Falls are the leading cause of injury death among adults 65 and older. Every year, one in four seniors falls, and falls cause 95% of hip fractures. A hip fracture in an elderly person often marks the beginning of rapid decline—up to 50% of seniors who break a hip never return to their previous level of function.
The good news: most falls are preventable. With the right modifications, exercises, and awareness, you can dramatically reduce your parent's risk.
Many people assume falling is just part of getting old. It's not. Falls happen for specific, addressable reasons: medication side effects, vision problems, home hazards, muscle weakness, balance issues. Addressing these factors can prevent most falls.
Why Elderly People Fall
Physical Factors
- Muscle weakness: Especially in legs and core
- Balance problems: Inner ear issues, neurological conditions
- Vision changes: Depth perception, contrast sensitivity, cataracts
- Foot problems: Neuropathy, bunions, improper footwear
- Arthritis: Joint pain and stiffness affect mobility
- Chronic conditions: Parkinson's, stroke, diabetes complications
Medication Effects
- Blood pressure medications: Can cause dizziness when standing
- Sleep medications: Cause grogginess, impaired balance
- Antidepressants: Many increase fall risk
- Pain medications: Especially opioids
- Multiple medications: Risk increases with each medication; 4+ is high risk
Environmental Hazards
- Loose rugs and carpet edges
- Poor lighting
- Clutter and obstacles
- Slippery floors
- Stairs without railings
- Pets underfoot
- Cords and wires in walkways
Ask the doctor or pharmacist to review all medications specifically for fall risk. Many seniors can reduce or eliminate high-risk medications. Even over-the-counter sleep aids and antihistamines increase fall risk significantly.
Home Safety Modifications
Bathroom (Highest Risk Area)
- Grab bars: By toilet and in shower/tub (professionally installed into studs)
- Non-slip mat: In tub/shower and on bathroom floor
- Raised toilet seat: Easier to sit and stand
- Shower chair or bench: Allow sitting during bathing
- Handheld showerhead: Enables seated bathing
- Night light: For nighttime bathroom trips
- Remove throw rugs: Major tripping hazard
Bedroom
- Bed height: Should allow feet flat on floor when sitting on edge
- Light switch accessible from bed: Or use touch lamp
- Clear path to bathroom: Remove obstacles, use night lights
- Phone within reach: In case of fall from bed
- Bed rails: If appropriate (can also be a hazard—assess carefully)
Living Areas
- Remove throw rugs: Or secure with double-sided tape
- Tack down carpet edges: Loose edges cause trips
- Clear clutter: Keep walkways open
- Furniture placement: Allow clear paths, stable items to hold
- Secure cords: Along walls, not across walkways
- Bright lighting: 100-watt equivalent bulbs
- Light switches: At room entrances
Stairs
- Handrails on both sides: Continuous, securely mounted
- Non-slip treads: On each step
- Light switches: At top and bottom
- Bright lighting: No shadows on steps
- Contrasting tape: Mark edges of steps
- Remove items stored on stairs: Common tripping hazard
Kitchen
- Non-slip floor mats: At sink and stove
- Reorganize cabinets: Frequently used items at reachable heights
- Sturdy step stool: With handrail if needed for high items
- Clean spills immediately
Outdoors
- Repair walkway cracks: Uneven surfaces cause trips
- Handrails on steps: All outdoor steps
- Motion-sensor lights: For evening navigation
- Clear leaves and debris
- Ice/snow removal: Plan for winter weather
An occupational therapist can do a professional home safety assessment and recommend specific modifications. Medicare may cover this as part of home health services. Local Area Agencies on Aging sometimes offer free safety assessments.
Exercise for Fall Prevention
Exercise is the single most effective fall prevention intervention. It improves strength, balance, and confidence.
Key Types of Exercise
- Balance exercises: Standing on one foot, heel-to-toe walking, Tai Chi
- Strength training: Leg and core strengthening especially
- Flexibility: Range of motion exercises
- Walking: Maintains endurance and confidence
Proven Programs
- Tai Chi: Reduces fall risk by up to 50% in studies
- Otago Exercise Program: Evidence-based home exercise program
- Matter of Balance: Addresses fear of falling
- Stepping On: Community-based fall prevention
Do daily, holding a stable surface:
- Stand on one foot for 10 seconds, then switch
- Walk heel-to-toe in a straight line
- Stand up from a chair without using hands
- March in place, lifting knees high
Gradually increase difficulty as strength improves. Always have something stable nearby to grab if needed.
Vision and Hearing
Vision
- Annual eye exams are essential
- Keep glasses prescription current
- Treat cataracts (major fall risk factor)
- Use single-vision glasses for walking (progressives/bifocals increase fall risk)
- Ensure adequate lighting throughout home
Hearing
- Untreated hearing loss affects balance (inner ear connection)
- Hearing aids may improve spatial awareness
- Get hearing tested regularly
Footwear Matters
What they wear on their feet significantly affects fall risk:
- Supportive shoes: Low heel, non-slip sole, fit well
- Avoid: Loose slippers, walking in socks, high heels, flip-flops
- Replace worn shoes: Smooth soles lose grip
- Proper fit: Shoes that are too big or too small cause problems
- Indoor shoes: Not barefoot or in socks
Assistive Devices
Mobility Aids
- Cane: For mild balance issues; must be correct height
- Walker: More stability than cane
- Rollator: Walker with wheels and seat for resting
- Physical therapy: To learn proper use of devices
Medical Alert Systems
- Allows calling for help after a fall
- Reduces time lying on floor (dangerous—can cause rhabdomyolysis)
- Provides peace of mind
- Some include fall detection technology
Many seniors resist using walkers or canes because they feel it makes them look "old." A serious fall makes them much older—often permanently. Frame assistive devices as tools for independence, not signs of weakness. Would you refuse to wear glasses because they make you look old?
What to Do After a Fall
Immediate Steps
- Stay calm: Take a moment to assess before moving
- Check for injuries: Can they move all limbs? Severe pain anywhere?
- If injured: Don't move them; call 911
- If uninjured: Help them get up safely (see technique below)
- Monitor for delayed symptoms: Head injury symptoms can appear later
Safe Way to Get Up After a Fall
- Roll onto side
- Push up to hands and knees
- Crawl to sturdy furniture
- Put hands on furniture seat
- Bring one foot forward flat on floor
- Push up and turn to sit
- Rest before trying to stand
After Any Fall
- Report to doctor: Even without injury—falls predict future falls
- Investigate cause: What happened? What can prevent recurrence?
- Check medications: Were new medications started?
- Assess environment: What hazard caused the fall?
- Watch for delayed symptoms: Especially head injury
If they hit their head (or can't remember if they did), watch for: worsening headache, confusion, vision changes, nausea/vomiting, difficulty walking, bleeding from ears/nose. These symptoms need immediate medical attention—even days after the fall, especially if on blood thinners.
Fall Risk Assessment
Use this quick assessment:
| Risk Factor | Points |
|---|---|
| Has fallen in the past year | +2 |
| Uses or needs a walking aid | +2 |
| Takes 4 or more medications | +1 |
| Has vision problems | +1 |
| Has balance or walking problems | +1 |
| Has cognitive impairment | +1 |
Score 4 or higher = high fall risk requiring immediate intervention
When to Seek Professional Help
- Physical therapy: For balance training, strengthening, gait analysis
- Occupational therapy: For home safety assessment and modifications
- Geriatrician: For comprehensive fall risk evaluation
- Pharmacist: For medication review
- Podiatrist: For foot problems affecting mobility
Home Safety Checklist
Our Home Safety Checklist provides a room-by-room guide to making your parent's home safer.
Get the Complete Caregiver Kit- Falls are preventable, not inevitable
- Address medications, vision, home hazards, and strength
- Bathroom modifications are highest priority
- Exercise (especially Tai Chi and balance training) reduces fall risk by 50%
- Proper footwear and assistive devices matter
- Report all falls to the doctor—they predict future falls
- After a head injury, monitor for delayed symptoms
- Medical alert systems provide help after falls occur