According to the Centers for Disease Control and Prevention (CDC), one in four adults over the age of 65 falls each year, making falls a significant health concern for this population. Falls can result in injuries that range from bruises and scrapes to broken bones and head injuries. In fact, falls are the number one cause of hip fractures, and one in five falls results in head injury or broken bone. Understanding the causes of falls and taking steps to prevent them can help older adults stay safe and maintain their independence.

Causes of Falls in Older Adults

There are many reasons why falls are more prevalent in the older adult population. Some of these include:

• Decreased eyesight, hearing, and reflexes with age
• Sarcopenia, which is age-related loss of muscle mass
• Balance deficits
• Postural hypotension/orthostatic hypotension, which is when blood pressure changes (drops) with transitional movements and can increase the risk of falling
• Pain in feet, knees, hips, or back
• Certain medications that can have side effects of dizziness or confusion

Falls in older adults are a serious concern as they can lead to hip fractures, head injuries, and broken bones. In fact, 1 in 4 adults over the age of 65 fall each year, and falls are the number one cause of hip fractures [1]. There are many reasons why falls are more prevalent in the older adult population, including decreased eyesight, hearing, and reflexes, age-related loss of muscle mass, balance deficits, and medication side effects [2].

Fortunately, falls can be prevented with a few simple steps. For example, removing tripping hazards in the home such as area rugs, cords, and clutter, installing grab bars in the bathroom, and using non-slip mats in the shower can all reduce the risk of falls [3]. Additionally, participating in exercise or balance programs such as Tai Chi, Yoga, and Pilates can improve balance and strength, reducing the likelihood of falls [4].

Fall Prevention Checklist

Preventing falls before they happen is the best way to avoid injury. Here are some tips for reducing hazards that may be present in your house:

Floors, Stairs, Steps:

• Move furniture so that walking paths are clear.
• Remove area rugs or use double-sided tape/non-stick backing to prevent rugs from slipping.
• Keep objects such as books, magazines, blankets, shoes, and boxes out of the walkway and off of steps.
• Tape electrical cords/wires down so you don’t trip; bright-colored tape will make this more visible.
• Make sure stairwell is lit or have a nightlight along stairs so you don’t trip going up or down stairs.
• Make sure there is railing along both sides of the stairwell.

Kitchen:

• If items are in cabinets that you cannot reach, try to put them in lower cabinets.
• If using a step stool, make sure it is steady and you have something else to hold onto for support.
• NEVER stand on a stool or rolling chair to reach.

Bedrooms and Bathrooms:

• If the shower/bathtub floor is slippery, use a non-slip rubber mat on the floor.
• If you have difficulty getting in and out of the tub, have grab bars installed to hold onto.
• A shower chair can also be useful to sit while you shower.
• Have a lamp that is easily accessible next to your bed in case you have to get up in the middle of the night.
• Have nightlights in your bedroom/path to the bathroom to see more easily if up in the night.

How to Get Up if You Fall

If you do fall, it’s important to know what to do to avoid further injury. Here are some steps to follow:

• Roll over to your side and turn to your hands and knees.
• If you are unable to do this, turn yourself to where you are sitting upright on your bottom.
• Crawl or scoot yourself over to the nearest piece of sturdy furniture.
• Prop your hands onto the chair/sofa/chest and bring one foot forward (still kneeling on the other knee).
• Use the foot that is flat on the ground (if possible, the stronger leg) and both arms to push yourself into standing.
• Sit down and call someone if there are any injuries or you think you may be hurt.
• Use your smartwatch or life alert if you fall and are unable to get up. You can also crawl to the nearest phone to call for help.

Take Control of Your Health

Maintaining good overall health and wellness can help prevent falls. It’s essential to take control of your health. Talk to your doctor about physical and occupational therapy if you’re worried about falling or have had a fall. They can assess and intervene where necessary, review medications to ensure that you’re aware of any side effects, and suggest interventions to improve strength and balance. Getting your vision and hearing checked annually can also help to reduce the risk of falls [5].

Summary

Here are the main takeaways to prevent falls in older adults:

• Become consistent with a good exercise or balance program (Tai Chi, Yoga, and Pilates are great for balance!). You can also see a physical therapist to assess your balance and provide interventions to improve strength and balance! 
• Talk to a healthcare provider – if you are worried about falling or have had a fall, let your healthcare provider know so they can assess and intervene where necessary. 
• Review medications with a doctor or pharmacist regularly to ensure that you are aware of any side effects. And always take medications ONLY as prescribed. 
• Get your vision and hearing check annually to ensure that these may not be contributing to loss of balance or falls. 
• Utilize a device such as a life alert or smart watch in case you fall and are unable to get up. 
• Keep your home safe! You may consider home modifications to make your home safe and accessible. 

If you want to get specific help to improve your balance and decrease your risk of falls, book an appointment with us now!

Susannah Azofeifa, PT, DPT was born and raised in Owensboro, Kentucky but now calls North Augusta, SC home. She attended the University of Louisville and graduated with a bachelor’s degree in Kinesiology/Exercise Science in 2017. She then attended Breanu University where she received her doctorate of physical therapy in 2021. Susannah enjoys treating a wide range of orthopedic conditions and also specializes in treating pelvic floor dysfunction, and pre and post partum individuals. She enjoys spending time doing activities such as CrossFit, being outdoors, traveling, being with family, and spending time with her husband, Fabian. She heads up our Pelvic Floor Physical Therapy (PFPT) program here at ProActive.

References

1. Centers for Disease Control and Prevention. (2021). Important facts about falls. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
2. Rubenstein, L. Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(suppl_2), ii37-ii41. doi: 10.1093/ageing/afl084
3. World Health Organization. (2007). WHO global report on falls prevention in older age. https://www.who.int/ageing/publications/Falls_prevention7March.pdf
4. Sherrington, C., Whitney, J. C., Lord, S. R., Herbert, R. D., Cumming, R. G., & Close, J. C. (2008). Effective exercise for the prevention of falls: a systematic review and meta-analysis. Journal of the American Geriatrics Society, 56(12), 2234-2243. doi: 10.1111/j.1532-5415.2008.02014.x
5. Tinetti, M. E., & Kumar, C. (2010). The patient who falls: “It’s always a trade-off”. JAMA, 303(3), 258-266. doi: 10.1001/jama.2009.2024