Falls in Older People

Many falls are caused by physical problems or by dangers in the home.

Physical problems that raise the chance of falling:

• Balance problems

• Problems moving around

• Problems seeing clearly

• Problems feeling your feet

• Medicines that make you sleepy or dizzy

• Blood pressure or heart problems

• Confusion

• Muscle weakness

• Sickness

Dangers around you that raise the chance of falling:

• Darkness or dim lighting

• Slippery floors

• Electrical or extension cords or objects that are in the way of walking

• Clutter on the stairs or floor

• Uneven sidewalks and broken curbs

• Being in a place you don't know well

Falls can cause:

• Broken bones, especially a broken hip, because older people often have weak bones (osteoporosis)

• Bruises, strains, or sprains

• Deep cuts

• Organ damage

• Torn ligaments

• Head injury

If you fall while alone and have to stay on the floor for a long time, you may develop problems like:

• Dehydration (when there isn't enough water in your body)

• Low body temperature (hypothermia)

• Pneumonia—an infection in your lungs

Doctors will ask you what happened and whether you had any symptoms before the fall (like dizziness or chest pain). They'll ask about your medicines and whether you’ve been drinking alcohol.

Doctors will do a physical exam to look for injuries and figure out why you fell. They'll look at your:

• Blood pressure—if your blood pressure goes down when you stand up, your fall may have been caused by dizziness or light-headedness

• Your heart to see if you have problems with your heartbeat, abnormal heartbeat pattern, or heart failure

• Muscle strength

• Eyes and vision

• Ability to balance and move easily and smoothly

Doctors will:

• Treat injuries from your fall

• Treat any problems that might have caused you to fall

• Help you make a plan to avoid future falls

• Refer you to physical or occupational therapy, if needed

The effects of a fall can last a long time. For example, if you break your hip, you may not be able to walk well even after treatment and rehabilitation.

Fear of falling can also lead to problems like less activity and joint stiffness.

• Get regular exercise—weight training, balancing, and stretching exercises are helpful

• Wear shoes with nonslip soles

• Stand up slowly after sitting or lying to avoid getting dizzy

• Have your doctor show you the Epley maneuver if you have problems with vertigo (dizziness)

• Talk with your doctor about the medicines you take to see if any of them raise the chance of falling

• Have your vision checked and get new glasses if you need them, and have glaucoma or cataracts treated

• Work with a physical therapist, especially if you use a walker or cane, so you know how to use it safely

Make your home safer:

• Have good lighting

• Add light switches that are easy to reach or on a motion sensor

• Add lighting to inside and outside steps

• Put nonskid strips and sturdy handrails on stairs

• Add more electrical outlets or securely fasten extension cords over doorways (or under carpet) so you won’t trip on them

• Keep floors and stairs free of clutter

• Put grab bars in the bathroom by the toilet and bathtub

• Install an elevated toilet seat

• Tape down loose throw rugs (or get rid of them)

• Put nonslip mats in your bath and kitchen

• Put frequently used household items in places where you won’t have to stretch or bend to reach them

If you fall and can’t get up, turn onto your belly and crawl to a piece of furniture, and use it to pull up. Keep a telephone somewhere you can reach from the floor or wear a medical alert device.

Just the Right Height

For people who are recovering from a leg injury or surgery, using a cane that is the correct height is important. A cane that is too long or too short can cause low back pain, poor posture, and instability. The cane should be held on the side opposite of an injured leg.