What factors increase the risks of falls?
The following factors are known to increase the risk of falls and fall-related injuries in seniors:
- Mobility problems, including slower reflexes, muscle weakness, poor balance and poor posture.
- Advanced age.
- Gender. Females have a higher risk for falls and fractures, and men are more at risk for fatal fall injuries.
- Chronic and acute illnesses, such as osteoporosis, the effects of a stroke, Parkinson’s disease, arthritis, heart disease, incontinence or acute infection.
- Poor eyesight, poor hearing, reduced sense of touch and proprioception, which is the ability to know the position or movement of a body part without looking.
- Changes in mental alertness caused by cognitive impairments, depression, delirium, side effects of medications, alcohol use, poor nutrition, dehydration or lack of sleep.
- Taking multiple medications, particularly those known to increase your risk of falling such as antidepressants, tranquilizers and antihypertensives.
Indoor risk factors include:
- Poorly lit stairs, ramps or doorways.
- Stairs with irregular step width or height.
- Stairs without handrails or marking on the edges.
- No grab bars in bathrooms, or incorrectly installed bars.
- Slippery floors, throw rugs, and loose carpets.
- Raised sills in doorways.
- Floors cluttered with objects like cords, pet dishes or newspapers.
- Toilet seats that are too low or too high.
- Poorly maintained or improperly used mobility aids and equipment.
Outdoor risk factors include:
- Uneven sidewalks or cracks in sidewalks.
- Stairs without handrails or marking on the edges.
- Poor lighting: either not enough or too much glare.
- Objects on sidewalks such as bike racks, garbage cans or metal grates that are slippery when wet.
- Snow, ice or wet leaves on stairs or walkways.
- Unmarked curbs or corners without curb ramps.
- Long crosswalks without pedestrian islands.
Risky behaviours include:
- Climbing ladders or using a chair in place of a step stool.
- Drinking too much alcohol.
- Not using walking aids, such as walkers or canes, or not using them correctly.
- Wearing loose fitting shoes or shoes with thick soles, or changing from one shoe type to another.
- Using heavy, awkward handbags which can affect balance.
Social and economic factors include:
- Living alone.
- Having limited or no social networks.
- Not having enough income to maintain good health.
- Not maintaining a healthy diet.
- Not having access to health care services or health information due to isolation, language or literacy issues.
What can I do to lower my risk of falling at home?
- Remove throw rugs or scatter mats, or if they must be used, use a non-skid backing and make sure they are not in high traffic areas, or at the top or bottom of stairs.
- Avoid using wax on floors. If wax is used, use non-skid wax.
- Make sure you have non-slip surfaces on stairs, balconies, porches and patios.
- Make sure all traffic areas are clear of telephone or electrical cords and other obstacles, like parcels.
- Make sure your home is well lit including all stairwells, porches and balconies.
- Be aware of any raised doorsills, and remove if possible.
- Watch that your pets are not under foot.
Stairs and Outside Steps
- Make sure you have light switches at the top and bottom of the stairs and that the stairs are well lit.
- Keep stairs in good repair and free of clutter.
- Make sure runner mats, carpeting or other floor covering on your stairs are well fastened.
- Make sure there are solid handrails on both sides of the stairway.
- Make sure the steps have a non-skid surface.
- Use a rubber bath or shower mat, or a non-slip surface in your tub or shower.
- Install grab bars by the toilet, bathtub and shower.
- Use a bath seat so you can take a shower or bath sitting down.
- Wipe up moisture or spills right away.
- Place items you use often within easy reach. Keep heavy items in lower cupboards.
- If you have good balance, use a stable step stool with a safety rail for reaching high places. Otherwise, ask for help.
- Always wipe up any spills right away.
- Make sure there is a light switch near your bedroom entrance and a lamp or light switch near your bed.
- Place night lights in the halls in case you get up in the middle of the night.
- Make sure there is a clear path from your bed to the bathroom.
- Have a cordless phone near your bed.
- Sit on the edge of your bed for a minute before getting up after a rest.
What can I do to lower my risk of falling when away from home?
Public areas are not always designed with older pedestrians in mind. You can protect yourself by being aware of the most common ways to fall and how you can prevent falls.
Actions you can take to lower the risk include:
- Maintain an active and healthy lifestyle through exercise and good nutrition. For more information see HealthLinkBC File #68j Healthy Eating and Healthy Aging for Adults and HealthLinkBC File #68e Food Sources of Calcium and Vitamin D.
- Get regular physical checkups and eye and ear exams.
- Make a note of the location of any hazards and report them to the local authorities.
- Consult a physiotherapist on the appropriate use of mobility aids and safety devices, such as a cane with spiked ends or shoes with ice grips.
- Avoid rushing or carrying too much.
- Wear footwear with good support, and with soles that have non-slip treads and are not too thick.
- Be socially active by joining a community group and getting together with friends or family.
- Have your health care provider or pharmacist do a regular review of your medications.
- If you do fall, talk with your health care provider to discuss medical problems that may have caused the fall, as well as ways to lower fall risk.
Did you know?
- One-third of people aged 65 and over will fall at least once each year.
- At least 1 in 3 women and 1 in 5 men will suffer from an osteoporotic fracture during their lifetime.
- Canadians spend over $3 billion a year on medical care for fall-related injuries among seniors.
- Women are 3 times more likely than men to be hospitalized for a fall-related injury, and men are more likely to die from a fall related injury.
- 95 percent of hip fractures are due to a fall.
- Half of the people who have a hip fracture never regain their pre-fall level of functioning.
- Almost half of admissions to long-term care facilities are fall-related.
- Most falls occur in seniors’ own homes, while doing their usual daily activities. However, up to 40 percent happen outdoors and in public places.
- Falls usually happen because of the combined effects of a number of factors, such as a loss of balance, side effects of medicine, impaired vision or mobility, and environmental hazards.
- Many seniors are afraid of falling and restrict their activities to a point where their risk of falling increases because of muscle weakness, joint stiffness and poor balance.