How To Prevent Falls at Home: Safety Tips from Physical Therapists
About 60% of falls happen at home — learn more about the steps you can take to reduce your risk and feel steadier on your feet.
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As you get older, or as a loved one ages, you may worry about the risk of falling. It’s understandable. One in four adults over the age of 65 experiences a fall every year, according to the U.S. Centers for Disease Control and Prevention (CDC). And many of those falls take place at home.
It’s a scary prospect, but there’s a lot you can do around your home to reduce the risk of falls, reassures Caleb Wolters, PT, DPT, a physical therapist at Hinge Health. And that doesn’t mean you have to completely renovate your home, either. “A few simple steps can go a long way to improve safety,” he adds.
Read on to learn more about what you can do to prevent falls at home, including our room-by-room checklist of safety precautions.
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Our Hinge Health Experts
Caleb Wolters, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
Common Causes of Falls
Falling becomes more common if you’re over the age of 65. Just as it’s normal to grow some gray hairs or develop wrinkles on your skin, it’s normal for the systems in your body to change with time. While these changes are expected and oftentimes unnoticeable, some of them may impact your sense of balance, putting you at increased risk for falls. Here are some common reasons for falls:
Medications. Roughly 90% of adults 65 and older take one or more prescription medications each day. Some have side effects, like dizziness or lightheadedness, that can leave you feeling less steady on your feet.
Medical conditions. Issues like peripheral neuropathy (tingling in your feet) can affect your balance or gait. Heart conditions can cause weakness, blood pressure changes, and faintness. Bowel and bladder problems may cause a fall while rushing to the bathroom, especially at night. Mental health concerns such as depression are also linked with fall risk.
Vision problems. Poor vision makes hazards such as unsecured rugs and uneven room transitions more likely to contribute to a fall.
Hearing problems. The hearing and balance systems are both housed in the inner ear. When your hearing isn’t working properly, it can affect your balance.
Age-related loss of muscle mass. Sarcopenia — a gradual loss of muscle mass and strength — is a key risk factor for falling. It’s also part of aging. Experts estimate that we lose three to eight percent of our muscle mass per decade after the age of 30, and even more after 60. “If you don’t have good muscle strength, you won’t be able to react quickly and catch yourself if you trip,” says Dr. Wolters. Lack of muscle strength can also affect balance, which aids in keeping you steady on your feet so you don’t fall.
Fall hazards in your home, such as dim lighting, tripping hazards, and uneven surfaces. (Read on for tips on how to make your home safer.)
Falling: A Hinge Health Perspective
In most cases (four out of five times, in fact) a fall doesn’t cause a serious injury. So why bother talking about them? Because some falls are a big deal, which is why it's important to be armed with knowledge and tools to prevent falls and stay safe as you age. In some cases, a fall can cause such issues as fractures (broken bones), head injuries, teeth damage, bruises, cuts, and more.
This information isn't intended to cause alarm. Rather, we want to highlight the incredible benefits that come from learning about falls and how you can reduce your risk of having a fall or a fall-related injury. And that starts with movement and exercise therapy to improve your balance, strength, and mobility. And as you’re getting stronger and steadier on your feet, simple modifications around your home can help you stay active safely.
Practical Ways to Prevent Falls at Home
The following strategies can help to keep you safe at home, and confident as you move around.
Wear shoes inside. It might not seem as comfy, but one study in the journal Footwear Science found that wearing slippers or padding around in just socks at home more than doubled the risk of a serious fall.
Stay strong. “The best way to build balance is to build strength,” says Dr. Wolters. “The stronger you are, the faster you’ll be able to walk, and the better reaction time your muscles will have if you do lose your balance.” There are fairly simple moves you can do at home to build up lower leg strength, he adds, like sit to stand, body weight squats, and even marching up and down stairs.
Keep your mind sharp. You don’t just want to keep your body strong — you want to keep your brain strong, too. “As we get older, it’s harder to keep our brain focused on a task, especially if we’re doing more than one thing at once, like walking while talking to someone,” explains Dr. Wolters. One thing he does in physical therapy is have patients do a walking test for speed, and then do the same walking test counting backward from 100 by threes (100, 97, 94, 91 …). “If there’s a discrepancy between the two tests, it’s a sign that we need to work on memory and cognitive tasks while doing basic exercises,” he says.
Better your balance. One effective way to do this is through mind-body practices, like tai chi. Tai chi has been found to significantly lower fall risk in older adults, according to a 2017 review. Other good balance exercises you can do at home include standing on one foot, or walking heel to toe.
Do a medication review. About a quarter of all falls that lead to being hospitalized occur in people who take more than four prescription drugs, according to a 2020 study in the journal BMC Public Health. Medicare covers a medication review annually, where you can meet with your primary care provider or your pharmacist to go over your current medications to determine which ones you do or don’t need, which ones have side effects that can impact balance, and which ones may interact negatively with each other. Cutting out unnecessary medications, switching to safer alternatives, or lowering your dosage if recommended could help reduce the risk of side effects that impact balance and falls.
Get your eyes checked. Staying current with annual eye check-ups is important to make sure any age-related vision changes aren’t putting you at unnecessary risk for falls. If you wear glasses, make sure your prescription is up to date.
Train your pets. Furry friends are great company, but it’s a good idea to train them to move when they are in your way, rather than trying to step over them, recommends Dr. Wolters. Also keep pet toys in a toy basket, so that they’re not strewn all over the home, increasing the risk you may trip over them. You can also use nightlights to help you see pets in the dark and put a collar with a bell on them so that you can hear when they’re near. Keep their water and food bowls in a separate area of the house, too, like in the laundry room, so you don’t slip or trip on a spill or food pellets.
Removing Fall Hazards by Room: What to Look Out For
About 60% of falls happen at home, but there’s a lot you can do to help prevent them. Remember that saying “Lights. Camera. Action!” When it comes to fall prevention, remember this: “Lights. Clutter. Access.”
“It’s important to do these three simple things as much as possible: use bright lights, remove clutter, and make sure you have easy access to everyday items,” says Dr. Wolters.
You may also want to check your health insurance: some plans, including Medicare, offer a home safety assessment, which includes checking for fall hazards. Below are some suggestions, but it’s okay if you can’t implement them all. Even just a few of these changes may significantly reduce fall risks at home.
The Kitchen
Place items that you frequently use, like pots and pans, within easy reach. Keep everyday dishes on the lowest cabinet shelves.
Remove rugs.
Keep the floor dry. Clean up spills immediately, and stay out of the kitchen after you mop.
Family Room or Den
Tape down tripping hazards like rugs, loose carpets, and electrical cords.
Keep the floor free of clutter. Place plants on shelves, not on the ground. Keep toys for pets and grandkids in separate toy baskets. Encourage them to clean up after themselves when they visit.
Get help rearranging your furniture if needed. Ideally, you’ll want to create a three-foot-wide path for you to walk, says Dr. Wolters.
Bedroom
Place a nightlight in the room to keep it well lit if you have to get up to go to the bathroom in the middle of the night.
Keep a landline (remember those!?) or a charged cell phone near your bed.
Put a flashlight on your bedside table, in case the power goes out and you need to get up.
Bathroom
Place a non-slip mat in your shower or tub.
Mount grab bars near the toilet (towel racks don’t count) and on both the inside and outside of your tub and shower.
Use a night light in the bathroom for middle-of-the-night visits.
Add a raised seat to your toilet.
Stairs and Hallways
Place handrails on both sides of stairs — and use them! Even if you don’t think you need them, they can help to keep you more secure, stresses Dr. Wolters.
Make sure that there are light switches at the top and bottom of all stairs and on each end of a long hall. Motion-activated lights that plug into electrical outlets and automatically turn on when you walk by are also a good idea.
Don’t leave anything in hallways or stairs, even your shoes.
If you have throw rugs, make sure they’re secured. Put no-slip strips (you can find them at hardware stores) on any tile and wood floors.
Entryways
Add a porch light or front light outside your front door.
Install a handrail outside to help you when you lock and unlock your door.
Remove loose rugs in entryways and use no-slip strips instead.
Treat ice on walkways in the winter.
Remember: You don’t have to undergo major home renovations or even remove all tripping hazards in order for your home to be a safe place. No one expects that. Plus, your home may have a few areas that challenge your balance in a good way — like steps or seats that sit lower and require a little more strength to get up from. But a few small changes, like the ones shared above, may help you feel more confident moving around in your home.
PT Tip: Acknowledge Your Fear of Falling
A past fall can as much as double your chances of falling again. One reason is fear of falling, says Dr. Wolters.
If you’re worried about falling, you’ll unconsciously limit physical activity, which leads to an even greater loss of muscle strength and balance. Caleb Wolters, PT, DPT
Knowledge is power. Understand what situations make you most unsteady at home and then take the necessary steps to make adjustments to reduce fall risk, while working to improve your balance.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
How Hinge Health Can Help You
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
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This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Keep on Your Feet—Preventing Older Adult Falls. (2023, March 24). Centers for Disease Control and Prevention. https://www.cdc.gov/injury/features/older-adult-falls/index.html
Kirzinger, A., Neuman, T., Cubanski, J., & Brodie, M. (2019, August 9). Data Note: Prescription Drugs and Older Adults. The Henry J. Kaiser Family Foundation. https://www.kff.org/health-reform/issue-brief/data-note-prescription-drugs-and-older-adults/
Fielding, R. A., Vellas, B., Evans, W. J., Bhasin, S., Morley, J. E., Newman, A. B., Abellan van Kan, G., Andrieu, S., Bauer, J., Breuille, D., Cederholm, T., Chandler, J., De Meynard, C., Donini, L., Harris, T., Kannt, A., Keime Guibert, F., Onder, G., Papanicolaou, D., & Rolland, Y. (2011). Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences. International Working Group on Sarcopenia. Journal of the American Medical Directors Association, 12(4), 249–256. doi:10.1016/j.jamda.2011.01.003
Volpi, E., Nazemi, R., & Fujita, S. (2004). Muscle tissue changes with aging. Current Opinion in Clinical Nutrition and Metabolic Care, 7(4), 405–410. doi:10.1097/01.mco.0000134362.76653.b2
Kelsey, J. L., Procter-Gray, E., Nguyen, U.-S. D. T., Li, W., Kiel, D. P., & Hannan, M. T. (2010). Footwear and falls in the home among older individuals in the MOBILIZE Boston Study. Footwear Science, 2(3), 123–129. doi:10.1080/19424280.2010.491074
Four Types of Exercise Can Improve Your Health and Physical Ability. (2021, January 29). National Institute on Aging.