Watching Your Step: Safety Tips for Preventing Falls Among Seniors

By Alicia Schwartz, MSN, RN, Care Coordinator, VNSNY CHOICE Health Plans

The first day of fall—September 22, 2016—begins National Falls Prevention Awareness Week, an effort to educate people about how to prevent and reduce falls, especially among older adults. Nearly all 50 states, including New York, will participate in Falls Prevention Awareness Week activities this year. It’s a good time to talk about what family caregivers can do to help reduce this epidemic.

In the United States, more than 11 million people over the age of 65 fall each year— that’s one of every three senior citizens in the country! Plus, falls are the leading cause of fatal and non-fatal injuries to older people, and cause more than 90 percent of hip fractures. Aside from the injuries and even death that might result, falling can lead to decreased mobility and even more fear of falling, which in turn can limit a person’s independence and negatively affect their quality of life. As more of our elderly loved ones choose to age independently in their homes, it’s important that we have conversations about ways to prevent falls and reduce unnecessary injuries.

As a registered nurse with VNSNY CHOICE Health Plans, an affiliate of the not-for-profit Visiting Nurse Service of New York, I work closely with the elderly and their loved ones to develop a healthcare plan that addresses each patient’s individual needs, helping them live safely and independently in the home.

I’m often asked by family caregivers who don’t live with their older parents for advice on how to keep their loved ones safe. This helpful video suggests simple home modifications and daily living guidelines to help prevent trips and falls in the home: A handy Home Falls Prevention Checklist can also be downloaded at: Here are a few things to keep in mind to help at-risk seniors avoid serious fall-related injuries.

• Age: While falls can happen to people of all ages, the older you are, the more susceptible you are to injury, and recovery becomes more challenging. In fact, people age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.

• Multiple Medications: Taking four or more medications, especially those that may cause side effects or interactions such as dizziness or drowsiness, increases one’s risk of falling. You should talk with your primary doctor about any side effects your family member is experiencing from medications. Taking medicine with a meal or before bed or working with the doctor to have lowest possible dosages might help ameliorate some symptoms.

• Vision: Family caregivers should encourage older loved ones to get an annual vision exam, because failing vision can go unnoticed when someone is able to carry out daily activities such as reading the paper or watching television. Vision problems can be the cause of a trip or fall and improving vision can go a long way to keeping seniors safe on their feet. For individuals with visual problems, there are agencies like the Light House or Visions for the Blind that can evaluate the home to ensure it has the proper equipment or lighting. A study published in the Journal of the American Medical Association by researchers at the University of California, Los Angeles, found that for the oldest patients, and those who were very ill, those who had cataracts removed sustained 16 percent fewer hip fractures in the year after surgery than those who did not. Patients ages 80 to 84 experienced the most significant benefit, with 28 percent fewer hip fractures.

• Home Environment: It’s important to make periodic assessments of the home to reduce tripping hazards. Keep pathways clear of clutter and well-lit, make sure floors are dry, ensure that stairs are level and evenly spaced, and install handrails wherever there is more than one step down. Also, carefully gather wires, and tape down carpets. Bathtubs should have a bath mat to prevent slips and falls, a tub seat for individuals with poor balance, and grab bars in the bathroom so no one is tempted to grab onto a towel bar (which is not meant to support weight). Especially for those seniors who have some incontinence and find themselves hurrying to the bathroom, it’s critical that their pathways are clutter-free, secure and well-lighted. Obtaining a bedside commode, and using incontinence pads or pull-ups, can also help prevent accidents which can result in a fall.

• Footwear: Research says if you’re over 65, you increase your risk of falling if you walk barefoot or only with socks. Our reflexes decrease as we age, so if your family member happens to step on something injurious, the reflex that causes him or her to hop off it may cause them to fall. Encourage your family member to wear comfortable well-fitting shoes both around the house and outside. Avoid shoes that have open toes or open heels which can cause the individual to trip or lose their balance if the heel comes off the shoe.

• Assistive Devices: If your family member uses a cane, walker or crutch, make sure it fits properly in terms of height and handle grip size, and that they use it correctly. Avoid borrowing devices from others, since assistive devices are not one size fits all. Some individuals may be able to use a cane while others require a walker. At least once a month, turn it upside down and make sure the rubber tips are in good shape and change them if they show signs of wear.

• Balance: Good balance is important to prevent falls. But a person’s balance may be affected by illness or medication. Avoid bending or looking down as you walk as this causes the balance to shift, making the individual more prone to fall. Walking straight is best. If you feel you have to hold your family member or they may topple, talk to your doctor. He or she may recommend a balance retraining program.

• Muscle strength: Research at California State University showed that physical activity plays an important role in preventing and/or lowering an older adult’s risk for falling. As a caregiver, you can help your family member keep up their muscle strength by reminding them, coaching them, or participating with them in simple exercises such as walking, yoga, and exercise classes for seniors.
Alicia Schwartz is an RN and Care Coordinator with VNSNY CHOICE Health Plans, affiliated with of The Visiting Nurse Service of New York, the largest not-for-profit home- and community-based health care agency in the country. For more information please visit or call 1-888-867-6555.