One-third of people aged 65 and over will fall at least once each year. Falls can lead to traumatic brain injury (TBI) hospitalizations and concussions, as well as osteoporotic fractures (e.g. broken hip, broken ankle).
Many older adults fear falling so restrict their daily activities so much that their risk of falling actually increases.
What factors increase the risks of falls?
Personal risk factors:
- Inactive or sedentary activity: Not achieving 150 minutes of medium to intense physical activity each week.
- Frailty: Loss of muscle mass, grip strength and balance, mobility problems, slower reflexes, muscle weakness, poor balance and poor posture.
- Age: Adults aged 65 years or older are at increased risk for fall-related hospitalizations, loss of mobility and independence.
- Gender: Women are at higher risk for falls and hip fractures and men are more at risk for fatal fall injuries.
- 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 eyesight, hearing, reduced sense of touch and ability to know the position or movement of a body part without looking.
- Changes in mental alertness due to depression, delirium, interactions or side effects of medications, alcohol use, poor nutrition, dehydration or lack of sleep.
- Taking multiple medications, particularly those known to increase drowsiness and risk of falling such as antidepressants, tranquilizers and antihypertensives.
- Poor nutrition: Not reaching recommended intake of protein, calcium or Vitamin D for age and gender.
Outdoor risk factors:
- Lack of pedestrian-friendly sidewalks and walkable areas close to home, services and amenities.
- Uneven sidewalks or pathways.
- Steps without handrails or marking on the edges.
- Poor outdoor lighting: either not enough or too much glare.
- Objects narrowing or impeding sidewalks or pathways such as bike racks, garbage cans or metal grates that are slippery when wet.
- Snow, ice, pooled water or wet leaves on stairs or walkways.
- Unmarked curbs or corners without curb cuts.
- Long crosswalks without pedestrian islands.
- Timed pedestrian crossings which are too short to safely cross with limited mobility.
- Unlit pedestrian crossings, sidewalks or pathways.
- Sidewalks without street furniture such as benches.
- Climbing ladders or using a chair in place of a stable step stool with a safety rail.
- Exceeding the daily recommended limits of alcohol consumption in Canada’s low-risk drinking guidelines.
- Lack of awareness of medication interactions.
- 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.
- Wearing loose fitting shoes, shoes with thick soles, shoes with high heels, or shoes inappropriate for weather conditions
- Lifting or trying to carry bags which are too heavy or unevenly loaded.
Social and economic factors:
- Living alone.
- Limited or lack of social support or connections, especially support and connections that are close by.
- Not having enough income to choose a healthy lifestyle through diet and physical activity.
- Lack of accessible, safe housing or income to cover home adaptations as age and mobility changes take place.
- Lack of access to health care services or health information due to geography, social isolation, language or literacy issues.
What can I do to lower my risk of falling?
- Maintain an active and healthy lifestyle. Meet the Canadian Physical Activity Guideline of 150 minutes per week through exercise and good nutrition.
- Get recommended daily amounts of Vitamin D, Calcium and protein in your diet; consider finding a community centre with meals programs close to you.
- Get annual physical checkups, including vision and hearing exams.
- Maintain a physical activity program to increase your balance (e.g. Tai Chi or Yoga).
- 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.
- Take your time going up or down stairs, and step carefully when carrying items.
- 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.
- Be socially active by joining a community group, or an online community of interest.
- Get together with friends or family in person or using online video call technology.
- Have your health care provider or pharmacist regularly review your over-the-counter, prescription medications and supplements.
- 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 a future fall.
What can I do to keep my home safe?
Stairs and steps:
- Make sure that stairs are well lit and you have light switches at the top and bottom of indoor stairs.
- Keep stairs and outdoor steps in good repair and free from 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 indoor stairs and outdoor steps.
- Make sure the outdoor 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, in bathtub and shower areas.
- 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.
- 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 phone or communication device within easy reach from your bed.
- Sit on the edge of your bed for a minute before getting up after a rest.
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:
- HealthLinkBC File #68j Healthy Eating and Healthy Aging for Adults
- HealthLinkBC File #68e Food Sources of Calcium and Vitamin D
- Canada’s Low Risk Drinking Guidelines: https://www.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