How To Prevent Falls at Home As You Age

Simple ways you can make your home safer, with checklists and tips for fall prevention

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Getting older changes the way many people and their loved ones prioritize home safety, with fall prevention often topping the list.

"A fall is often a seminal event for an older adult, leading to an increased risk of life-threatening conditions such as a subdural hematoma or bone fracture and a decline in function and independence," said Liron Sinvani, MD, director of the geriatrics hospitalist service at Northwell Health and associate professor of medicine at Zucker School of Medicine at Hofstra/Northwell in the New York City area. A subdural hematoma is bleeding between the covering and surface of the brain that can occur after a head injury, per the National Library of Medicine MedlinePlus resource.

More than one out of four older adults experience a fall each year, according to the Centers for Disease Control and Prevention (CDC). Creating a home environment that reduces the risk of falls can improve your quality of life and increase the likelihood you're able to age in place.

Read on to learn the risk factors that make falls more likely to occur, fall prevention tips, and how home safety modifications can help you stay comfortable and independent in your home.

Risk Factors for Falls in Older Adults

Older adults are more vulnerable to factors that can lead to falls. Some of the more common risk factors for falls include, per the National Institute on Aging (NIA) and an April 2013 paper published in the Journal of the American Medical Association (JAMA):

  • Vision, hearing, or reflex impairments
  • Decline of cognitive functioning, including confusion or dementia
  • Balance and gait issues
  • Muscle conditions, such as weakness, decreased lower body strength, pain, or osteoarthritis
  • Medications that increase dizziness and affect balance—such as antidepressants, opiates, and high blood pressure drugs—or using four or more medications
  • Improper footwear, such as shoes with heels or heavy soles, backless slippers, or shoes without arch support
  • Foot pain
  • Heart disease
  • Movement disorders, such as Parkinson's disease
  • Urinary incontinence (accidentally leaking urine) or nocturia (waking up multiple times at night to urinate)
  • Insomnia or sleep deprivation
  • Depression

In 30–50% of falls, the living environment is a factor. Hazards to watch for, per StatPearls, include:

  • Poor lighting
  • Uneven surfaces
  • Floor rugs
  • Slippery floors

Fortunately, fall-proofing your home can help reduce the risk of falls, according to the NIA.

How To Prevent Falls

Getting older is an unchangeable risk factor that contributes to falling because of potentially decreased reaction time, per StatPearls. That said, you can prevent falls by improving your overall health and implementing at-home safety interventions. Here are six ways to get started.

Improve Overall Strength and Balance

Staying physically active is key to optimizing strength and balance and reducing falls. The NIA recommended getting at least 150 minutes of physical activity every week. Even a simple routine like standing up from a seated position may help with balance, per the NIA.

Many physical therapy clinics and fitness facilities offer fitness classes designed for older people that focus on strength training, flexibility, mobility, and balance exercises. Look for programs that include gentle exercise methods such as Tai Chi, which can improve balance and decrease the fear of falling in older adults, per a December 2018 paper published in the Journal of Exercise Rehabilitation.

Review Medications With Your Healthcare Provider

Ask your healthcare provider if any medications you're taking, prescription and non-prescription, can increase the risk of dizziness or loss of balance. If possible, lower the dose or switch to a different drug that may reduce these risks, per the April 2013 paper.

"There are many medications, including over-the-counter, that can inadvertently lead to falls. For example, over-the-counter cold and sleep medications may contain diphenhydramine (Benadryl), which can increase falls in older adults," Dr. Sinvani said.

Vitamin D and calcium deficiency may affect your balance, per the April 2013 paper. Talk to your healthcare provider about potentially getting tested for vitamin D levels and starting vitamin D and calcium supplementation.

Fall-Proof Your Home

A home safety assessment can identify high-risk areas you can change to prevent or decrease falls. While not an exhaustive list, here are some home safety modifications to consider, per the CDC.

  • Remove or secure loose rugs and cords.
  • Keep loose items off staircases and floors.
  • Install handrails on staircases.
  • Move furniture that gets in your way.
  • Use nonslip mats in the bathroom or other potentially wet areas.
  • Keep the house well-lit with accessible lamps and night lights.
  • Add grab bars in the bathtub or shower and by the toilet.
  • Keep items on lower shelves.
  • Put railings on both sides of the stairs.
  • Install a walk-in tub with a low-step threshold for easier access in and out of the tub. A walk-in tub also comes with a seat to reduce falling when bathing.

Walk Safely at Home and on the Go

When you are up and moving around, Dr. Sinvani said a focus on safe ambulation (walking without assistance) can reduce falls—for example, you can:

  • Wear glasses.
  • Choose comfortable shoes with nonslip soles and ankle support.
  • Wear hearing aids if appropriate.
  • Use a cane or walker when needed.

If the tasks you need to perform at home each day, such as going to the bathroom or getting into the bathtub, are difficult for you, consider using some assistive devices. If accessible to you, you could consider:

  • A walk-in tub if you find it difficult to get into and out of the bathtub safely
  • A bidet toilet seat if it becomes challenging to clean yourself well

Consider a Medical Alert System With Fall Detection

Purchasing a medical alert system with fall detection can help you stay safe, especially if you live alone. These devices provide emergency monitoring through a wearable help button you can activate if you need emergency assistance.

Some systems also offer an added feature of automatic fall detection that can tell when you fall. When the device senses a fall, it sends a signal to the monitoring company.

Get Regular Vision and Hearing Evaluations

Regular vision checkups, along with exercise and environmental safety management, have been shown to reduce fall risk, per the April 2013 paper. Conditions such as cataracts (which typically affect older adults, per the CDC) and vision loss are risk factors for falls. If your healthcare provider prescribes contacts or glasses, make sure to take the time to get used to them. The NIA also recommended getting regular hearing assessments.

What To Do After a Fall

If you or a loved one experiences a fall, it's important to contact a healthcare provider right away. During non-office hours, a trip to the emergency room may be necessary to get an X-ray imaging test and assess any injuries. If you live alone and suspect a serious condition like a broken bone or head injury, call 911 immediately or activate your medical alert system for emergency assistance. Otherwise, you may ask a family member to take you to the hospital.

After a fall, take some time to review fall prevention guidelines. Ask a friend or family member to do a home walk-through with you to assess fall hazards and make appropriate safety modifications. Depending on your living situation, this may require assistance from a senior health expert, occupational therapist, or Certified Aging-in-Place Specialist from the National Association of Home Builders.

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