How to prevent falls

At any age, you can fall.

However, when you’re over 65, falls come with much bigger risks including broken bones that may not heal quickly.

Falls are the leading cause of injuries among adults aged 65 and older. Here’s why:

Falls can happen because of:

Vision: As you age, your vision may change, and you can develop macular degeneration, glaucoma, cataracts, diabetic retinopathy, etc. Changes in your eyesight can keep you from clearly seeing obstacles in front of you as well as changes in flooring surfaces. Those vision issues also can make it harder to judge the steepness of steps or curbs.

Sense of balance: Your inner ears contain three fluid filled semicircular canals that help you keep your balance. The sensory organs in your inner ears help you figure out how your head and body are moving to maintain your balance. Medications and some illnesses can sometimes cause vertigo, the feeling that the room is moving, which can affect your balance. Physicians and vestibular rehabilitation physical therapists can help treat the balance system in your ears to improve your balance.

Network of nerves that help you recognize objects, textures and body movements: This network enables you to feel and respond to different sensations and process information about body position and movement. It allows us to recognize different textures like walking on an even sidewalk versus walking over an uneven surface like grass. Certain metabolic conditions such as diabetes with peripheral neuropathy can damage this network of nerves. That can cause you to experience numbness, tingling, pain, reduced sensation, decreased coordination and a decreased sense of movement, which can affect your balance.

Reaction time: As you age, your reaction time slows and you lose muscle mass and strength, making it difficult to regain your balance after a sudden movement. To reduce your risk for injury-related falls, keep an active lifestyle to maintain muscle tone and flexibility, and to slow bone loss. Strong muscles can improve how well you move and react to regain your balance.

Medication side effects: Some medications can cause dizziness, lightheadedness, drowsiness and blurred vision, which in turn can affect your balance. If you’re taking several different medications, you’re at higher risk of falling. Cognitive changes, alcohol and unsafe footwear can also make it more likely for you to fall.

Changes you can make to your home to prevent falls

• De-clutter: Keep the floor clear of clutter. Avoid using throw rugs. For large area rugs, make sure they have nonslip backing or use double-sided tape to keep the rug secured to the floor. Use bright tape to mark where floor surfaces change.
• Light up your home: Use night lights in the bedroom and bathroom and by stairways, in case you need to get up in the middle of the night.
• Have handrails for your stairs: Mark the edge of each step with bright tape so that you can see where the step below begins.
• Make your bathroom safe: Use a non-slip mat in the shower and bathtub. Install grab bars by the toilet and in the shower. Use a tub seat and/or elevated toilet seat as needed.
• Make your kitchen safe: Place the most used kitchen utensils at counter height or within easy reach. Ask for help or use a sturdy stepstool with a handle if you need to reach something on a higher shelf.
• Keep outside lights on: Get help to remove ice on walkways, as well as leaves and rocks in the yard. Wear supportive shoes when walking.

10 fall prevention tips

When you move from lying down to sitting up or from sitting to standing, do it slowly to make sure you don’t feel dizzy or lightheaded.

1. Don’t rush when walking.
2. Be aware of your pets so that you don’t trip over them.
3. Use a cane or walker to provide additional support while walking.
4. Stay active. Do exercises that work on your strength and balance.
5. Make sure you drink enough water. If you’re dehydrated, you may feel dizzy and off-balance.
6. Talk to your physician about possible medication side effects that may be affecting your balance.
7. Get your vision and hearing checked regularly.
8. Have a device within reach to call for help in the case you fall — a cell phone, smart devices like smart watches that detect falls, Alexa to call for help or emergency alert necklaces.
9. Have a fall risk assessment done by physicians or physical therapists.

The Ohio State Wexner Medical Center offers a specialized Fall Prevention Clinic, with dedicated experts ready to help you assess risk, address risk factors and treat problems from falling or that increase your risk of falling.

Getting over a fear of falling

Sometimes after you fall, you can become fearful of falling again. I try to build my patients’ confidence by having them do strengthening exercises and perform balance exercises in the clinic that gradually challenge them to stay balanced.

After a fall, if you become inactive because you fear falling again, that can lead to even more weakness and put you at a greater risk of falling again.

Fall Prevention Clinic

What’s the best way to get up from a fall?

First, stay calm and take a few deep breaths to relax. Figure out how you’re feeling and decide whether you’re hurt.

If you think you can get up safely without help, slowly get up on your hands and knees and crawl to a sturdy chair. Put your hands on the chair’s seat, slide one foot forward so that it’s flat on the floor, keeping the other leg bent so your knee is on the floor. From this high kneeling position, use your arms to push up from the chair, slowly stand up, and turn your body to sit down on the chair.