Lyme Ambulance Association, Inc.
Senior Safety: Fall Prevention
One-third of Connecticut seniors (age 65+) fall each year. Sometimes with tragic or life-altering consequences.
Falls are the #1 cause of injury and injury-related death among seniors
No wonder many older residents suffer from a ‘Fear of Falling.’
At best, fear is a powerful motivator to stay in shape and alert to tripping hazards. At worst, it causes withdrawal from normal activities in a misguided effort to ‘stay safe’ by staying home and doing little — leading to deteriorating physical strength, social isolation, and heightened fall risk — a perverse self-fulfilling prophecy.
But prophecy isn’t destiny. And even if you have a medical condition that puts you at greater fall risk, there are many other risk factors you CAN control.
So what should you do to prevent falls? Everything you can!
We collected 100 fall prevention tips and recommendations and organized them into categories. Use the color menu below to ‘jump’ to a particular section.
TALK TO YOUR DOCTOR
MAKE YOUR HOME A SAFE HAVEN
BE SENSIBLE
GET FIT/STAY STRONG
WHAT TO DO IF YOU FALL
These recommendations don’t apply to all seniors or all situations, but if you have balance problems, a history of falls, or are concerned about a loved one’s safety, review these lists for suggestions on how to stay as fall-safe as possible.
TALK TO YOUR DOCTOR
- ALWAYS tell your doctor if you’ve fallen
Even if you didn’t get hurt. - Understand your medical risk
Certain diseases and conditions make you more vulnerable to falling. Talk to your doctor about what you should do to stay safe, given your medical profile. - Share your concerns
Be honest about problems you’re having with balance, mobility, or fear of falling. - Seek counseling if fear is holding you hostage
Ask your doctor for a recommendation or explore local or online options to get help from a certified therapist. - Ask your doctor about exercise
Get clearance and guidance on starting or stepping up an exercise regimen. - Ask about assistive devices
They can help keep you safe. Items like canes, walkers, and rollators may be covered by Medicare B if prescribed by your doctor. - Get a referral for physical therapy
PT can design an effective exercise routine to strengthen the muscles needed to avoid falls, and give you the confidence to work out at home. They can also make sure any assistive devices are the right height and show you how to use them correctly for best protection against falls. - Review your prescriptions
Ask your doctor if any of the drugs you take increase your fall risk. Are safer alternatives available? - Don’t press your doctor to prescribe unnecessary drugs
Polypharmacy, taking 5 or more prescription drugs, is a growing problem among seniors: it can cause frailty, cognitive impairment, and falls. Just stick to what you doctor thinks is medically necessary. - Tell your doctor about over-the-counter drugs you use
Some can seriously affect balance, either on their own or in combination with your prescription medications. - Schedule a ‘Brown Bag’ appointment with your local pharmacist
That’s when you put ALL the prescription and non-prescription drugs you take regularly, including vitamins, supplements, herbal remedies and ‘magic elixirs’ you found on the internet in a paper bag and sit down with the pharmacist to identify any negative synergies or inadvertent mega dosing of vitamins beyond recommended limits. - Tell you doctor how often you drink alcohol
And whether you use recreational drugs. Your doctor needs to know in order to prevent potentially dangerous interactions with your prescription medications. - Get help if you you have a problem with alcohol
It’s one of the best things you can do to prevent avoidable falls. According to the National Institute of Aging, alcohol is involved in 60% of all falls. - Have your vision checked annually
Get and wear the glasses you need; get tested for glaucoma, macular degeneration, and cataracts. Talk to your eye doctor about minimizing fall risk if you wear bifocal glasses (a potential hazard on stairs). - Get your hearing checked annually
Hearing loss and untreated ear problems can cause loss of proprioception, dizziness and imbalance, increasing your fall risk. - Don’t forget your feet
Neuropathy, arthritis, bunions and other toe deformities can all affect balance and gait. See a foot doctor periodically and on a regular schedule if you’re diabetic. Get your feet measured too: Our feet tend to flatten and change size as we get older; make sure you’re wearing the correct size shoes. - Know your bone density score
Get tested and discuss bone-strengthening/preserving drug options with your doctor if you have osteoporosis or osteopenia. - If you’ve been inactive or have osteoporosis…
Be sure check with your doctor before starting any exercise program and get guidance on what types of exercise to avoid.
MAKE YOUR HOME
A SAFE HAVEN
IN THE HOUSE
- Have plentiful and bright (non-glaring) light
Let there be light throughout the house and especially in stairwells. Evenly distributed light is best; avoid dark pockets or shadows anywhere you walk. - Consider using a timer to turn on lights
Especially in winter, darkness can creep up on you. Use a timer to turn on lights in one or more rooms. Otherwise, if you fall asleep in the lounger after lunch, you could awaken, disoriented, in the dark. - Make sure a light switch is accessible as you enter a room
If that’s not possible, consider voice- or motion-activated lights. - Eliminate floor clutter and slipping and tripping hazards
Get rid of throw rugs or use double-sided carpet tape to hold them firmly in place. Don’t keep magazines or piles of mail on the floor by your chair. Keep clothes, shoes, packages, and toys (grandchildren’s or pet’s) off the floor or away from where you walk. Ideally, thresholds should be even with the floor. If you live in an old house, check to make sure floor nails are tight and haven’t worked their way out a bit — hard to see and easy to trip. - Be sure rugs and carpeting are secured to the floor
Use non-slip mats or double-sided carpet tape. Always watch for curled edges, a significant trip hazard. Choose rugs or carpeting with short, dense pile. - Ensure electrical and phone wires are out of the way
Ditto computer cables. Keep wires, cords, and cables coiled and close to the wall, hold in place with tape or cable clips if necessary. - Keep clear passage
Make sure you have plenty of room to walk around furniture comfortably. Cramped access makes it more likely you’ll catch a foot on a table leg or bump into something and lose your balance. Low coffee tables can be especially risky. - Reposition mirrors that ‘blind’ with sunlight
Mirrors can catch and reflect sunlight into your eyes at certain times of the day or in certain seasons, causing a temporary inability to see where you’re walking. Lower a shade or move the mirror if it’s a persistent problem. - Replace ‘tippy’ chairs
Use only sturdy, stable chairs with arm rests; they’re much safer. - Avoid soft couches and chairs you ‘sink’ into
They can make it very difficult to rise and may exhaust you with the effort. Consider replacing too-soft seat cushions with firmer ones; or sometimes reupholstering with stiffer material helps. If the couch is just too low, replace it or add a tight-fitting piece of firm foam under the seat cushion and use double-sided carpet tape to secure in place. - Keep frequently used items easily accessible
Reorganize closets, cupboards, and other storage areas so that you don’t have to bend down too far or reach up too high. - If you must reach for something on a high shelf…
Use a stable, low step stool, preferably one with a handrail — never use a chair! - Always watch out for your pets
Who hasn’t tripped over their dog or cat? Train your dog to ‘Go to your bed’ and, well, do the best you can with your cat. The point is: pay attention to where they are when you’re walking in the house. - Get a FREE In-home Safety Evaluation, provided by a Registered Nurse from the Ledge Light Health District (the local health agency for Lyme). Call: 860-448-4882.
ON THE STAIRS
- Keep clutter off the stairs
Always check to make sure steps are clear before going downstairs. - Have handrails on BOTH sides
Having rails on both sides gives you more support and makes it much easier to catch yourself if you take a misstep. Make sure handrails are securely attached to the wall. - Have stairway light switches at the top and bottom
Never go down stairs in the dark. Have bright overhead light you can turn on upstairs or down. - Do not use throw rugs near stairs
Even taped-down throw rugs can be a hazard when placed right at the top or bottom of stairs. - Fix worn or loose stair treads
And replace worn carpeting on steps. Make sure new carpeting is firmly secured. - Add a thin strip of non-slip tape to steps
Fluorescent or other high visibility tape can help delineate step edges when going downstairs. - Affix permanent hand-holds for other interior steps
Is there an interior doorway with a step up or down to the next room? Install a hand-hold and use it as you move between the rooms. - Ensure porch lighting reaches outside steps
Unlit or partially lit steps are dangerous.
IN THE BATHROOM
- Have secure, permanent (not suction) grab bars
Place them near your bathtub or in your shower; next to the toilet too. - if you must use suction grab bars…
Check that they’re secure every time you take a bath or shower. - Use non-slip mats
Always use non-slip mats in the bathtub or shower and clean off soap scum regularly. - The bathroom floor throw rug must have non-slip backing
The bathroom is one of the most dangerous rooms in the house for seniors: make sure to keep it as fall-safe as you possibly can. - Consider a shower seat
Best is a correctly installed permanent ADA-compliant seat, but a stable portable seat can work too. - Have a hand-held shower head
Have the hand-held in addition to the overhead so you can use the handheld when seated. - Never use body oils in the shower or tub
Be careful with some oil-based hair conditions too — they can be very slippery. - Raise the toilet seat
If your toilet is too low, there are several options for making it taller, including frames that provide support to help you push up to stand up.
IN THE BEDROOM
- Ensure well-lit passage from the bedroom to the bathroom
Use bright nightlights and/or motion-activated lights. - Consider having a bedside commode for emergencies
Don’t rush to the bathroom to avoid an ‘accident’ in the middle of the night. Getting up from a lying position too quickly may cause dizziness — and a fall. - Remove obstacles from hallways
Get rid of anything you might bang into and knock over on your way to the bathroom at night, like a free-standing incidental table. You could lose your balance and fall over it. - Keep walking aids you need by your bedside
Get an extra walker if your need one upstairs too. Check with the Lyme/Old Lyme Senior Center. They often get donated assistive devices. - Make sure a light switch or lamp is within easy reach
You should never have to get out of bed to turn on light in your bedroom. - Keep your glasses by you bedside at night
If possible, keep an extra pair in a bedside table drawer. - Keep a flashlight handy
Always keep a flashlight by your bedside, in case of a power outage. - Have a phone within easy reach
Always keep a phone (wired, portable, or cellular) by your bedside. If a cellphone, remember to keep it charged by having the charger by your bedside.
IN THE KITCHEN
- Put a water-absorbing non-slip mat in front of the kitchen sink
A water-absorbing mat will safely contain any drips that occur while you’re washing dishes. - Clean any spills off the floor immediately
Especially greasy ones! Be sure to use a degreasing solvent (like dish detergent) then rinse with water and dry. Do not walk in the area until it’s fully dry and you’re sure all the slippery grease is gone. - Don’t let dust build up on wooden, tile, or linoleum floors
Dust is a lot slipperier than you may think. - Don’t wax your floors
Or if you must, be sure to use non-skid wax. But not waxing at all is better. - Avoid throw rugs in the kichen
Or make sure they’re tight nap, low-profile rugs with non-slip backing. You move back and forth a lot in a kitchen, sometimes carrying hot dishes: you really don’t want to catch your toe on the edge of a rug! - Keep your ‘File of Life’ affixed to your refrigerator
Or keep it in another easy-to-spot location. Don’t have a ‘File of Life’? Call 860-434-7225. Learn more here.
OUTSIDE
- Be sure your house number is clearly visible from the road
It should be reflective so emergency services, like Lyme Ambulance, can find your house quickly at night. If you’re not sure your numbers are visible enough, call 860-434-7225 and we’ll come out to double-check for you. - Is your walkway dangerous?
It is if the bricks or pavers are cracked or uneven due to frost-heave; repair or replace. - Make sure outside paths are well lit
Use switch-operated or motion-activated lights, and always keep a small flashlight in the glove compartment, your jacket pocket, or your purse if you leave the house at night (in case there’s a power outage.) - Be careful doing gardening or yardwork
Tree roots, uneven ground, bending over and getting dizzy, and forgotten tools half hidden in the dirt are fall risks. - Be careful walking your dog
Leash pulling, getting your legs wrapped up in the leash, and tripping over uneven ground or pavement can cause falls. - Rake leaves off paths you use
Wet leaves can be very slippery. - Shovel and de-ice paths when it snows
Or ask a neighbor for help. Being Lyme, your neighbor may already have done it for you. Avoid walking on and compacting un-shoveled paths since they’ll get slipperier each time you walk on them. - Consider using strap-on cleats when icy
If you absolutely have to be out in icy conditions, strap-on cleats can be very effective — but always remember to take them off before you come inside. They are dangerously slippery on many types of indoor flooring — especially tile.
BE SENSIBLE
- Go slow getting out of bed
And don’t stand up too quickly from a chair. Seniors often suffer from orthostatic hypotension: a temporary drop in blood pressure when you change position that can cause dizziness. Before getting out of bed, just sit on the bedside for a moment. Then slowly stand, being ready to sit back down immediately if you feel dizzy at all. The dizziness will last only a few moments… but you could fall if you aren’t prepared. - Phone ringing? Don’t run!
No phone call is worth risking a fall. They’ll leave a message or call back. - Need glasses to see where you’re walking? Wear them!
Keep a spare pair too, in case you lose or break your current glasses. - Lunch date on a sleety winter day? Stay home.
Setting a new date is a lot less easier and less painful than setting a fractured wrist. - Consider getting your groceries delivered when weather is bad
Maybe one of your neighbors already uses Instacart (for Big Y) or Peapod (for Stop and Shop) home delivery and you can just piggyback your order on theirs. - Wear a small ‘fanny-pack’ around the house
Keep essentials like reading glasses and your cell phone handy. - Time to toss those ratty old slippers
And the flip flops and stiletto heels too — and any other shoes that add to your fall risk. It’s safest, by far, to wear non-slip, flat-bottomed, well-fitting supportive footwear with a firm heel. If you want to wear ‘high heels’ for a special occasion, chose ones with a broad and not-that-high heel. - Never walk around in just socks
Really — don’t do it. Significant fall risk. - Check your shoe laces
Lace-up shoes are a good choice for safety, but double-check that the laces are securely tied and won’t come undone, creating a classic tripping hazard. - Avoid carrying anything that requires using both hands
Laundry basket full? Don’t carry the basket — separate the load into smaller piles and use a carry bag with handles instead so one hand always stays free. - Never carry anything that blocks your view
Carry groceries in a carry bag — not in a paper bag you hold in front of you. Always make sure you have a clear view of where you’re walking. - Know thyself
What are your particular risky behaviors? What are the things you’ve told yourself over and over that you shouldn’t do? Do you go down the rickety cellar steps even when you’re home alone? Tack a sticky note that says “NOPE” on the cellar door. - Thinking of having a second drink?
You’re a grown-up. You have freedom of choice. But know that the more you drink the greater the chance of a fall. 60% of all falls involve alcohol. Is that second drink really worth the risk? - Be aware of how much time your spend sitting
Nothing wrong with watching TV, but if you spend 4 hours without getting up, you’re going to be stiff. And stiffness is a fall risk. Be sure to get up and move around for a minute or so every hour. - Ask for help when you need it
That little kid next door you used to babysit is a teen now who’d be happy to get your suitcase down from the attic for you. Whether it’s a neighbor, or someone from your church, or a friend of a friend, if you live alone and need help, ask. We’re a really nice town. There’s always someone to help. - Buy useful tools
For example: Get a ‘grasper’ stick so you can pick up the pill bottle you dropped on the floor or reach the cereal box on the high shelf without having to bend over or stand on tip-toe. Practice using the ‘grasper’ and never try to pick up something heavy overhead; they’re intended for lightweight objects only. - Technology could save your life
Use an ‘emergency alert’ wearable that has fall detection (a pendant or a watch) so you’ll have peace of mind every day and help in an emergency. - Get safety with a bow on top
Are your children or grandchildren wondering what to get you for your birthday? Suggest gifts that support your efforts to exercise more and avoid falls. - Embrace reality
Embarrassed to use a walker even when you really need one? Why? Nobody in the hospital with a broken hip thinks, “I’m so glad I didn’t use my walker.”
GET FIT
STAY STRONG
The Basics
- Eat a nutritious diet
A poor diet contributes to weakness
(which can lead to falls) - Drink lots of water
Dehydration can cause dizziness
(which can lead to falls) - Get enough sleep
Fatigue can cause clumsiness
(which can lead to falls) - Maintain a healthy weight
Being too thin is bad for your bones
(which can make falling more dangerous) - Take vitamin D and get enough calcium
Vitamin D is very important
(and many seniors don’t get enough) - Exercise regularly
But be sure to check with your doctor first if you haven’t exercised in a while
Exercise Safety
- CHEST PAIN: If you have chest pain or severe shortness of breath, Call 911 immediately!
- DIZZINESS: If you get dizzy while exercising, stop and sit down!
- PAIN: If an exercise hurts, stop!
- BALANCE: Watch your balance: Hold on to the back of a sturdy chair when doing standing balance exercises
- DRESS APPROPRIATELY: Wear comfortable, loose-fitting clothes and supportive non-slip footwear
- STRETCH: Do mild stretches before and deeper stretches after; stretching is particularly important as we get older
- BREATHING: Don’t hold your breath while exercising or stretching; breathe normally
- WARM UP: Warm up before and cool down after exercise: March in place for a few minutes before and walk around for a few minutes after
- HYDRATION: Sip water before, during, and after exercise
- MODERATION: Start low and go slow. Don’t walk too far, peddle too fast, use too heavy a weight, or attempt too many ‘reps’ (repetitions of an exercise) when starting out
- KEEP TRACK: Mark on the calendar which days you exercised. Always rest a day or two in between strength training
- SAY YOUR ABCs: If you can easily recite the whole alphabet out loud while you’re exercising, you’re probably not working out hard enough. But if you struggle to breathlessly recite even a few letters, you’re exercising too hard. Look for the sweet spot where you’re working hard enough to get aerobic benefit (raising your heart rate) but not so hard you exhaust yourself and create a different fall risk.
Exercises
If you’re just starting out (and once you’ve gotten the OK from you doctor) you have lots of choices for how and where to exercise. The Lyme/Old Lyme Senior Center has some great classes — many are free and some charge just a nominal fee. Check out the Senior Center calendar here. Join a class, bring a friend, and grab lunch after. Classes are held at the Senior Center in Old Lyme (26 Town Woods Road). They also offer some ‘virtual’ classes, meaning you can participate online from your own home. And there’s a wealth of exercise guidance and instructional videos for seniors online from a variety of other sources.
If exercising at home, you can spend a ton of money on fancy home gym equipment and a personal trainer. Or you can spend around $25 for some exercise bands and hand/ankle weights to have all the equipment you need to build muscle to defend against falls.
What exercises should you do? Experts recommend four types of training for maximum benefit:
- Strength Training
– Work out 2-3 times a week
– Use bands, weights, or just your body weight
– Get started with the video below - Balance Training
– One+ balance exercise daily
– Sturdy chair nearby to be safe
– Click here for exercises to try - Flexibility Training
– Stretch every day
– No special equipment needed
– Click here for stretches to do - Endurance (aerobic) Training
– 30 minutes a day 5 days a week
– Brisk walking, biking, swimming
– Yard/housework can count too
– 30 minutes too much?
Do three 10-minute sessions - The three-minute video below from SilverSneakers demonstrates four easy exercises that are particularly good for building the muscles needed to prevent falls:
Ask your doctor or physical therapist for recommendations on the best strength training exercises for you.
The strength, balance, flexibility, and endurance you gain from exercising regularly not only help defend against falls, but improve your mood, sleep, heart health, brain function, and even help protect against some cancers.
WHAT TO DO
IF YOU FALL
Take several deep breaths to try to relax. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.
Decide if you are hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse.
If you think you can get up safely without help, roll over onto your side. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.
Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor. From this kneeling position, slowly rise and turn your body to sit in the chair.
If you are hurt or cannot get up on your own, ask someone for help or call 911. If you are alone, try to get into a comfortable position and wait for help to arrive.
Carrying a mobile or portable phone with you as you move about your house could make it easier to call someone if you need assistance. An emergency response system, which lets you push a button on a special necklace or bracelet to call for help, is another option.
‘What to do if you Fall’ – National Institute of Aging ‘Prevent Falls and Fractures’
Sources: Recommendations and tips included in this compilation come from various sources, all of which are included in the ‘For More Information’ section.