Preventing Falls in Older Adults at Home

Why Older Adults Fall

A fall is rarely caused by a single factor. Muscle weakness, poorer balance, slower reactions, reduced eyesight, joint pain and certain medical conditions all make falls more likely. Illness can add to this risk suddenly — an infection, dehydration or a change in medicines can make a person unsteady for days or weeks.

Fear of falling can also lead older people to move less, which in turn weakens muscles and increases the risk. The goal of prevention is therefore not to keep the person still, but to help them move safely.

Making the Home Safer

Floors and walkways

• Remove or secure loose mats, rugs and trailing electrical cables.
• Keep walkways free of clutter, especially between the bed and the toilet.
• Wipe up spills promptly; wet floors are a common cause of falls.
• Mark the edges of steps and any change in floor level so they are easy to see.

Lighting

• Make sure rooms, corridors and stairs are well lit.
• Place a light switch or lamp within reach of the bed.
• Use a night light on the route to the toilet — many falls happen at night.

Bathroom and toilet

• Use non-slip mats and consider grab rails near the toilet and in the bathing area.
• A shower chair or bathing stool can make washing safer for people who tire easily.
• A raised toilet seat or a bedside commode can help people who struggle to get up or who need to use the toilet urgently at night.

Stairs and furniture

• Handrails on both sides of stairs are ideal. Avoid carrying items while using the stairs.
• Keep frequently used items within easy reach so the person does not need to climb or bend awkwardly.
• Chairs and beds should be at a height that allows the person to stand up without strain. Very low or soft seating makes standing harder.

Medicines and Health Factors

Some medicines increase the risk of falling by causing drowsiness, dizziness or a drop in blood pressure on standing. These can include sleeping tablets, some medicines for anxiety, depression, pain, blood pressure, and bladder problems. Taking several medicines together increases the risk.

If an older person has had a fall or feels unsteady, ask a doctor to review all their medicines, including those bought without a prescription. Do not stop a medicine yourself, as some need to be reduced gradually or replaced.

Other health factors worth checking include eyesight (and whether glasses are up to date), foot problems, joint pain, bladder urgency that causes rushing to the toilet, low blood pressure, and memory problems. Dehydration is another common and easily missed contributor.

Everyday Habits That Help

• Get up slowly. Sit on the edge of the bed for a moment before standing, especially at night or after a meal.
• Wear safe footwear. Well-fitting shoes or slippers with a firm, non-slip sole and a back are safer than loose slippers, socks alone or walking barefoot on a slippery floor.
• Use walking aids correctly. If a walking stick or frame has been recommended, make sure it is the right height and is used consistently.
• Keep active. Regular exercise that improves strength and balance is one of the most effective ways to prevent falls. A physiotherapist can advise on safe exercises suited to the person.
• Eat and drink regularly. Missing meals or drinking too little can cause weakness and dizziness.

If a Fall Happens

Stay calm and check whether the person is hurt before trying to move them. If they have pain in the hip, back or neck, cannot move a limb, have hit their head, or seem confused, do not try to lift them — keep them warm and comfortable and get medical help.

If they are not injured and feel able to, they may be able to get up slowly with support: rolling onto their side, getting onto hands and knees, and using a sturdy chair to rise. Do not attempt to lift someone on your own if this risks injuring either of you.

A fall in an older person should prompt consideration of why it happened, particularly if falls are recurrent, unexplained, associated with dizziness or illness, or represent a change from the person's usual function. A fall can be the first sign of an illness such as an infection, a heart rhythm problem or a medicine side effect.

Related Guides

• Warning Signs in an Older Person That Need Medical Assessment
• Preventing Dehydration in Older Adults
• Preparing the Home Before a Patient Is Discharged from Hospital
• How to Measure Blood Pressure Correctly at Home