircases.
- Install handrails on stairs that are of the right size for you to grip.
- Put non-slip strips on the bottom of rugs beside your bed or the bathtub to prevent them from slipping across the floor. Or, replacing them with mats with a rubberized bottom.
- Have grab bars installed in your bathtubs. (Get help from an occupational therapist on installing these properly.)
- Wear shoes that fit properly and do not have slippery soles or heels. Slip treads over your winter boots to improve your grip on ice during winter.
Have you considered using hip protectors? These plastic shields fit in pockets in your underwear, right over your hipbones. Several excellent studies have shown that they can reduce your risk of hip fracture when you fall. Like seat belts, they can be a little uncomfortable in the beginning. Also, like seat belts, you have to wear them for them to do any good!
Maintaining bone health
Research has shown that physical activity, sunlight, and social activity are good for us in many ways, including our bone health. Combine them with a healthy diet, supplemented with Vitamin D and Calcium.
Weight-bearing physical activity helps keep your bones strong to reduce the risk of fracture if you do fall. Tai Chi and strength training are two weight-bearing exercises that have been proven very helpful in preventing falls. They increase the strength of your legs, ankles, and feet. They can also improve your walking stride and to help you keep a good sense of balance.
Before you start any physical activity program, discuss your plans with a health care professional. Make sure that the program emphasizes safety and can be tailored to suit your needs. This is especially important if the activity is new to you. Get guidance from a qualified leader.
Your local seniors club or public health unit can probably help you find physical activity programs for older adults. If there aren’t any programs for older adults in your community, see if you can get one started at the local seniors club, recreation department, college or university.
Professionals who can help with preventing falls
Your family doctor or nurse practitioner can address overall health, dizziness, eyesight, and medications. Physical therapists and kinesiologists are experts on muscle strength, range of motion, and exercise programs. Occupational therapists are experts on helping you make your home environment safe. Nutritionists are experts on healthy eating.
About the Author
Mark Speechley, PhD, Western University, London Ontario
Your home safety checklist
Anyone can fall, but the risk of falling becomes greater with age. Health Canada reports that every year, one in three Canadian seniors will fall at least once. Nearly half of those falls will occur in the home — most often in the bathroom or on the stairs.
Factors that can increase your risk of falling include:
decreased muscle and
reduced vision or hearing
unsafe conditions in and around your home.
We have prepared this home safety checklist to help you think about changes you might want to make to reduce falling risks.
Safety on the stairs
- Do not store loose items on stairs.
- Repair uneven or broken steps.
- Install a light switch at both the top and bottom of the staircase.
- Make sure carpets are securely attached and have no rips.
- Remove loose rugs or secure them with double sided, non-slip backing.
- Install solid handrails on both sides of the stairway.
- Wear shoes indoors. Slippers can increase the risk of falling.
Safety in the bathroom
- Use a rubber bath mat for the tub and shower. Install the mat when the tub is dry.
- If you need to, use a bath seat in the shower.
- Install grab bars by the toilet and in the bath.
- Store items such as soap and shampoo within easy reach
- Install a raised toilet seat, if you need one.
- Consider upgrading to a walk in tub. This makes it easy to get in, and they have great safety features. There are also hydrotherapy options, such as water jets.
- Think about getting cordless phones for the main rooms you use, so that you do not have to rush to answer the phone.
- List emergency number in large print near your phones.
- Think about getting an alert device in case you fall and are unable to get up.