Limiting Exposure to Falls

Monday, January 21, 2019 | By Dennis Stoops, PT, Kosciusko Home Care & Hospice

It is common knowledge that as a person ages there is greater risk of falling. In fact, statistics reveal that one-third of seniors fall in their homes at least once a year. Falls are the leading cause of accidental death for those 65+ and once occurring often happen again. A serious fall may result in a traumatic fracture. Quality of life is often compromised from subsequent decreased function. A person may become more fearful, following a fall, resulting in avoidance of previous activity. If decreased activity follows, this results is weakness and reduced mobility, thus enhancing an individual’s fall risk. To understand considerations to reduce fall potential, we must look at intrinsic and extrinsic factors. Intrinsic focuses on the person and extrinsic deals with our environment. Let’s look at both including potential ways to reduce your risk:

Intrinsic Factors:

Age-related changes are inevitable but we can take measures to reduce the effects.

Vision: Have your eyes checked regularly to ensure the best awareness of your surroundings. If you have a known issue such as Glaucoma, Cataract or Macular Degeneration, use of a cane or walker may be appropriate for safety. A University of Michigan study found that visual impairment doubles fall risk for those 65 or older.

Hearing: A John Hopkins study found that hearing can be a contributing factor to falling. Even a minor hearing loss involving study participants was found to increase risk three-fold. Perhaps a reason to reconsider purchasing those hearing aids you have been putting off?

Systemic Changes: As we age there is a natural decline in Central Nervous System function which increases the likelihood of instability. Transmission of nerve information declines. Systemic diseases may arise involving blood flow, affected by blood pressure, diabetes and smoking. Be sure and have an annual physical to assess status and learn possible ways to limit effects. Take prescribed medicine correctly and faithfully. Understand what your medication does and if there are possible side effects that might influence your balance. Remain active by walking and exercising daily. We may be unable to stop natural decline, but we can influence how slippery the slope is!

Extrinsic Factors:

When dealing with our environment, there are many opportunities to limit our exposure to falls by making changes around the home. Here are a few considerations:


-Keep paths cleared and in good shape.

-Enhance lighting along walkways and at entry areas. Solar and/or motion detection lights work well to illuminate possible hazards.

-Review your entry. If steps are present, are they in good shape and not slippery? Would a railing be beneficial if not present? Could a ramp be helpful, particularly if you already use an assistive device?


-Repair or replace torn carpet and linoleum. Use tape or tack down loose edges. Remove throw rugs where you normally transfer/walk or consider non-skid backing to reduce tripping hazard. Keep pathways cleared of clutter.

-Make sure that lighting in the home is sufficient. Night-lights are recommended for evening trips to the bathroom. Consider motion-activated lights that automatically turn off and on themselves.

-If you’re having trouble getting out of chairs, perhaps a change is needed. Height is your friend, making it easier to rise! Consider using risers under a couch and/or a platform base for your recliner. If possible, limit sitting in a chair that swivels, rocks, or is on wheels. Always push off armrests when attempting to stand and return to sitting by safely backing up to the chair and slowly descending while using armrests.

-In the bathroom, several considerations may bolster safety through the use of durable medical equipment (DME). A toilet riser, with or without armrests, can simplify transfers. Use heavy bath rugs that won’t slip. Grab bars can enhance safety getting in and out of a tub/shower. Remember that grab bars are secured into studs. Plastic suction bar devices may provide stability but can fail if too much pressure is involved. Clamp devices secured to the side of a tub can help when stepping over and back. If you are still fearful, consider using a transfer bench that allows you to sit outside the tub and then scoot over into the enclosure for a shower while remaining seated.

-While spending time in the kitchen or laundry, additional measures can also promote stability. Any rug should be non-skid. Have a secure stool if you must reach and if fearful allow someone else to perform the task. When arranging cabinets keep the most used items near counter height with lighter/less used items placed higher, keeping heavier/ bulkier items such as pots/pans/appliances reserved in a lower position.

In closing, falls may affect many of us as we age. It is important to manage not only our bodies but also our environment to reduce exposure. Become or remain pro-active. Report changes in strength, vision, hearing, sensation, blood pressure and mental status to your physician. Take medication if needed as prescribed, and be aware of possible side effects. In needed, address your safety concerns for possible therapy referral to a home care or outpatient Physical Therapist or Occupational Therapist. Remember to stay active and exercise to influence strength and stability.


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