Fall Prevention At Home In The Elderly: Common Causes, Risk Factors and How To Prevent Them

Falls affect one in four elderly people (65 years and over) each year. According to the CDC, falls result in costly medical treatment and raise the risk of mortality by at least 30%. Having a fall can radically affect a person’s, and their loved ones, quality of life. Preventing seniors from having falls at home is always the best option when possible and this begins with education. Knowing the multifactorial risks associated with falling can give a good starting point for lowering the chance of falling.

Environmental risk factors for falling.

Having a poorly set up home comes with a whole plethora of fall risks. Most of them are fairly easy to modify to promote safety prevention. These include:

• Stairs. Poor endurance and strength for navigating them, lack of handrails, or poor stair design.
• Entrances. Having a lip or elevated sill in the door frame, having stairs, or lack of handrails.
• Bathroom. Lack of grab bars, low toilet seat, or a high rise tub.
• Slippery or uneven surfaces. Including wet floors, ice, and walking on moveable surfaces such as carpet, grass or gravel.
• Clutter and tripping hazards. This includes doormats and area rugs that a foot can easily catch on in addition to general disorganization.
• Poor lighting throughout the home. Particularly from the bedroom to the bathroom in the middle of the night.
• Medications. Ones that affect cognition, coordination, and vision such as psychoactives, opiates, anticonvulsants, diuretics, laxatives, and sedatives.
• Improper use of assistive devices.   Having a grab bar, cane or walker can become hazardous if not used precisely and in a coordinated manner.

Personal risk factors for falling.

Individual risks factors related to body function can be more complicated but equally as preventable with the right awareness and treatment. These include:

• Muscle weakness. It’s normal to lose up 5% muscle mass each decade once you hit 30 years old. This can lead to poor endurance for standing activities and muscle imbalances that affect completing activities of daily living.
• Past falls and fear of falling. According to the CDC, falling once doubles the chance of falling again. Once having fallen, a psychological component is also evident that makes the individual more nervous and rigid with normal activities, ironically making their chance of falling higher.
• Poor vision. Vision is the key component to our ability to balance, especially as we age.
• Postural hypotension. Getting up too fast from a chair or bed can cause dizziness and lead to falls.
• Gait and balance issues. Poor walking mechanics and general poor balance can be caused by any of the above-mentioned issues in addition to inner ear deficits, poor sensation, or injury.
• Chronic conditions. These all affect the body in different ways but all ultimately decrease the body’s ability to coordinate efficient and safe balanced movement.
  1. Pain that alters movement patterns and decreases motivation to exercise regularly.
  2. Parkinson’s. Causes poor and stiff coordination of the body with everyday movement.
  3. Typically affects cognition and coordination (due to weakness on one side) to safely complete daily tasks.
  4. Neuropathy (poor sensation) or fluctuating blood sugar levels increase fall risk.
  5. Can lead to poor safety awareness when trying to rush to the bathroom.
  6. Poor decision-making skills and safety awareness can cause falls.

Tips for preventing falls.

A great place to start is to read through the list of risk factors and make a list of which ones affect you. Then prioritize them based on what you feel is most important for your safety and what you can most easily start doing today. Make your goals for decreasing fall risk manageable.

Still not sure where to start? Try these:

1. Get your vision checked regularly. At least once a year is recommended.
2. Exercise regularly to optimize muscle strength and balance. (Try these.)
3. Take your time when getting up from a chair or bed to allow your body to prevent dizziness.
4. Assess your home’s safety. Here is a great checklist to use. Have a friend or familymember help you to get an unbiased opinion related to clutter and layout. It can behard to be honest with yourself due to attachments to items like furniture or area rugs. If you notice trouble areas that require installing bars, look around for a price quote or ask for help from someone you trust.
5. When you get up in the middle of the night, ALWAYS turn on a light. Have a light next to your bed that you can easily reach.
6. Talk regularly to your doctor.
   • Make sure your medications are optimized and taken as prescribed.
   • Make sure any health conditions you have are well managed.
   • Discuss any fall concerns you have with them.
7. See a physical therapist.
   • Get advice on whether you need an assistive device for safety.
   • Get a formal assessment of your home. Discuss options for modifying your home
   • Discuss any fall concerns you have with them.
   • Work on your balance in a safe environment and get a home exercise program.
8. Complete all these steps to feel at ease and decrease your fear of falling so you can enjoy life to the fullest!

Tools that can help decrease your fall risk.

• Assistive devices, such as a walker or cane, can help with poor balance when used properly. Especially if you find yourself dependent on others for balance, regularly feel off balance or try to “furniture surf” around your home.
• Home adjustments. Toilet seat risers, walk-in bathtubs, shower chairs, installing lights and grab bars are all accessories that can make a huge difference in safety at home. They also make life easier as age makes it harder to get around.
• Home exercise programs and any equipment you prefer to stay strong and fit.
• Medical alert systems or some other form of communication. Plus, have someone check on you regularly so that you don’t feel anxious or worried about possibly falling at home, especially if you live alone.

Falling is a serious health risk that is multifactorial. Once you understand the components you can take control today and significantly decrease your chances. There are only benefits associated with making these changes, so what is stopping you?