Falls are a fact of life. No matter how hard you try, it may be impossible to prevent yourself or a loved one from falling. When falls happen, stay calm and call for suitable help as soon as possible. Fortunately, you can improve the likelihood of staying on your feet by following straightforward falls prevention and safety strategies.

Who is at risk of falling?

Anyone can have a fall at any time, however children under the age of 5 as well as older adults are at greater risk. Older people are also more likely to be seriously injured by falling.

Everyone with a vestibular disorder is at increased risk of falling. Research suggests adults with some form of inner-ear dysfunction are up to 12 times more at risk.

People who have a fear of falling are at increased risk of having a fall.

Why falls happen

Causes of falls range widely and include:

• Fear of falling – seniors and people with dizziness and balance disorders may become overly concerned about falling. This fear can contribute to inactivity, disability – and falls.
• Feeling light-headed or dizzy when arising from a lying or sitting position.
• Seizures, strokes, or heart attacks.
• Lack of sensation in the feet – this may be due to neurological problems, including Parkinson’s disease, multiple sclerosis (MS) and peripheral neuropathy.
• Tripping, stumbling, or slipping – this can happen to anyone, but is more common with increasing age.
• Inattention and not looking where you are going – everyone is susceptible.
• Dizziness and imbalance along with an illness (such as the flu) or post-surgery.
• Side effects of some prescribed drugs and over-the-counter medications.
• Not detecting obstacles at home and when out and about because of vision challenges.
• Hearing loss – if you are unable to hear someone or a vehicle approaching from behind, you may be startled into a fall. Older adults are particularly susceptible. Hearing should be checked regularly and hearing aids worn if needed.
• Poor muscle strength can result in being less likely to catch yourself in time before falling. Being unable to get up from a chair without using your arms is a sign of lower body weakness. Exercise can improve muscle strength.
• Problems with walking – these include “slapping” or scuffing your feet as you walk, frequent tripping, and problems walking without support from another person, furniture, or walking aid.
• Needing help with activities of daily living such as meal preparation or bathing.
• Having to rush to the bathroom due to an overactive bladder or urinary incontinence.
• Toddlers lacking the coordination, strength, and balance to recover in time when they trip, slip, or misstep on stairs.

Tests to assess falls risk

A number of tests can be used to assess balance ability. These are best done with a health professional who knows how to interpret the results accurately.

• Activities-Specific Balance Confidence Scale (ABC)
• Balance Error Scoring System (BESS test)
• Berg Balance Scale (BBS)
• Functional Gait Assessment
• Timed Up and Go (TUG) Test

Tips for lowering your risk of falling

Many risk factors can be changed or modified to help prevent falls. Ideas to minimize your risk of falling include:

• Never, ever try to function in the dark if you have a vestibular (inner-ear balance mechanism) problem. We rely on a 3-part balance system to stay upright. If your inner-ear balance sensors are not working and it is dark, you must rely on touch alone. This increases your risk of falling.
• Use a nightlight and be mindful when turning off lights at bedtime. Stash flashlights in easy-to-find places in case of power outages. Mark your calendar to check and change the batteries regularly.
• Make your home safer. Over 50% of falls occur at home. Tips to fall-proof your home.
• Use support to walk if necessary – this might be finding someone to walk with, using a walker, or holding onto a sturdy table, counter-top, or railing.
• Do balance exercises. Everyone can benefit from adding balance-specific exercises to their regular fitness regime. You will benefit most by doing them for 15 to 20 minutes daily. Start slowly and build up to more difficult exercises.
• Extend your range of motion. Do stretching exercises directed at improving the movement of joints. Increasing flexibility in your hips, for example, will also help improve your gait.
• Strengthen your leg and core muscles. Older adults with weak muscles are 4 to 5 times more likely to fall. Doing exercises to strengthen leg and core muscles can improve balance at any age. Read more about how physical activity helps.
• At the gym, avoid the treadmill if you have a vestibular problem. Its motion under your feet will put you at even greater risk for falling. An exercise bicycle is a better choice.
• Include power training in your daily routine. Power is the ability to exert strength quickly. If you struggle to get out of a chair, start doing chair squats. Power training will help you get up more quickly – it teaches your muscles to fire quickly. If your toes get caught in a rug, for example, you will be able to react and stay erect rather than simply falling over.
• Get enough vitamin D. There is a correlation between vitamin D deficiency and falling.
• Stay hydrated. Being dehydrated can make you dizzy and prone to falling.
• Choose your footwear carefully. Wear shoes with a good grip and flat or low wide heels both at home and outside. And make sure to tie your laces before taking a step! Avoid flip-flops, floppy slippers, and walking in your stocking feet. Footwear has an effect on gait and balance.
• Take care of your vision. Poor vision puts you at extra risk of falling. Address vision challenges.
• Manage your medications. Some medications are linked to dizziness. Ask your family doctor or pharmacist to go over your prescription and over-the-counter medications:
  • every 6 to 12 months
  • whenever your prescriptions change
  • if you feel drowsy, dizzy, light-headed, or unsteady

• Talk about previous falls with your healthcare providers. Note details, including when, where and how you fell. Talk about times when you almost fell but were caught by someone or managed to avoid a fall by grabbing hold of something. These details can help in identifying fall-prevention strategies specific to you. It can be helpful to keep a health diary.
• Be aware of other health conditions. Vestibular disorders and some other health conditions can increase your risk of falling.
• Protect young children. Babies and toddlers tend to be on the go and naturally have more falls. While parents and caregivers cannot prevent all falls, it is their duty to prevent those that might cause serious injury or even death. Essential safety measures include:
  • blocking stairs with sturdy baby gates
  • preventing window falls by installing locks or bars
  • making sure all railings are in good repair and meet code as to height and spacing of vertical dividers

If a child in your care does fall, carefully monitor them for a few days. Watch for signs of concussion.

Plan ahead for help after a fall

If you are at particular risk for falling, or if you have already had a fall, it is important to develop a plan to get help. You may not be able to get up by yourself - almost 50% of people who fall need help getting up after a second fall. Read more about planning ahead for an emergency.

More resources

The following can offer more help and support for affected individuals and their families.

Canadian Frailty Network
Canada’s sole network devoted to improving care for older Canadians living with frailty and supporting their families and caregivers.

Parachute: Falls in Children
Most fall-related injuries to Canadian children under 5 happen in the home. Here’s how to keep your kids safe from falls in the home.

Parachute: Falls in Seniors
Key strategies and resources to help older adults prevent falls and the importance of fall prevention in Canada’s aging population.

STEADI (Stopping Elderly Accidents, Deaths & Injuries)
Provides information and tools to assess and address fall risk. Download brochures (PDFs) that older adults can use to self-assess and reduce their risk of falling.

Safety Superheroes: Preventing Grandparents From Falling
This program was created by Vancouver Coastal Health and Fraser Health to help children and families learn how to keep grandparents and loved ones safe from falls. The program includes online activities as well as 22-page picture book entitled Safety Superheroes: Preventing Grandparents from Falling by Crystal J. Stranaghan (2010).

Books