Fall Risk Assessment and Prevention in the Elderly

Fall Risk Assessment and Prevention in the Elderly

Studies suggest that fully one-third of seniors in the U.S. will experience a fall each year. That is a huge number, indicating that the need for awareness regarding fall prevention in the elderly is more necessary now than ever before.


For younger people, a simple fall at home may not be much to worry about. A bruise may be the most serious injury, but that is not the case with the elderly. When proper fall precautions are not taken and a fall occurs, elderly people are apt to receive a serious injury, perhaps even including a broken bone.


It is extraordinarily difficult for an older person to recover from such an injury. They may require extensive hospitalization, physical therapy, and ongoing care. Many fall victims never make a full recovery as the fall causes their overall physical and emotional condition to deteriorate.


If you are concerned about preventing falls at home for yourself or a loved one, then it is advisable to be able to identify the risk of falls in elderly people. When you understand these risks, you will better understand the steps you need to take toward fall prevention.

Because falls are the leading cause of injury to seniors, it is imperative that you begin today if you want to protect yourself or a loved one.


Risk Factors for Falls in the Elderly

Several risk factors may be at fault when a senior suffers a fall. In fact, it’s not usual for fall victims to actually have a combination of several of these risk factors, making a fall virtually inevitable. Studies suggest that an individual with four risk factors suffers from a 78 percent likelihood that they will fall.


One of the most common risk factors is having suffered previous falls. A single fall triggers a fear response in the victim, making them feel averse to engaging in the same activity again that led to the fall. This may lead elderly people to fear simple things like walking to the mailbox or preparing a small snack.


Muscle strength naturally decreases as people age. Part of this decrease is owed to being less active than before. Muscles quickly atrophy when they are not put to regular use, and a natural breakdown of muscle fibers happens concurrently. This loss of strength is a major risk of falls for elderly people.


As people age, they also may experience a number of conditions that affect their gait and balance. These impairments make it difficult to walk or stand, increasing the likelihood of a fall. Visual impairments maybe even more common, and they frequently are a contributing factor to falls at home and elsewhere. Various functional limitations also are connected to fall risks. As completing ordinary tasks becomes more difficult, seniors are more likely to fall while trying to accomplish them.


Medications similarly may play a major role in falls. Seniors who are prescribed psychoactive medications may experience alterations in perception, mood, behavior, and consciousness. Any of these side effects may make a fall more likely.


Additionally, many elderly people are at risk because of polypharmacy. It’s not unusual for older people to visit several health care practitioners. They may have specialists who treat them for various conditions. Unfortunately, it’s not uncommon for these doctors to be unaware of each other and what prescriptions they are recommending for the patient. This causes the patient to take too much of one class of drugs, leading to confusion and possible physical impairment. When assessing fall risk factors, it is vital to obtain a correct accounting of each prescription the elderly person is taking to check for psychoactive effects and polypharmacy.


Depression may be a risk factor for and a result of a fall. Physical impairments frequently affect the patient’s mental state. Feelings of hopelessness become magnified as the person realizes how many things they can no longer do. This mental state makes a fall more likely. Additionally, depression frequently settles in after a fall as the patient makes a slow recovery. In a disordered mental state, the patient is more likely to suffer another fall. The same is true for any form of cognitive impairment. Cloudy thinking and judgment lead people toward behaviors that are too high risk for them to undertake.


Orthostatic hypotension also may be the culprit behind a fall. This condition causes the individual to experience periodic low blood pressure upon rising from a position of sitting or lying down.


Additional risk factors include being over the age of 80 and having a lower body mass index. Females tend to be at higher risk for falls as well. Common conditions such as arthritis and diabetes similarly have been identified as making individuals more likely to suffer a fall. Anyone experiencing periodic dizziness or untreated pain further is at higher risk.


How to Prevent Falls in the Elderly

The good news is that many of these incidents are preventable. Several fall precautions can easily be put in place wherever the senior lives. This is vital because most falls in the elderly occur in the home.


Preventing falls at home begins with a thorough assessment of the possible trouble spots that are more likely to put an elderly person at risk. Whether it’s a slippery floor or an electrical cord that’s in the way, all of these issues can be resolved.


Identifying trip hazards is a sensible first step. Trip hazards may include a corner of carpet that is sticking up or a throw rug that creates a slippery spot on a hard floor. Floorboards or tiles that are loose or uneven also should be identified. Then, each of these hazards must be removed or repaired.


Clutter is a major problem for seniors. With their more limited mobility, it’s far more difficult for them to negotiate around a stack of old newspapers or a pile of boxes. Clear away all clutter on floors, paying special attention to stairs, hallways, and other places where seniors frequently walk.

It’s also recommended that seniors avoid exceptionally loose or oversized clothing. A hem that drags on the floor or extra-long sleeves may complicate movement as does extra material around the torso. Opt instead for clothing that is properly sized and closer fitting.

Grab bars and handrails are essential safety devices if you’re wondering what to do when the elderly keep falling. These can be installed in stairwells, bathrooms, hallways, and anywhere else that a senior may need assistance with walking. A handyman or relative can easily help with the installation.


Slipping frequently leads to a fall for the elderly, which means that it’s advisable to wear shoes instead of just socks when around the house. People who are uncomfortable with wearing shoes in the house may want to invest in a few pairs of socks with non-slip bottoms.

Similarly, non-slip mats may be placed anywhere that floors routinely get wet. This is an obvious choice in bathtubs and elsewhere in the bathroom, but these mats also are useful in entryways and kitchens where wetness may affect how slippery the floor is.


Seniors also are encouraged to let adequate light into their homes. This largely may be natural light during the day but it doesn’t hurt to use artificial light at all hours as well. Shadowy, dark spaces are always falling hazards, and a brightly lit room may be all that’s needed as a fall prevention mechanism.


Moving with more caution further is recommended for seniors. It’s wise to pause for a moment when switching from lying down to sitting up, and then to pause again before standing. It also makes sense to take a breath after standing and before beginning to walk or before negotiating a flight of stairs. These brief moments may be enough to help the elderly maintain or regain equilibrium so that they are at less risk of a fall.


Stairs can be particularly dangerous for seniors, even with a handrail. If there are steps leading into the house, then it makes sense to have a ramp installed for greater safety. Seniors living in a two-story house may decide to live only on the first floor so that they no longer have to negotiate the staircase. If restricting your living situation to one floor isn’t possible, then try to limit how many times you use the stairs each day.


It also may be wise to invest in a medical alert system. These systems provide enormous peace of mind to older adults and those who love them. The senior wears a necklace or bracelet that is connected to a speaker. A button is located on the device that the wearer can push when they experience an emergency like a fall. When the button is pushed, a trained operator comes over the speaker system to ascertain the condition of the older person. A family member or emergency personnel may be called to provide assistance.

A fall protection harness is another helpful device that many elderly people and their caregivers swear by. It’s a simple yet sturdy belt that is designed to make it easier to switch between positions. Since this is often an activity that leads to a fall, the use of a fall protection harness can prevent serious injuries.


Visits from a home health care nurse or personal care assistant who can provide 24-hour home care may be indispensable when a senior wants to remain in their home. Living independently is the dream of many elderly individuals, and a home health care nurse or personal care assistant can help to make this a reality. These experienced and highly trained individuals become familiar faces to the people for whom they provide care. That’s because they stop by on a regular basis to ensure that everything is going well.


Personal care assistants and home health care nurses can provide a wide variety of services for patients. This may include the administration of prescriptions and ensuring that the senior gets regular, nutritious meals. These professionals may take seniors to doctor appointments or on other errands around town. They assist with the tasks of daily living such as bathing, dressing and eating, and they provide a much-needed connection with the outside world.

When a senior has serious medical concerns but still wants to remain in their home, then it is possible to arrange 24-hour home care. An experienced nurse is there for the patient at all times, ensuring that the doctor’s orders are carried out to the letter. There’s no risk of forgetting medications or going without essential nutrition. The patient is bathed, dressed and well-cared for at any hour of the day or night.


Senior people who have a home health care nurse or a personal care assistant are less likely to suffer a fall. This is because they have someone who comes into their home, perhaps on a daily basis, to ensure that there are no trip hazards and that the home is optimally set up to accommodate the senior’s unique needs. When it comes to how to prevent falls, having regular visits by a trained health care professional may be the best possible option.


How to Respond to a Fall

Prompt and proper fall response may be the key to ensuring a greater likelihood of successful recovery from a fall. Here are some simple steps to take to help speed recovery after a fall.


1. Monitor and Evaluate the Patient 

The first 24 to 72 hours after a fall are critical. When caregivers and health care personnel react quickly and appropriately, then it may be possible to avoid some of the more long-term effects of a fall. Whether the patient is transported to a hospital, lives in a care facility or lives alone, it is essential that someone monitor their health and behavior for at least 24 to 72 hours after the fall. This ensures that the patient’s needs are met and that any changes in their condition are promptly noticed and addressed.

2. Investigate Why the Fall Happened

Was there a trip hazard in the hallway? Does the senior have trouble negotiating stairs? Was there a wet spot on the floor in the bathroom? Answering questions such as these may be the key to preventing another accident. Thoroughly look into why the fall happened so that it is possible to correct the problem.

3. Keep Records 

Whether the fall occurs in a private residence or a group facility, it is wise to keep records about the incident. The circumstances may need to be related to the elderly person’s doctor or other health care professional.

 4. Inform the Primary Care Provider

Even if the elderly person who suffered a fall does not require hospitalization and does not need long-term care, it is advisable to keep their primary care provider informed regarding the situation. This way, the doctor can follow up with the patient regarding the circumstances that led to the fall. It may be necessary to re-evaluate the patient’s medications or to look for an undiagnosed condition that may have contributed to the fall. Keeping the primary care doctor in the loop ensures better overall care for the patient.

5. Take Immediate Interventions

Within one day to one week after the fall, it makes sense to make any necessary repairs or alterations to the patient’s home to ensure that a similar accident does not occur again. At the same time, it is wise to communicate openly with the patient’s health care team to ensure that the patient is being properly assessed and treated for all known medical concerns.

6. Have a Falls Assessment

The patient’s primary care physician may want to perform a full falls assessment. Such an assessment may involve asking a number of questions in addition to observing the patient as he or she walks or changes from a lying down position to a sitting position and then to a standing position. The doctor may a variety of tests to determine how likely the senior is to fall again before making further treatment recommendations.

7. Developing a Care Plan

Based on the falls assessment, the doctor will outline a care plan that should protect the elderly person from future falls. It is the responsibility of the patient, their caregivers, and anyone else who regularly visits the patient to ensure that this plan is carried out in full.

8. Monitor the Results

For the next six months or so, the patient’s caregivers will closely monitor how well the new care plan is progressing. Revisions may need to be made, and this can be coordinated with the patient’s primary care physician.


Senior Fall Safety Tips

Falls in the elderly are far too common, and they too frequently result in life-altering injuries. Fortunately, most falls are preventable. If people take precautions to make themselves less likely to be a fall victim, then they can better enjoy an independent life in their own home.

One of the most beneficial things that an older person can do to protect themselves from suffering a fall is to keep moving. The more physically active an older person is, the less likely they are to be at risk for many of the conditions that lead to a fall.


Regular exercise improves both mental and physical well-being. It helps people to retain their range of motion and muscle strength. It even assists with maintaining essential bone density so that bones are less likely to break in a fall.


Walking, hiking, stretching, yoga, gardening, golfing, swimming, and water aerobics are just a few fun activities that keep seniors on the move. The exercise does not have to be incredibly strenuous. It’s enough to be up and about and doing.


Similarly, it makes a great deal of sense to stay connected with the community. This may mean volunteering at a local event or teaching a class. Some seniors even decide to learn something new like painting or a foreign language.


Having a home health nurse or other caregiver visit on a regular basis is another way to stay connected, active and help to prevent falls. They can ensure that the elderly person gets the care and attention that they deserve. Moreover, they will be alert to any physical, mental and emotional changes that may mean that an updated falls assessment is required.


Additionally, be certain that the elderly person regularly visits their primary care doctor and keeps all appointments with specialists. This helps to ensure that the entire health care team is up-to-date on the patient’s condition so that medications may be adjusted, discontinued, or added and so that new treatments may be tried.


Good nutrition is another component of preventing falls. A body that is well nourished is less likely to fall prey to numerous debilitating conditions. Moreover, a sensible diet helps to keep the mind clear.


Most falls are absolutely preventable. Use the tips here to protect yourself or a loved one from suffering an accident that is all-too-common.

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