One-third of people aged 65 and over who live in the community will fall each year. Falls are the leading cause of injury-related deaths and hospitalizations for adults aged 65 years and older in BC. Falls can lead to fractures (e.g. broken hip, broken ankle), head injuries, loss of mobility and independence, long-term disability and reduced quality of life.
Falls, however, are not a normal part of aging. They are predictable and preventable. Fear of falling is common, but restricting physical activity and movement to avoid falls can actually cause further frailty, increasing the risk of falling.
What factors increase the risks of falls?
- Frailty: Loss of muscle mass, grip strength and balance, mobility problems, slower reflexes, muscle weakness, poor balance and poor posture.
- One or more chronic and acute illnesses: e.g. osteoporosis, the effects of a stroke, Parkinson’s disease, arthritis, heart disease, incontinence or acute infection.
- Changes in mental alertness due to depression, delirium, interactions or side effects of medications, alcohol use, poor nutrition, dehydration or lack of sleep.
Social and Economic Factors:
- Limited or lack of social support or connections, especially support and connections that are close by.
- Lack of accessible, safe housing and transportation .
- Inappropriate footwear / clothing.
- Climbing ladders or using a chair in place of a stable step stool with a safety rail.
- For those with frailty or mobility limitations, not using assistive mobility aids, such as walkers or canes, not using them correctly, or not properly maintaining the equipment.
Environmental Factors (Home):
- Environmental factors that increase the risk of a fall at home include tripping hazards, such as clutter and inadequate lighting.
Environmental Factors (Outdoors)
- Uneven sidewalks or pathways.
- Steps without handrails or marking on the edges or building design / maintenance.
How do I know if I am at risk of falling?
The best indicator of a future fall is a past fall. The more someone falls, the more likely it is that they will have a severe fall leading to injuries.
You can use the Staying Independent Checklist to assess your risk for falls, or ask your doctor about falls risk assessment and management.
How can someone lower their risk of falling?
There are four main ways that anyone can reduce their risk of falls and maintain independence.
1. Keep your body active:
- Not only does regular physical activity help prevent falls by improving your strength and balance, it also increases energy levels and helps to keep your brain healthy and improves mood.
- Adults aged 65 and older should do at least 150 minutes of moderate to vigorous intensity aerobic physical activity per week, in chunks of 10 minutes or more.
- Do a variety of activities that improve strength and balance (lifting light weights, tai chi), endurance (walking, dancing) and flexibility (tai chi, stretching).
- Always ask your doctor, physiotherapist, or health care provider about the best type of exercise program for you.
2. Have your eyes checked by an optometrist once a year
- People with vision loss have twice the risk of falls and fall-related injuries such as serious hip fractures.
- Get a comprehensive eye exam at least once a year.
- Common causes of vision impairment among older adults are: cataracts, age-related macular degeneration, diabetic retinopathy, glaucoma and presbyopia.
3. Make your home safer
- There are a number of simple and inexpensive changes you can make to your home to reduce your risk of falling.
- Keep stairs, walkways and outdoor steps in good repair and free from clutter.
- Make sure there are solid handrails on both sides of indoor stairs and outdoor steps.
- Make sure that stairs are well lit and you have light switches at the top and bottom of indoor stairs.
- Install a non-skid surface on outdoor steps.
- Use a bath seat so you can take a shower or bath sitting down.
- Install a toilet seat riser to make toileting safer.
- Wipe up moisture or spills right away.
- Remove carpets or rugs that can be a tripping hazard; use only non-slip rugs and non-slip mats in hallways and bathrooms.
- Install grab bars by the toilet, in bathtub and shower areas.
- Place items you use often within easy reach.
- Keep heavy items in lower cupboards.
4. Have your doctor or pharmacist review your medications
- Medications include prescriptions, over-the-counter pills, vitamins and herbal supplements.
- Alcohol can affect medications.
- If you are a BC resident with a valid BC Services Card, and you have taken at least five medications within the last six months, you may be able to receive Medication Review Services. Talk to your pharmacist for more information.
Other things you can do:
- Make a note of the location of any safety and walkability hazards and report them to your local government.
- If you need an assistive mobility device, consult a physiotherapist, occupational therapist or pharmacy.
- Wear weather appropriate footwear with good support, soles which have non-slip treads and are not so thick that you can’t ‘feel’ how your foot is positioned.
For more tips and resources, ask your doctor about a fall risk management plan tailored to you.
If you do fall, report it to your health care provider and discuss medical, environmental and lifestyle factors which may have led to the fall, and ways you can lower future fall risk.
If you have already experienced a serious fall, consider wearing hip protectors as extra prevention for hip injury in case of a future fall. A hip protector is pants or underwear with pads designed to prevent hip fractures following a fall.
For More Information
For information and advice regarding physical activity call 8-1-1 to speak to a qualified exercise professional.
For more information, visit the following resources:
- Finding Balance BC
- HealthLinkBC File #68j Healthy Eating and Healthy Aging for Adults
- Canada’s Low Risk Drinking Guidelines: https://ccsa.ca/canadas-low-risk-alcohol-drinking-guidelines-brochure
- Public Health Agency of Canada – Physical activity tips for older adults: www.canada.ca/en/public-health/services/being-active/physical-activity-your-health.html#a5