Fall Prevention for the Elderly: Risk Factors & Prevention Strategies 

The importance of fall prevention in ensuring the health and well-being of elderly persons cannot be overstated. Not only are elderly patients more likely to experience balance problems, but they are also more susceptible to potentially serious injuries that falls can lead to. 

There is a direct link between falls and mortality, and loss of mobility and function.

In this article, we’ll take a look at why that is the case, as well as some of the fall prevention strategies that can help. 

Fall Risk Among the Elderly in Australia 

Falls are the leading cause of accidental injuries among older Australians. This is especially concerning as our population is ageing (that is, the percentage of the population that is over 65 is rising). 

According to HealthDirect, 1 in 4 people who are aged 65 and over have at least 1 fall per year.

Falls accounted for 233,000 hospitalisations in 2021–22. 

Problems that arise from falls

Falls can result in a multitude of injuries in the elderly, ranging from minor to debilitating and even fatal. 

• Hip fractures. Falls are the most common reason for hip fracture hospital admissions (9 in 10 cases). This injury causes severe pain and loss of mobility, and requires surgery. 
• Head injuries. One of the biggest dangers from falls is the potential for head injuries, which can be life-threatening.
• Broken bones. Osteoporosis is another factor to consider. Elderly people’s bones are more brittle and vulnerable to fractures when subjected to impact. 
• Loss of mobility. Even if someone is not seriously injured by a fall, it can still lead to a loss of confidence and make someone hesitate to be physically active. This can in turn lead to a deterioration in their lifestyle and health. 

Identifying risk factors for falls 

Certain disorders, lifestyle changes, as well as physiological changes that occur with age, can make elderly people more likely to fall. 

• Inner ear problems. One of the most common causes of falls is balance disorders due to inner ear problems, e.g., benign paroxysmal positional vertigo (BPPV). Episodes of BPPV can bring mild to severe dizziness, and can easily lead to a fall. 
• Motor and cognitive impairments. Impairments caused by either physiological or neurological conditions can affect someone’s gait, balance, and coordination, as well as prevent them from reacting in time to a loss of balance.

• Muscle weakness. Muscle naturally weakens and atrophies with age. If an elderly person does not take care to maintain muscle, it can result in a loss of strength and coordination that can make them more likely to trip and fall (for example, if they have difficulty lifting their feet when walking). 

• Medications. Some medications used for managing other illnesses can cause dizziness as a side effect. 

• Vision problems. Poor vision from eye disorders or age-related macular degeneration can make it difficult to see tripping hazards, such as uneven flooring or objects on the floor. 

Fall prevention strategies

Fall prevention involves a number of strategies to minimise the physiological risk factors as well as the environmental hazards, and providing assistive devices as necessary. 

Here are different ways occupational therapists, physiotherapists, and other health professionals can help an elderly person prevent falls: 

Home safety

One of the most important keys to fall prevention is making one’s home as safe as possible.  A good starting point is identifying and remediating risks such as:

• Clutter on the floor 
• Loose rugs, or mats 
• Uneven flooring
• Raised thresholds 
• Slippery surfaces, particularly in the bathroom
• Poor lighting 

Unsecured rugs can pose a tripping hazard for the elderly. 

On top of that, healthcare providers can also recommend home modifications such as: 

• Handrails and grab bars, particularly for stairs, toilets, and showers 
• Ramps to replace steps 
• Non-slip surfaces to cover slippery wood or tile 
• Handheld shower wand to allow for showering while seated 
• A raised toilet seat or over-toilet frame to make it easier to safely get on and off the toilet

Improving physical health to avoid falls  

Another important aspect of fall prevention is improving the elderly person’s overall health and mobility. Not only does this help prevent falling, but it can also help make them more able to catch themselves, and less likely to sustain a serious injury, if they lose balance. 

• Physical therapy to improve balance. Physiotherapists can test for balance impairments, and provide a treatment plan specifically to address it. 
• Strength and mobility exercises. A physiotherapist or occupational therapist can guide the patient through different resistance exercises that are safe and effective. This will help combat the muscle loss that comes with age, and help maintain the functional strength and mobility needed to move around safely. 
• Rehabilitation after hospitalisation or injury. Similarly, a physiotherapist can help someone regain strength and mobility after being hospitalised, undergoing surgery, or sustaining an injury. 
• Gait correction. A physiotherapist can also evaluate a person’s gait, and see if they are walking in a way that makes tripping more likely (such as shuffling). 
• Correcting vision impairments. It’s important that any vision impairments are immediately evaluated by an eye doctor so that the necessary treatment — which can range from simple corrective glasses and eye drops to surgery — can be prescribed. 

Assistive devices

In some cases, an occupational therapist may prescribe assistive devices to help with mobility. The type of assistive device recommended will vary depending on how significant one’s stability or balance impairment is. These include: 

• Canes. Canes, or walking sticks, make walking easier by providing an extra base of support. 
• Walkers. For those with more significant difficulty in walking, walkers offer more stability and allow more of the person’s body weight to rest on the apparatus, reducing the demand on the person’s lower body. 
• Reachers. Reachers or grabbers are tools that allow a person to more easily grab something that’s on a high shelf, or on the floor. This can reduce the need to use a step stool, as well as the risk of positional vertigo from bending down. 

Fall prevention is always better than cure

Fall prevention is, unfortunately, one aspect of health that many people don’t think of until it’s too late. 

But given how serious the possible consequences of falls can be, it’s worth it to be proactive. If you or a loved one is affected by one or more risk factors for falls, consider starting a conversation with your healthcare providers about what fall prevention steps may be appropriate. 

We have an expert team of physiotherapists and occupational therapists ready to help keep you safe. Give us a call at 02 8808 4000 or send us a message through our contact form to learn how we can help!