Preventing falls


According to the U.S. Centers for Disease Control and Prevention:

• One in four Americans age 65 and older falls each year.

• Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.

• Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.

However, falling is not an inevitable result of aging. Through practical lifestyle adjustments, evidence-based falls prevention programs and clinical-community partnerships, the number of falls among seniors can be substantially reduced, the CDC reports.

“Dori” is far from what one would consider clumsy. For most of her near 70 years she has been a talented and graceful dancer, trained in Japanese classical dance, salsa and ballroom, plus some hip-hop, line dance and modern. While she asked to remain anonymous, she shared her history of falls with the hope of helping others. “I used to trip a lot, often over those parking lot blocks,” she said. She attributes most of her past falls to “always rushing and not paying attention (to her surroundings),” having a lot on her mind, especially when she was still working. She recounted one of the worst incidents: “It was raining as I went to unlock a gate while carrying heavy bags of groceries. I leaned forward to unlock the gate and lost my balance, crashed my face into the gate and knocked out a tooth.” She also described being in a hurry and running down the wooden stairs in her home, missing a step and spraining her ankle. Twice. “There was also the time I fell when my foot got caught in a (wire) tomato cage in the garden. Again, I wasn’t looking or paying attention …”

Due to the frequent mishaps, “Dori’s” doctor ordered a neurological screening and asked her to record every fall she had after that. They didn’t identify any concerns, and the falls stopped after “Dori” retired several years ago. At least until recently.

“It was one week after my cataract surgery, and I had strict instructions to avoid fast or quick movements. Being bored,” she and her husband “decided to play ping-pong using our dining room table. I made a bargain with myself, saying, ‘I’ll play but I won’t move around fast.’”

The game went smoothly as she carefully refrained from making typical abrupt and quick movements, until she reached too far for the ball, lost her balance and fell. Landing on the edge of a chair resulted in a bruised rib, which has finally healed, three months later.

Reflecting on her physical changes, “Dori” believes that her balance and coordination have been affected since dancing is no longer part of her regular lifestyle. She still works hard to maintain physical strength and mobility through other forms of exercise such as yoga, walking and biking. “Before the pandemic, we also enjoyed playing pickleball. And now we can’t even go out to walk or bike because of the fires.”

“Dori” and her husband look forward to enjoying the outdoors again once the air quality returns to safe levels. To boost safety in their home, they painted stripes on the wooden steps to improve visibility, and added a handrail so there is one along both sides of the steps.

“Dori” made a conscious decision to slow down and be more mindful about how she moves around. She has not allowed her history of falls to prevent her from staying active and enjoying life. When asked what advice or suggestions she might have for others, she laughed and reiterated the importance of “practicing mindfulness, slowing down and not rushing!”

As “Dori” said, common behaviors like rushing and being distracted contributed to most of her falls. Other common factors that can increase the risk of falling are:

Previous falls — Older adults who have fallen tend to become overly cautious and restrict their activities, which can create a cycle of increased fall risk.

Balance problems — Balance problems can cause a sense of dizziness, motion or spinning (vertigo); feeling of faintness or lightheadedness (presyncope) or confusion.

Chronic diseases — Many conditions such as diabetes, chronic kidney disease and cardiovascular disorders can increase fall risks. Orthostatic hypotension (a form of low blood pressure that causes dizziness or lightheadedness when a person stands up from lying down or sitting) is another example.

Alzheimer’s Disease and other dementias — Cognitive impairment can cause confusion that can lead to falls. In addition, cognitive impairment can also cause physical deconditioning, gait changes, poor balance, memory impairment, poor judgment and visual misperception.

Depression — Depressive symptoms, antidepressant medications, poorer balance and poorer cognitive functioning are all associated with increased risk of falls.

Footwear — High heels and poorly fitting shoes can cause problems. Wearing nonskid shoes, even in the home, is a good alternative. To avoid going barefoot, some people may prefer to have a pair of shoes (not flip-flops or zori) just for wearing inside the home.

Multiple medications — Any medication that causes side effects like drowsiness, dizziness, vision problems, gait disturbance (ataxia), hypotension (low blood pressure), increased bleeding risk or worsening osteoporosis could potentially increase one’s chances of a fall. People should also consider their over-the-counter medications like NSAIDS and antihistamines, and even vitamins and other supplements.

Muscle weakness — Diseases such as Parkinson’s can cause a progressive deterioration of muscle function. Motor symptoms such as stiffness, tremors, postural changes, slowness, impaired balance and shuffling gait, can contribute to the risk of falling, according to the Parkinson’s Disease Foundation.

Sensory problems — Many medical conditions such as diabetes, kidney failure and shingles can cause tingling, numbness, weakness or burning pain in the legs and feet, known as peripheral neuropathy.

Visual Impairments — Common age-related vision diseases such as cataracts and glaucoma can alter depth perception, peripheral vision, and visual acuity. These restrictions can affect one’s capability to navigate their environment.

Because there are so many different factors that contribute to falls, specific recommendations for each individual are different. Some simple, preventive steps to consider:

• Get a fall risk assessment
Talk with a health professional to identify and treat medical problems that might lead to falls. This includes discussing any previous falls, reviewing medications and supplements, and getting vision checked at least once a year.

• Maintain or increase physical activity
Talk with a health professional or doctor about regular physical activities that can safely improve or maintain balance, strength, flexibility and endurance.

• Address safety hazards in the home and community
Identify fall hazards and make changes for safety, including footwear. Proper fit and use of assistive devices such as canes and walkers is also important. There are many home safety checklists available online. For example:

Older adults need to take special consideration related to falls due to the increased risk of hip fracture. The risk increases because bones tend to weaken with age (osteoporosis). A hip fracture is a serious injury, with complications that can be life-threatening, the Mayo Clinic states. A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. Taking early steps to maintain bone density and avoid falls can help prevent a hip fracture.

For more information, visit the Fall Prevention Center of Excellence’s Website at:

For additional information on healthy aging and prevention of falls, visit

To find out about local home modification programs and grants, contact the National Association of Area Agencies on Aging:

National volunteer programs such as Rebuilding Together may assist with home modifications:

The U.S. Department of Veterans Affairs provides a limited number of grants to assist qualified, disabled veterans with home modifications. For more information, visit: or call 1-800-927-1000.

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