Preventing falls at home

About falls

In 2018-19 falls were identified as the leading cause of injury-related hospitalisations, accounting for 3 out of 4 presentations to hospital. There were close to 53,000 emergency presentations and 44,000 hospitalisations for people over 65 years.

Around 3% of older Victorians were admitted to hospital as a result of a fall, with an annual increase of 4.4% in fall-related admissions. In that same year, 62% of those aged 65 years and over and admitted to hospital as a result of a fall were women.

Older people are almost 12 times more likely to have a fall than a motor vehicle or pedestrian accident.

Falls are common among older people

It is estimated that at least one-third of people aged 65 years and over fall one or more times a year. Although many of these falls do not result in injury, they can cause:

• hip and wrist fractures
• chest injuries including rib fractures
• hip and shoulder dislocations
• head injuries and abrasions
• bruising and sprains
• fear of falling that can result in loss of confidence and restriction of activities.

What causes people to fall

There are a number of factors that contribute to your risk of falling as you grow older, including:

• age-related changes in your body such as poor eyesight, slowed reaction time, cognitive loss and reduced sensation or numbness in lower limbs
• weakening muscles and stiffening joints
• new health problems
• side effects from your medication – especially if you are taking 5 or more medicines
• sensory, unsteadiness and balance problems
• not doing enough physical activity
• poor diet and not drinking enough water
• low calcium – increases the risk of having a fracture if you do fall
• sore feet or unsafe shoes
• trip or slip hazards like rugs or floor mats, uneven or wet surfaces and poor lighting at home or outside.

A short-term illness, such as the flu or another infection, or recovering from surgery or a recent hospital stay can also temporarily increase your risk of falling.

How to prevent falls

Contrary to popular belief, falls are not inevitable and many older people can be prevented from falling. Some risk factors for falls are relatively easy to change and, where falls occur, the severity of injuries can be reduced.

The first step is to ensure that if a person is feeling unsteady or has a fall, even one that does not cause an injury, an appointment is made to discuss this with a doctor. Falls can be an indicator of an underlying health problem. Falls and balance clinics are available at many public health services to address common causes of falls.

Avoiding falls

To avoid falls and injuries from falls:

• Take steps to improve safety in and around your home.
• Look after your health. Stay up to date with routine health checks, eat a healthy diet, and exercise to improve your balance, strength and flexibility. Try to stay active – home or group exercise programs and tai chi are good options.
• Wear shoes that are comfortable and fit well – they should be wide enough in the toe area, have low or no heels, and have slip-resistant soles.

Improve safety inside

To increase safety in the home to reduce your risk of falling:

• Have good lighting, especially between the bed and the bathroom or toilet at night and near any internal steps. Replace light globes with CFL energy efficient light globes of 12 watts or higher. Use plug-in night-lights and have movement-sensitive lights near stairs and the bathroom. These lights are available from most hardware stores.
• Daytime glare through glass doors and windows can be reduced with sheer blinds.
• Remove clutter and make sure walkways and corridors are kept clear and well lit.
• Repair or replace carpets with worn areas, holes or long threads.
• Check that mats and rugs are secure and have no tears or wrinkles. Put adhesive strips on all mats and rugs, including those in the bathroom.
• Make sure that chairs and beds are sturdy and easy to get into and out of, and that tables and benches do not have sharp corners.
• Wipe up spills immediately.
• Install grab rails in the bathroom (towel rails are not usually strong enough to use as grab rails). Bathroom tiles can be slippery, especially when wet. Cover these areas with a non-slip material or treatments.
• Avoid having highly polished floorboards.
• Install support rails near steps if there is no hand rail.
• To reduce the risk of falling in an emergency, make sure your house has smoke alarms in working order and a fire blanket or extinguisher that is easy to reach.
• Avoid wearing clothing that is too long or touching the floor, as this can cause you to trip over (for example, your dressing gown).
• Do not wear socks or loose slippers around the home.
• Ask an occupational therapist about ways to make your home safer.

Improve safety outside

To increase safety outside the home to reduce your risk of falling:

• Clear away garden tools.
• Avoid using ladders, or ask someone for assistance if you need to access something at height (for example reaching to a high shelf in the pantry, or changing a light bulb).
• Remove leaves, mosses, fungi and lichen that make garden paths slippery when wet.
• Mark the leading edge of outside steps (for example, with white paint) so they are easy to see.
• Install grab rails next to steps that do not have hand rails.
• Make sure outside steps are well lit.
• Keep paths well swept.
• Repair broken, uneven or cracked paths, patios and other walking surfaces.
• Report cracked footpaths to your local council.
• Wear sunglasses and a hat to reduce sun glare.

Stay healthy

To maximise your physical wellbeing and reduce your risk of falls:

• Talk to your doctor or other health professionals about:
  • your diet
  • managing your medications (including non-prescription ones)
  • ways to manage chronic medical conditions, including dizziness and incontinence.
• Have your eyes tested annually.
• Visit your podiatrist regularly to minimise foot problems.
• Wear shoes that are comfortable and fit well – they should be wide enough in the toe area, have low or no heels and have slip-resistant soles.
• Consider wearing hip protectors or limb protectors to help prevent hip fracture and skin tears in the event of a fall.
• Make sure your vitamin D levels are enough for strong bones and muscles
• Eat a healthy diet and drink plenty of fluids.
• Get active. Research shows that exercise at any age is beneficial.

Physical activity

The more active you are the better your chance of keeping your muscles strong and joints flexible.

To avoid falls and injuries from falls, exercise to maintain or improve your balance, strength and flexibility. Home or group exercise programs and tai chi are good examples. Or you could join a walking group or your local gym – some of which have programs specially tailored for older people. Many local councils support local walking and activity programs.

Check with your GP before starting a physical activity program. A physiotherapist can help design an exercise program that suits you.

Don’t fall for it – Falls can be prevented!: A guide for preventing falls for older people is a handy resource that you can use to reduce your risk of falling.

What to do if you fall at home

If you happen to have a fall at home

• Don’t panic – stay still for a few minutes and try to calm down.
• Call for help if you can.
• Dial triple zero (000) for emergency services or call your local doctor for help – keep your telephone in easy reach of the floor, for instance on a low table.
• Decide whether you can get up yourself.

If you can get up by yourself

• Roll over onto your stomach and try to get into a crawling position.
• Crawl to a stable piece of furniture, like a lounge chair.
• Try to get up onto your knees.
• Push up, using your strongest leg and arms, still firmly holding onto the furniture.
• Sit down on the furniture.

See your doctor to check for injuries and to assess whether there was a medical cause for the fall.

If you can’t get up by yourself

• Try to crawl or drag yourself to somewhere on carpet and find anything that can keep you warm, such as bedclothes, a towel or clothing, while you wait for help.
• Use your personal alarm, if you have one.
• If you don’t have a personal alarm, use an object that you can bang to make a loud noise, like a walking stick against the wall, to alert a neighbour.
• If you know no one will hear you, keep warm and try to get up again later.

See your doctor to check for injuries and to assess whether there was a medical cause for the fall.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Local community health services
• Victorian Falls and Balance Service Directory – find a Victorian falls and balance service near you
• My Aged Care Tel. 1800 200 422
• Carers AustraliaTel. 1800 422 737
• COTA Tel. (03) 9655 2100
• Independent Living Centre Victoria Tel. 1300 885 886