Falls are a leading cause of injury and loss of independence in older adults, and most happen at home. Many falls can be prevented by finding the risk factors and fixing them one by one.
Key symptoms
- A fall in the past year or fear of falling
- Unsteady walking or needing to hold onto furniture
- Dizziness on standing
- Poor vision, foot pain or numb feet
- Getting up at night to urinate
What you find on exam
- Timed Up and Go test; over 12 seconds suggests higher risk
- Orthostatic blood pressure
- Gait, balance, leg strength and feet
- Vision and cognition
- Footwear and walking aid fit
Tests
- Medication review for sedatives, blood pressure medicines and other fall-risk drugs
- Vitamin D level and bone density when relevant
- Blood count, glucose and other tests based on the history
- Home safety checklist
Treatment basics
- Strength and balance exercise, such as physical therapy or tai chi
- Stop or reduce risky medicines where possible
- Home fixes: remove loose rugs, add grab bars, good lighting and night lights
- Treat orthostatic hypotension, vision problems and foot issues
- Vitamin D and osteoporosis treatment to lower fracture risk; teach how to get up or call for help
Red flags
- Head injury on a blood thinner
- Fall with loss of consciousness or new confusion
- Repeated falls or unable to get up without help
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Related guides
Sources: CDC STEADI (falls in older adults); Open RN, Nursing Fundamentals 2e; AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back). Written by Making Synapses. Making Synapses is not affiliated with these organizations.