Fall prevention in older adults

Are you afraid of falling? With falls being the leading cause of injury to senior citizens, it is more important than ever to address fall prevention in older adults.

A dear friend fell in her home and broke her hip recently, just before her 101st birthday. She lived through surgery to repair the fracture, but the trauma proved too much for her. She passed away a few short weeks after falling. I miss her and want to remind everyone to take the risks of falling seriously.

According to the National Council on Aging (NCOA), one in four older Americans falls every year. Falls are the leading cause of injuries to people 65 and older. Also, the fear of falling can cause us to limit our activities and prevent us from fully enjoying our lives.

Falls in older adults can cause

  • cuts
  • bruises
  • hip fractures
  • head trauma

These falls can lead to

  • surgeries
  • lengthy stays in rehab centers
  • long term pain
  • decreased mobility
  • self-confidence issues

When I was a kid my knee would often give out underneath me for no clear reason. So from an early age, I learned to be careful with how and where I walked. Then, 10 years ago, I had both knees replaced. I finally was free to walk unencumbered.

My freedom was short lived, though. Hip and back problems have currently renewed my fear of falling. Now I walk with a cane, and I watch every step.

So I set out to find tips to help keep us safely upright. Surprisingly, I’ve learned that preventing falls involves far more than watching how and where we step.

Can We Prevent Falling as We Get Older?

We may be able to significantly reduce our risk of falling.

The National Institute on Aging identifies steps to take to Prevent Falls and Fractures:

  • Stay active
  • Have vision and hearing tested
  • Be aware of medication side affects
  • Get enough sleep
  • Limit alcohol
  • Stand up slowly
  • Use a cane or walker if needed
  • Walk carefully on wet or icy surfaces
  • Wear supportive shoes with non-skid soles
  • Let your doctor know if you have fallen since your last visit

Personalizing Our Fall Risk

In her article Why Adults Fall, Geriatrician Dr. Leslie Kernisan recommends a personalized approach to fall prevention in addition to the general advice for fall prevention. Dr. Kernisan suggests tailoring our fall prevention strategy to our own personal health conditions, medications, lifestyle, and environment. Her suggestion makes a lot of sense because we all have different and varying levels of challenges in our lives.

What Exercises Can Prevent Falls in Older Adults?

Exercise doesn’t have to be breathtaking to build muscle strength and better balance. Older adults can practice slow, purposeful movements like those found in Tai Chi and Qi Gong. These exercises can help improve balance, increase flexibility and stamina, and build body muscle, all which can help prevent falling.

According to a meta analysis in the Journal of the American Geriatrics Society,

“In at-risk adults and older adults, tai chi practice may reduce the rate of falls and injury-related falls over the short term (<12 months) by approximately 43% and 50%, respectively.”

In the comments section of Why Adults Fall, Dr. Kernisan cautions that the benefits of exercise are more effective when done under the guidance of trained professionals:

“Strength exercises are also safer and more effective when a physical therapist or other qualified person is available to select appropriate starter exercises, train the older person in doing the exercises, and also step up the resistance or difficulty of the exercises when it’s appropriate.

I am not aware of any completely “do it yourself” programs that have been proven to reduce falls, plus doing a program on one’s own would require more motivation and discipline than many people can maintain on their own. So generally I recommend doing a program via a live class or with a physical therapist.”

Leslie Kernisan, MD MPH, Better Health While Aging

Dr. Kernisan suggests the Otago Exercise Program for Fall Prevention  and provides videos of the program on her website.

Caution: Be sure to check with your own personal medical professional before changing your routine or adding exercises. It is crucial to rule out other causes for weakness in any part of your body before starting an exercise plan.

Can Medical Conditions Contribute to Falling Risk?

Medical conditions can affect balance in older adults. In a study published in Clinical Interventions in Aging  study participants with:

  • Diabetes had a 3.6 times higher risk of gait and balance deficits compared to nondiabetic participants.
  • Arthritis had a 17 times higher risk of gait and balance deficits compared to participants with no arthritis.
  • Greater than 50% disabilities in the upper limbs had a 24 times higher risk of gait and balance deficits compared to participants with less than 50% disabilities in the upper limbs.

Clin Interv Aging. 2016; 11: 1043–1049.

Balance disorders, ear infections, stroke, and blood pressure (too high or low) can all increase our risk of falling. Hearing and vision problems can contribute to falls, too. It’s important to have vision and hearing checked annually. We shouldn’t ignore psychological problems either. An article in The American Journal of Geriatric Psychiatry notes the relationship of depression and falling in older adults.

So, talk to your doctor about your medical conditions and treatments and how they might affect your balance and risk of falling.

Can Medications Affect Our Risk of Falling?

The CDC cautions that medications, even over-the-counter medications, can contribute to falls. Psychiatric medications and blood pressure medications can increase the risk for falling. More recently the Harvard Health Letter reports that blood pressure medications may not be responsible for falls as previously studied.

In 12 Medications That May Increase Fall Risk in Older Adults, AgingCare  recommends a periodic “brown bag checkup.” Gather all medications into a bag for an assessment by the pharmacist. The pharmacist can check for interactions that could pose a fall risk. Include over-the-counter medications in the brown bag checkup, as well. It’s a good idea to discuss medications with the doctor, too, to find the right balance between needed medications and fall risk.

How to Keep Seniors Safe in Their Own Homes?

Staying safe in our homes may call for outside intervention. We can discuss home safety with close friends or family members. They may have observations and suggestions for keeping us from falling.

We have non-slip bath mats inside the tub and are debating putting in grab bars. But my daughter noticed that we were using plain bath rugs for our post-shower dry off in the bathroom. She picked up a couple of non-slip, rubber-backed bath rugs for us at Walmart. What a difference they made, yet we had no idea we needed them. I feel much less likely to slip when I get out of the shower now. The new bath mats impressed my husband, too, and that’s no easy feat.

At our age, reaching for items can prove dangerous or simply painful. We’ve added Reacher Grabbers to our household tool set. These handy helpers have made our lives easier, too.

I found A Place for Mom’s comprehensive list of Home Safety Tips for Seniors to be a helpful checklist. We are going through the list and finding ways to make our home “senior safe” for us. I hesitate to get rid of my throw rugs, but I’ve read that suggestion on more than one senior safety article. And bare floors are less painful than a trip and fall.

How have you addressed fall prevention in older adults for yourself or a loved one?

Further resource: 

The National Council on Aging maintains a list of Evidence-Based Falls Prevention Programs.

Remember to check with your own personal health provider before making any changes in your lifestyle, eating, or exercise routines!

Photo credit:  Pexels | rawpixel.com


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