Table of Contents

• Introduction
• Causes of Falls in the Elderly
• How to Prevent Falls in Senior Citizens
• Environmental Factors
• Medications
• Keeping Seniors Active
• Preventing Falls in the Home

How Do You Prevent Falls in the Elderly

Each year, millions of elderly folks fall. In fact, more than 25% of the senior population in the US  falls each year. But, typical for this demographic,  less than half tell their doctor about it. Did you know that falling once doubles your chances of falling again?

Each year, 3 million older people are treated in emergency departments for fall injuries and over 800,000 of these folks are hospitalized because of a fall injury, most often because of a head injury or hip fracture. Statistics show that in 2015, the total medical costs for falls totaled more than $50 billion and Medicare and Medicaid shouldered 75% of these costs.

 As a result, this important issue is being researched by local and national organizations in an effort to curtail injury and cost.

Along with that, many caregivers are wondering what they can do to prevent their loved one from falling and sustaining an injury that may take them to the hospital or something worse.

In order to prevent something from happening, you have to understand why it may be happening in the first place. There are many different reasons that may cause the elderly to fall. It’s a safe bet that there are a combination of things that lead to someone losing their balance and falling.

What Causes the Elderly to Fall

The number of things that lead (or can lead) to falls are almost infinite. And in many cases, factors that cause seniors to fall can combine and be difficult to single out. So it’s not just one thing to consider but it could be 2 or more. 

In general, the causes for falls in the elderly generally fall into 5 or so major catagories. The following is a list of the major areas.

1. Medications
2. Health conditions
3. General weakness
4. Environmental factors
5. Poor choices

With this list, the combinations of causes are too many to count. For instance, a person who may have early dementia or who has had a stroke, may have poor memory and may over medicate themselves with a narcotic or blood pressure medicine that may make them drowsy and they end up falling. Another person may have vision trouble and their cat gets underfoot and they end up falling. Still others may think it’s a good idea to climb up on a step ladder to change a light bulb rather than waiting for another family member to do so safely.

In each of those scenarios it’s a combination of things that lead to falls. Or, it could be something general weakness combined with breathing problems that will lead to low oxygenation in the muscle tissues and rather than sitting down, the care recipient has it in their mind that they are going to finish the current task no matter what. Frequently, a call to the paramedics is the end result because they were not realistic about their limitations.

How to prevent Falls in Senior Citizens

Figuring out the real cause of falls is a matter of honest discussion, self awareness, and observation of patterns. If your loved one is falling frequently, then there has to be a pattern to be discovered. Is it only at certain times or after certain events, like going to the bathroom? Is it only in certain areas of the home? When did the falls start? Was there a change in medication?

Having a detailed discussion about the falls will help your doctor or other health care provider come up with a game plan.

In many cases, it takes a little more investigation and may have to do with something that may not be as apparent, like a urinary tract infection or possibly a condition known as orthostatic hypotension. 

Orthostatic hypotension is a lowering of the blood pressure when a person stands up. Many times, this condition goes unnoticed because when a person measures their blood pressure, it’s usually while they are seated, not when they are standing and it looks like it’s normal. But once they stand up, their blood pressure may drop 30 points and continue to drop a little more the longer they stay on their feet. So a simple test would be to take their blood pressure while they are standing and see if there is a problem.

How to Keep Seniors From Falling

It’s difficult to prevent any falls because accidents do happen from time to time. However, the goal of this particular guide is to help you learn how to reduce the potential for falls with fall prevention strategies.

There are obvious steps to take when you understand the general reasons why someone may be more prone to falling. Some of these steps are simple and are under our direct control.

Environmental causes of falls are easier to address than others. In many cases, there are things in the home that contribute to the elderly falling. Floors that are in disrepair or have unsafe coverings like throw rugs or “runners”. Stairs that may be a little too steep or do not have handrails. Poorly lit hallways and rooms. Poor choices for floor coverings. Electrical cords. Clutter. 

The above “environmental” hazards are easier to address more so than say a chronic health condition like hemiplegia. However, sometimes the elderly can be a little stubborn when it comes to changing things in their homes or when confronted with discarding furniture or other items that may have sentimental value. Let’s face it, many people just don’t want to admit that they are getting old and need more help. 

Along this same train of thought, many people just haven’t planned for their golden years. Most of us really have not considered that we will eventually get old or the changes needed that will make living independently easier. 

For instance, many elderly have lived in the same home for 50 years or more and never have had their home remodeled for their golden years. A home that was built in the 1950s will typically have narrow hallways and doorways, poor lighting (by today’s standards), and typically not have open floor plans that will accommodate walkers or wheelchairs. There may be stairs to enter the home without handrails. There may be very small bathrooms. Many times, the powder rooms are just large enough for 1 person to fit into and will not accommodate a walker or a caregiver to help if needed. It’s just the way things were done.

Making the necessary “environmental” changes are relatively easy when compared with a chronic health condition that has no cure. Changes to the living space can run from simply removing throw or area rugs and installing motion activated night lights on the easy end, to downsizing and exchanging larger pieces of furniture for smaller pieces, thereby providing more room to maneuver, to full blown remodels of bathrooms, entry ways, and installation of wheelchair ramps.

Managing Medications Properly

Another cause of falling is due to issues involving medications. Again, this may be more of an easy fix, than trying to address a chronic health condition. Many seniors take many medications and many different times of the day. This can get confusing and if the senior has a poor memory this can complicate matters even more. 

Helping seniors manage their medications is another way that falls may be prevented. There are simple ways to help older folks who want to live as independently as possible better manage their medications. 

Some pharmacies may fill prescriptions in what are called “bubble packs”. Instead of providing individual containers filled with one medication, the bubble pack is filled with each medication prescribed and is to be taken at a specific time. This is very convenient for people who may have trouble filling a pill box on a weekly basis.

If your pharmacy doesn’t supply the bubble packs, then a “Medi-set” or weekly pill box is another option. These containers are divided by the days of the week and can help keep seniors on track with taking the right pills at the right times to avoid over or under medicating. The senior or their caregiver manually fills the prescribed medication into the correct day and time of the week and are generally refilled weekly.

But in other cases, a different tool may be needed. For some, the medi-set pill boxes can still be confusing and the elderly may get confused about dates and times. So, as a solution for this particular issue there are electronic medication dispensers that only dispense pills at certain times for those who may take multiple medications at multiple times of the day. As with most things these days, there are multiple electronic options for dispensing medications ranging from simple stand alone options to those that are connected to the internet and allow caregivers the ability to track dispensing and when prescriptions need to be refilled.

Stay Active to Prevent Falls

But, one of the easiest ways to prevent seniors from falling is to keep them as mobile as possible. As mentioned previously, one primary reason for falls in the elderly is general weakness. Many seniors, having retired, have become sedentary. This inactivity leads to reduced strength and stamina.

Getting your loved one more active with a regular program of physical activity or even exercise is imperative to help them maintain the best quality of life possible and to keep them in their home as long as possible.

The physical activity needed for the elderly is not the same as for their younger caregivers. Lifting weights or jogging are not necessarily the goal. It’s better to simply help them increase their physical activity on a regular basis with more functional activities that will be helpful for their day to day living than to try to get them to do something that is more complicated or inconvenient for them. 

If possible, a simple walking program is a good way to start. It doesn’t have to be strenuous, involved, or take much time. Getting out of the house and walking a short distance down the sidewalk is a good way to start. 

A progressive walking program done consistently will not only strengthen the legs and lower body, it will also improve their balance and their confidence in their own ability and decrease any fear they may have of falling. 

The important part, as with any endeavor,  is “consistency”. It should be looked at as a lifestyle change that will continue for the rest of their lives. For them to get started, will probably mean that caregivers will need to take time out of their day to help the elderly stay consistent and to assess how they are progressing. If possible, getting them involved in a local senior center where their peers gather to exercise is also an option.

Preventing Seniors From Falling in the Home

As this guide points out, there may be many different reasons or causes of falling in the elderly. Whether its a medication issue, a result of a medical condition such as a urinary tract infection or blood pressure issues, or, has more to do with general weakness, environmental factors in the home or just plain stubbornness and unwillingness to accept that they are just getting older, the cause has got to be discovered before a remedy applied.

Determining the cause will take observation and having honest conversations and afterwards implementing a remedy will be a lot easier. Having the family doctor request home health services can also be of benefit as they will be able to help educate the family and care recipient about medication management, chronic disease management, assess the home for safe mobility and also any appropriate medical or mobility equipment that may be needed.

Implementing a fall prevention strategy is also something to be revisited regularly or with any change of health status and as the years roll as modifications to the program will be ongoing.