The 8 Best Ways to Reduce and Prevent Falls

What is a fall?

There are different definitions and perspectives of what constitutes a fall. A fall includes the body lowering to the ground regardless of if it was controlled or uncontrolled and regardless of if injury is present. Near falls (or almost falling) may appear like a loss of balance.

Who falls?

Falls and near falls can occur in people of all ages, including children and young adults.

Contrary to popular belief, even though falls occur more frequently in older adults, falls are not a normal part of aging. Every year, millions of people fall.

Falls are expensive in both time and money and are responsible for many emergency room visits, especially in our older adult population. According to the Morbidity and Mortality Weekly Report from 2016 by the U.S. Department of Health and Human Services, about 1 in 4 adults age 65 and older fall every year.

Why do falls happen?

Health conditions and physical changes that come with wear and tear on our body can attribute to fall risk. In addition, side effects from medications that are used to treat chronic conditions – although they are necessary when prescribed – may also increase your fall risk.

If you are an older adult on a lot of medicine, you may benefit from seeing a geriatrician, a primary care physician who often has additional specialized training in treating older adults, specifically those 65 years and older. Their scope of practice encompasses many multifaceted areas; two of these areas include mobility and medication management.

For example: A geriatrician and a pharmacist may look at all of your medications and discern their risks versus benefits and focus on reducing the amount of multiple medications, which can thereby reduce one’s risk factor of falling due to side effects of medications.

When you add in other factors such as environmental hazards, limited physical activity or fear of falling, your fall risk factors grow exponentially.

How to reduce falling?

Here are eight tips to improve your fall risk reduction and fall prevention skills.

1. Survey. Self-assess: How are you doing? Check out the CDC STEADI (Stopping Elderly Accidents, Death, & Injuries) initiative, which has downloadable materials and brochures for patients, families and practitioners. In addition to free downloadable brochures that emphasize safety and independence, there is guidance and education on simple exercises, quick facts on falls, graphics, success stories and more.
2. Modify: Prevention does not mean you should stop doing everything you love. Activities that are meaningful to you are important to continue. If you stop all your activities to reduce your fall risk and sit in a chair all day long, other problems impacting both your physical health and mental health will occur.
3. Attend appointments: Attend your health management appointments on a regular basis. This includes seeing your primary care provider, following up with specialists as recommended, receiving an annual vision exam from a vision specialist (i.e ophthalmologist, optometrist), and getting your hearing checked (audiologist).
4. Manage prescriptions: Follow your prescriptions (both for medications and for assistive devices). Your pharmacist works alongside physicians and providers to support a medication regimen that is tailored to you. Taking yourself off a medication can be dangerous and attribute to your fall risk. Likewise, if you were prescribed by a physical therapist to use a rolling walker after an elective knee replacement without completing the next steps of your rehabilitative can put you at higher risk for falls and re-injury.
5. Home assessment: Home is where the heart is (ask for a referral to occupational therapy for a home assessment)
   1. Place bed in lower position as needed. If you are having difficulty stepping up into bed, consider removing the box spring so your mattress is lower. Another potential helpful factor is to place removable bed rails in between your mattress and box spring.
   2. In addition, an OT practitioner may also work with you on balance similarly to how a physical therapy practitioner does. The difference is in the why. An OT may guide you to improve your balance while , bending and reaching while seated to get dressed. A PT may instruct you to increase your sitting balance with core strength exercises in preparation for better standing.
6. Shoes: Wear sensible shoes. Nowadays there are many options that are both stylish, supportive and adaptive. There are a multitude of stylish and adaptive shoe technology options by shoe companies such as Friendly Shoes, Zappos Adaptive, Kizik, BILLY, and SOREL Universal. These shoes have options such as seamless zippers and extended pull-ties to ease reach or options that eliminate bending forward at the hip (perfect option for someone having had a recent hip replacement!).
7. Move: Move it or lose it (ask for a referral for a physical therapy evaluation for balance training and strengthening). Ps never take yourself off an assistive device.
8. Implement: In addition to the above, here a few additional strategies to improve your longevity and reduce your fall risk.
   1. Perform slow position changes (for example, when going from lying down to sitting up, take an extra minute to sit on the edge of the bed and pump your ankles before standing). Change positions throughout the day. Reposition your body frequently whether you are seated in a chair, lying in your recliner, etc.
   2. Journal five minutes a day to reflect on any near falls and why they may have occurred. You may also get in the habit of recording your blood pressure.
   3. Before standing or whenever entering an unfamiliar area, visually scan the environment. Notice any changes in flooring as well as scan to find areas of rest for just in case scenarios (such as a sturdy chair or bench).
   4. Sequence effectively. Rather that pulling up on a surface to stand (pulling up on walker or pulling up on towel rack in bathroom, which is a bad idea), push up from the surface you are seated from to stand.
   5. Maintain proper fluids. Drink water or other fluids throughout the day (unless you are on a physician-prescribed fluid reduction program, then drink to the amount allowed). Dehydration increases fall risk; this is usually preventable.
   6. Eat well. I am not a registered dietitian or nutrition expert so I will keep this broad. Eat more vegetables. Eat foods that fuel you. Consume foods that give you withstanding energy not quick bursts of sugar high followed by crash and burn. Prevent a fall associated with blood sugars dropping by eating mindfully.
   7. Engage in exercise and household activity as able. Set an alarm on your phone to go off a few times a day to auditorily cue you to stretch, raise your arms above your head, perform a few knee kicks, reach across your body, turn your head, etc. Remember that when you are performing dreaded household chores, that you are also moving your body. Your body thrives on movement.
   8. Socialize with others. Community fosters accountability.