Balance & Fall Prevention in Older Adults

By: Cole Howell, PT, DPT

As time goes on, it is normal to deal with decreased strength, muscle atrophy, impaired balance, and visual impairments. That being said, falling is NOT a normal part of aging.

Many older adults are concerned with falling (either for themselves or for a loved one). As winter approaches, and icy sidewalks are a certainty, it is especially important to consider improving your balance. In this blog post, I am going to outline how you can reduce your risk of falling.

Why does having a fear of falling matter?

Living with a fear of falling can have a huge impact on your physical and psychological well-being. People with a fear of falling tend to become more sedentary, as they are apprehensive to try new activities. The inactivity can result in decreased muscle strength, muscle atrophy, and social isolation (which can lead to depression). Most notably, living with a fear of falling stops people from doing activities that they enjoy.   

Factors that increase your fall risk

Here is a list of things that can increase your risk of falling (don’t worry, we will discuss how you minimize these risk factors):

• History of a previous fall!
• Being female
• Having a sedentary lifestyle
• Being in overall poor health
• Recent hospitalization
• Advanced age
• Difficulty with walking or balance
• Leg weakness
• Becoming fatigued easily
• Limited flexibility
• Problems with your vision or sensation
• Getting dizzy when you stand up from sitting or lying down (orthostatic hypotension)
• Medical conditions such as heart disease, diabetes, stroke, Parkinson disease, or Alzheimer disease
• Trouble with your memory and cognition
• Joint pain or arthritis
• Poly-Pharmacy
• Depression and/or anxiety
• Home hazards such as throw rugs, poor lighting, or a lack of handrails on stairs
• Inappropriate footwear
• Inappropriate use of an assistive device

The more risk factors you have, the greater your risk of falling.

What can I do to reduce my chances of falling?

There are a few factors that increase your fall risk that cannot be changed, such as age and certain medical conditions. However, the vast majority of the contributing factors can be altered either on your own or with the help of a healthcare professional.  These include:

• Physical activity levels
• Home environment
• Vision
• Medication Use
• Addressing your fear of falling
• Muscle weakness
• Improper use of assistive devices
• Addressing social isolation

Home Set-Up

The easiest (and cheapest) way to reduce your risk of falling is to alter your home environment. Here are a few suggestions to make your house a bit safer:

1. Install night lights/well lit hallways! I can’t tell you how many times I’ve encountered people telling me “I woke up in the middle of the night and fell while walking to the bathroom.” Being able to safely navigate your home, especially at night, will reduce your risk of accidentally falling.
2. Get rid of loose/throw rugs. This mostly pertains to the kitchen and bathroom, but any loose rugs are potential tripping hazards. Bathroom rugs that do not slide around may be a better alternative. The fewer tripping hazards you have in your home, the better.
3. Install a shower chair or grab bars in your bathroom. Bathing or while transiting in/out of the tub is a common time for falls to occur. Installing a shower chair can help make bathing a safer process. Grab bars are another great safety precaution to have installed, as they give you something sturdy to grab onto while bathing, and while transferring in/out of the tub.
4. Use those handrails! If you have to navigate stairs (in your home, or out in the community), be sure to use the handrails for increased stability, especially if you feel unsteady. Make sure your handrails are secured properly!
5. Use a life-alert emergency response system. This is especially important if you live alone. Buying an emergency response system is a great safety net to have, just in case a fall does occur. This will allow you to get help in your time of need and can help you avoid further medical complications. If you buy one, be sure you actually wear the system (most are necklaces or bracelets).

Get your vision checked

Another way to reduce your risk of falling is to go for an annual check-up with your eye doctor. Making sure your current prescription is up to date and that you are seeing as clearly as possible will help you see potential obstacles that could otherwise lead to a fall.

Annual Physical

While you’re scheduling your annual eye appointment, you should also schedule your annual check-up with your Doctor. Keeping medical conditions under control and making sure you aren’t taking unnecessary medications will help you live a happier and safer life.

Physical Therapy/Exercise

Keeping yourself active and moving is a great way to reduce your risk of falling. Strengthening your muscles, especially your legs and core can create a noticeable difference. In addition, you should be training your balance and performing functional tasks (tasks that mimic things you do in your everyday life). You can get started by joining a group exercise class (yoga, tai chi, etc), meeting with a personal trainer, or scheduling an appointment with a Physical Therapist.

What do I do if I’ve experience a Fall?

Ideally, you are able to adopt some of the strategies discussed above and avoid experiencing a fall. However, accidents happen, and if so, you should know how to properly respond. Here are some steps to follow if you experience a fall:

• Check for injury
• Call for help
• If you hit your head head trauma or displays signs/symptoms of fracture/trauma, report to Emergency Room immediately.
• Once medically cleared, follow-up with Physical Therapist for an evaluation to discover the underlying cause and to receive appropriate exercises and education.  

I hope you all find this article helpful. Have a warm and safe Winter/Holiday season!