This post was written by Melissa Rumple, NP, PPG – Internal Medicine.
Patients sometimes laugh or act as though the question "Have you had any falls in the past year?" is irrelevant, unnecessary or silly. What you might not know, is that falls are not a "normal" part of aging. We ask, to determine your risk of falls or what contributing factors might be avoided.
The risk
In the United States, injuries from falls are a leading cause of preventable deaths for persons 65 years or older (Centers for Disease Control and Prevention, 2026). Falls for this specific population are common, costly and preventable. An average of 30% of Hoosiers fall every year.
One fall can change it all. Including but not limited to:
- Future fear of falling
- Head injuries
- Hip fractures
- Loss of independence
These factors can greatly impact how the next transition in your life follows.
Prevention
There are some easy interventions that can assist in preventing the first or next fall. This applies to patients and their caregivers.
Exercise – This is a great place to start. Maintaining strength and mobility can assist in maintaining balance. If you are currently inactive, you don’t have to start with a Jane Fonda workout! Start by sitting and standing during commercial breaks. Increase the amount of walking you do in a day, an extra trip down your hallway or around your kitchen. Hesitant? Contact your healthcare provider and talk about how you can build strength, balance and endurance. They can refer you to community resources or physical therapy options.
Review current medications – Medication reviews can help identify high-risk medications that may contribute to dizziness, balance concerns or changes in mental status. Remember, even if you have been on a medication for years, this does not mean it is the only option for you. Your body as it ages processes medications differently, possibly more slowly. Adjustments to doses, or new medications altogether may be necessary.
These high-risk medications may contribute to falls:
- Benzodiazepines - Alprazolam, Lorazepam, Diazepam. These medications help the body to relax, unfortunately they are among the leading cause of nighttime falls and hip fracture.
- Sleep Aides - Zolpidem, Eszopiclone. These medications can lead to next day grogginess, sleep walking and delayed coordination.
- Opioids - Hydrocodone, Oxycodone, Tramadol, Morphine. These medications can contribute to dizziness, sedation and orthostatic hypotension when combined with Benzodiazepines or alcohol the effects can be significant.
This is not an all-inclusive list. It is likely that these medications have greater risk factors when combined. Ask for a review if you use five or more medications. Ask if all medications continue to be necessary and review the option of decreasing medications that are no longer warranted.
Review home safety – This is the place we feel the safest. However, this is where most falls will happen (National Institute on Aging, 2022). Too often, when talking to patients I hear, "I don't use my walker at home. I use walls or chairs to help maintain my balance."
Here are some home safety ideas that can help prevent a fall:
- Clear the floors. Remove items that do not allow room to maneuver your walker, wheelchair or cane. Get rid of throw rugs, loose boards, cords or other trip hazards.
- Consider obedience training for small animals that often hang out at your ankles.
- Put grab bars in place in bathrooms to assist getting up from the toilet, and in and out of the shower. Place railings in hallways and stairs.
- Make sure you have adequate lighting during the day and especially at night. Consider motion lights for hallways and bathrooms.
- Get a life alert or other fall detection and emergency response device. Then activate it and keep it on your person at all times. In the event of a fall, response time can make a big difference. If you are unable to get up, you may not be able to get to your phone on the counter.
Get off on the right foot! – Ensure that you have proper footwear. Footwear should be properly fitted, have firm, textured soles, beveled and broad heels to prevent slips. Have ties or straps to allow shoe to "hold" onto the foot.
Quick takeaways
For quick reference, here are the key points for aging safely:
Risk factors for falls
- Medications
- Poor vision
- Weakness
- Neuropathy
- Blood pressure changes
- Improper footwear
- Dementia
- Parkinson's
- Clutter
Fall complications
- Hip fractures
- Loss of independence
- Fear of falling
- Depression
- Nursing home placement
Prevention
- Exercise - strengthening
- Home safety
- Medication review
- Walker/Cane - assistive device
- Balance training
- Foot care
Get resources for aging in place safely and fall prevention at cdc.gov.
