Falls are the leading cause of injuries to older people in the U.S. Each year, more than 11 million senior citizens fall--that’s one of every three people over 65. Treatment of the injuries and complications associated with falls costs the U.S. more than $20.2 billion annually.

The number of falls and the severity of injury increase with age. While some risk factors for falls, such as heredity and age, cannot be changed, several risk factors can be eliminated or reduced. The American Academy of Orthopaedic Surgeons has developed guidelines to help you avoid falls.

• Get an annual physical and eye examination, particularly an evaluation of cardiac and blood pressure problems.

• Maintain a diet with adequate dietary calcium and vitamin D.

• Participate in an exercise program for agility, strength, balance and coordination.

• Eliminate all tripping hazards in your home and install grab bars, handrails and other safety devices.

• Wear properly-fitting shoes with nonskid soles.

• Tie your shoe laces.

• Replace slippers that have stretched out of shape and are too loose.

• Use a long-handled shoehorn if you have trouble putting on your shoes.

• Avoid high heels and shoes with smooth, slick soles.

• Do not smoke.

• Avoid excessive alcohol intake.

• Keep an up-to-date list of all medications and provide it to all doctors with whom you consult.

• Check with your doctor(s) about the side effects of your medicines and over-the-counter drugs. Fatigue or confusion increases your risk of falling.

• Make sure all medications are clearly labeled and stored in a well-lit area according to instructions.

• Take medications on schedule with a full glass of water, unless otherwise instructed.

• Never walk in your stocking feet.

• Women who cannot find wide-enough athletic shoes for proper fit should shop in the men’s shoe department because men’s shoes are made wider.

What are the medical risk factors for a fall?

• Impaired musculoskeletal function, gait abnormality, osteoporosis.

• Cardiac arrhythmias (irregular heartbeat), blood pressure fluctuation.

• Depression, Alzheimer's disease and senility.

• Arthritis, hip weakness or imbalance.

• Neurologic conditions, stroke, Parkinson's disease, multiple sclerosis.

• Urinary and bladder dysfunction.

• Vision or hearing loss.

• Cancer that affects bones.

Falls can occur anytime, anyplace and to anyone while doing everyday activities such as climbing stairs or getting out of the bathtub. Research shows that simple safety modifications at home—where 60 percent of seniors' falls occur—can substantially cut the risk of falling. Protect yourself with these simple changes in furniture arrangement, housekeeping and lighting to prevent falls.

Bedroom

• Place a lamp, telephone and flashlight near your bed.

• Sleep on a bed that is easy to get into and out of.

• Replace satiny sheets and comforter with products made of nonslippery material, i.e. wool, cotton.

• Arrange clothes in your closet so that they are easy-to-reach.

• Install a night-light along the route between your bedroom and the bathroom.

• Keep clutter off the bedroom floor.

Living areas

• Arrange furniture so you have a clear pathway between rooms.

• Keep low-rise coffee tables, magazine racks, footrests and plants out of the path of traffic.

• Install easy-access light switches at entrances to rooms so you won’t have to walk into a darkened room in order to turn on the light. Glow-in-the-dark switches may be helpful.

• Walk only in well-lighted rooms, stairs and halls.

• Do not store boxes near doorways or in hallways.

• Remove newspapers and all clutter from pathways.

• Keep electric, appliance and telephone cords out of walkways, but don’t put cords under a rug.

• Don’t run extension cords across pathways; rearrange furniture.

• Secure loose area rugs with double-faced tape, tacks, or slip-resistant backing.

• Don’t sit in a chair or on a sofa that is so low it is difficult to stand up.

• Repair loose wooden floorboards right away.

• Remove door sills higher than 1/2".

Kitchen

• Remove throw rugs.

• Clean up immediately any liquids, grease, or food spilled on the floor.

• Store food, dishes, and cooking equipment within easy reach.

• Don’t stand on chairs or boxes to reach upper cabinets.

• Use nonskid floor wax.

Stairs and steps

• Keep stairs clear of packages, boxes or clutter.

• Light switches should be at the top and bottom of the stairs. Or consider installing motion-detector lights which turn on automatically.

• Provide enough light to see each stair and the top and bottom landings.

• Keep flashlights nearby in case of a power outage.

• Remove loose area rugs from the bottom or top of stairs.

• Replace patterned, dark or deep-pile carpeting with a solid color, which will show the edges of steps more clearly.

• Put non-slip treads on each bare-wood step.

• Install handrails on both sides of the stairway. Each should be 30 inches above the stairs and extend the full length of the stairs.

• Repair loose stairway carpeting or wooden boards immediately.

Bathroom

• Place a slip-resistant rug adjacent to the bathtub for safe exit and entry.

• Mount a liquid soap dispenser on the bathtub/shower wall.

• Install grab bars on the bathroom walls.

• Keep a night-light in the bathroom.

• Use a rubber mat or place nonskid adhesive textured strips on the tub.

• Replace glass shower enclosures with non-shattering material.

• Stabilize yourself on the toilet by using either a raised seat or a special toilet seat with armrests.

• Use a sturdy, plastic seat in the bathtub if you cannot lower yourself to the floor of the tub or if you are unsteady.

For more information on "Prevent Injuries America!^®," call the American Academy of Orthopaedic Surgeons’ public service telephone number 1-800-824-BONES (2663).

March 2000

For More Information:
How to Reduce Your Risk of Falling
Don't Let a Fall be Your Last Trip
Falls and Hip Fractures