5 Key Steps to Protect Seniors from Dangerous Falls

Making Safety a Serious Habit by Mark Steffen Thursday, February 16, 2023

For seniors living independently at home, falling poses a significant threat to health and well-being. In fact, falls are the leading cause of injury among older adults in the United States, according to the Centers for Disease Control and Prevention (CDC). Results from a fall can range from minor pain to health emergencies, with one in five falls resulting in serious injuries like broken bones or head trauma.

Against the backdrop of these startling statistics is another troubling truth: Too many seniors are not taking steps to mitigate the risk of falling in their homes. A recent survey of Minnesota residents 65 years of age and older revealed that over two-thirds (71%) were not concerned at all about falling and one-third (38%) had failed
to take any safety measures to fall-proof their homes.

This data reveals broader truths common to seniors across the country. Many simply don’t appreciate the implications that a fall can have on physical and psychological well-being. Seniors who fall and sustain an injury may never fully recover to their previous level of health and wellness. That’s why it is so vital to have educational conversations with older adults and their loved ones about the risk of falls.

A senior’s first fall also can lead to a fear of falling—which becomes a risk factor itself if it prompts detrimental changes in behavior. After a fall, older adults may start restricting their activities or avoiding leaving home, thinking it will keep them safer. However, this type of premature immobility can lead to other negative outcomes, such as social isolation, declines in mental health or the need for additional medications.

5 Key Steps for Fall Prevention

The consequences of a fall are real, but the good news is that most falls are preventable, especially when seniors, their loved ones, and their caregivers work together to improve mobility and safety. Following are some specific, proactive steps that you can take to support seniors and their families.

1. Get the conversation started.

As people age, it’s important to have open and honest discussions about health and well-being. Everyone wants to be heard and to feel seen. Here are some tips for home health staff to address the risks of falling—and the need to act—in a way that facilitates productive discussions.

Prepare for the conversation by anticipating potential questions.

Stay patient and positive, reinforcing that this is a common conversation millions of people across the nation are having (or should be).

Avoid sounding judgmental or skeptical, and don’t assign blame.

Affirm that it’s okay to feel nervous or anxious and that taking action is a good way to alleviate those feelings.

Establish yourself as a trusted person seniors can talk to and count on for help.

Encourage them to talk with their doctor about fall risks and prevention, including any concerns they may have and how the medicines they take may impact their risk.

Keeping the focus on reducing fall risks as a means to help seniors continue to live independently helps build trust and the CDC has great resources that can help inform these discussions, as well as materials that can be given to individuals and families.

2. Secure the highest-risk areas of the home.

Falls can happen anywhere in the home, but bathrooms and staircases are particularly important to reinforce with safety features. In the bathroom, it’s a good idea to have a safety rail by the toilet as well as grab bars and nonslip mats in the shower. Some seniors may also want a hand-held shower spray to use while sitting. For older adults with Medicare or another insurance plan, it’s worth checking to see if they have a home safety benefit that will help cover the cost of purchasing and installing such features. Local community or religious organizations may also be able to help.

Any stairs in the home should have handrails on both sides, and home health staff should encourage seniors to use the handrails consistently, even if they think it’s unnecessary. Establishing safe habits early can help protect older adults over time.

3. Walk through the home together.

While some areas of the home stick out as potential trouble spots, there likely are hazards seniors see every day and overlook. Going through the home with them can help identify issues to address. First, the home should have clear pathways that provide enough room to maneuver safely, alone or with any ambulatory devices like canes or walkers. Loose rugs that could cause tripping should be removed. Lighting should be bright enough to see clearly, and burned-out bulbs should be replaced promptly. For more ideas, home health staff can share the CDC checklist for home safety with seniors and their families.

4. Consider footwear choices.

Staying mobile and independent starts with the feet, and the right footwear makes a critical difference. Experts recommend shoes that offer good support, low heels, and a back. Slip-ons, while undoubtedly comfortable, are very unstable and prone to sliding on smooth surfaces.

Even at home, older adults should wear supportive, comfortable shoes rather than walking around in their bare feet, socks, or slippers, all of which increase the risk of falls. This doesn’t mean they have to wear excessively stiff, heavily cushioned shoes, however. The American Podiatric Medical Association recommends shoes with toe flexibility that allows natural foot motion and heels that are stiff enough to provide support. Any seniors who aren’t sure what their best footwear options would be can ask their primary care physician.

5. Explore activities to help build strength, balance & flexibility.

As seniors become progressively physically weaker with age, a commitment to staying strong is vital. The idea of exercising or stretching may sound daunting to some, but there are a range of options within reach of most. For example, simply standing up without using the hands is one simple exercise that strengthens leg muscles. Even if seniors can’t stand up all the way, they can push up a couple of inches and sit back down once they feel some tension. Even that small range of motion helps tremendously by strengthening the legs, hips and core.

Seniors who enjoy exercising in groups may want to look into yoga or tai chi classes to help improve balance and flexibility. There are many balance exercises and simple stretches that can be done at home as well. For more guidance, a primary care physician also can refer older adults to a physical therapist who can teach them an exercise routine designed for their needs.

As the population of seniors continues to grow in the U.S., older adults will need support to age at home safely, preventing falls and avoiding unnecessary hospitalization. Home health staff can play a vital role in communicating with seniors and helping them secure the safeguards that will protect their health and well-being.


As senior vice president of medical management and chief medical officer of Blue Cross and Blue Shield of Minnesota, Mark Steffen, MD, MPH, oversees medical and care management strategies for the company’s 2.5 million members.  Visit www.bluecrossmn.com.

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