Caregiver’s guide to falls: what to do to prevent them

September 13th, 2018

Let’s be honest: Nobody wants to think about falling. It’s a scary proposition for older adults and their family members. But it’s a part of aging for 25% of Americans 65 and up who fall each year, according to the Centers for Disease Control and Prevention (CDC). Three million of them are treated in Emergency Rooms, 800,000 are hospitalized and, tragically, almost 35,000 die.

That’s the bad news. The good news: the National Safety Council counts falls among the top three most preventable injuries.

This is why pushing past our fears and learning more is so valuable. Facing the facts increases our ability to reduce the complications from falls, and to lower the risk of seniors falling down in the first place. We can worry less and feel more confident about our parents.

To help, we compiled useful data about falls in the elderly, and expert advice for caregivers on reducing fall risk and complications.

Where and Why Do Older People Fall?

The majority of older adults fall inside their homes (especially the kitchen and bathroom) or in the yard. The most common causes of falls in the elderly are:

Aging: As we grow older, our bodies change. Our reflexes slow, our stamina decreases, and our bones may weaken, especially at the joints. These conditions make us more likely to trip, slip or fall, and less able to get back up after a tumble.

Diseases and other conditions: Fall rates are higher in people living with one or more chronic disease, such as COPD, diabetes, arthritis, dementia, hearing or sight impairment, and cardiac issues. Conditions like these can cause dizziness and balance disturbance, pain or loss of tactile sensation in the feet, decreased mobility and tensile strength, and increased fatigue. These same older adults are also at risk of falling more than once. Read our report on chronic conditions and fall risk.

Medications: Sometimes the prescriptions that help us also make us more likely to tumble. For instance, blood pressure medicine like ACE inhibitors and beta-blockers may cause dizziness. Anti-depressants and pain relievers can make us less mobile and agile. And NSAIDs may disrupt central nervous system function. Since many older adults are on more than one of these kinds of medications, their fall risk is 2.5 times higher than our relatives who are taking only one.

Hazards: Fall risks in and around the home include clutter, uneven terrain, cords, loose rugs and flooring, and narrow or dark passages. Kitchens (think grease and high shelves) and bathrooms (think water and bath mats) are common fall locations, as are stairwells and hallways.

Fear: Being afraid of falling can, ironically, make our loved ones more likely to do just that. Joint research from the CDC and the University of Colorado-Denver found that fear of falling causes many seniors to cut back on every-day activities. Being less active makes them less strong, so they can’t prevent a fall by holding themselves up or catching themselves, and they can’t get back up on their own if they do fall. Opting out of activities also leads to social isolation. Withdrawn older adults are more likely to be malnourished, skip or forget to take medications as prescribed, and become more susceptible to illness — all of which could make them more likely to fall. See how to build confidence in your loved one after a fall.

What are the Consequences of Falls?

Depending on the severity, a fall can have profound effects on our loved ones’ physical and psychological well-being. Here’s a run-down of the consequences of falling down and symptoms to look for after a fall.

Physical effects of a fall: Even a minor tumble can lead to lacerations, bruises and abrasions or general soreness. More serious harms include traumatic brain injuries (falls are the leading cause), fractured hips (95% of which are caused by falls) and broken wrists, arms and ankles. Additional complications occur when we can’t get up quickly. Half of older adults who fall can’t get up on their own, according to the CDC, and they can develop pressure sores or dehydration. If they go down outside, they may also experience dehydration, plus hypothermia or frostbite. Look for bruises, cuts and scrapes, as well as impaired movement or general discomfort.

Psychological effects of a fall: Older adults who fall can experience emotional and mental issues, too. Shame or self-consciousness are common. Those feelings, plus sadness over loss of mobility or long-term injury, may lead to depression and anxiety. Even more serious: a University of Portsmouth study found that some seniors even develop post-traumatic stress disorder (PTSD) after taking a tumble. Look for withdrawal, sadness, agitation or confusion. Read how to recognize the signs of depression.

Financial effects of a fall: In 2015 (the most recent year available), total medical costs for falls amounted to $50 billion. What does that mean to an individual family? An ambulance ride to the ER averages $429, a typical ER visit costs $1,233, and a fall-related hospital stay costs $30,000.

Learn more about what happens when seniors fall.

How to Keep the Elderly from Falling

Thankfully, we can lower the likelihood that our older loved ones will fall. Easy-to-implement preventions keep them safe without limiting their independence.

Prevent falls in the home: De-clutter and reorganize to limit trip and fall hazards. Reduce bathroom falls and injuries by installing grab bars and non-slip strips. Improve visibility with motion- and light-detection lighting inside and out. Download our Ultimate Home Safety Checklist to Prevent Falls.

Support good physical and mental health: Talk with your parents’ doctor about physical activities to improve strength and balance, and mobility aids to help them stay steady on their feet. Understand how medications and food and drug interactions may contribute. Schedule regular exams for their feet and vision. Talk to your parents about their (and your) fear of falling and get help if you feel the concern is limiting their activities. Review our doctor visit checklist.

Leverage technology: Remind your loved ones to keep their mobile phones in a pocket or pouch on their walkers or wheelchairs, so they don’t rush to answer a call. Encourage them to use apps to order food, hail a ride or stay connected to friends – just like we do. Consider a personal emergency alert system – a sleek wearable that makes sure our loved ones get immediate help if they feel like they might fall (nausea, dizziness, etc.) or if they do fall. Devices with automatic fall detection call for help even if the button isn’t pressed. Quick response lessens lie time and complications – and reduces their stress and yours. Understand the key factors in choosing a medical alert system.

Create a post-fall plan: Help your parent respond better to a fall by cautioning them against jumping back up. Counsel them to take a moment to get their bearings and get over the surprise of being on the ground. If they’ve broken a bone, in most cases, pain will be sharp and immediate, though some factures of the hip and spine may not present until later in the day, week, or even month. Encourage them to see a doctor after any tumble – even if they get up on their own – just to make sure they’re truly OK. Sadly, more than half the people who fall don’t tell anyone, a decision that puts their health and independence in unnecessary jeopardy.

The prospect of falls is a scary part of caring for our aging loved ones. Understanding the causes and risks helps us make better decisions about avoiding falls in the elderly. And taking preventive measures keeps older adults safe, independent and healthy. We want our parents to live long and live well. Using this information empowers us to do that.

Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be suffering from a healthcare condition.