How to Prevent Falls in Elderly Parents at Home

Your father stumbled over the bathroom rug last Tuesday. “I managed to grab onto the counter, so no big deal,” he told you. But you can’t stop thinking about it at 2 a.m. You know he’s hiding something: he knows the reality that he doesn’t want to admit—that the home he has called home for three decades is beginning to act as a hazard.

Fall prevention for elderly parents is rarely something most of us think about until a serious incident has already taken place. According to the Centers for Disease Control and Prevention, more than one in four adults aged 65 and older fall each year, and falls are the leading cause of injury death in that age group. Each year, 3 million older adults are treated for falls in emergency rooms, and more than 300,000 are hospitalized for hip fractures alone.

The good news: most falls are preventable. You can learn to recognize the warning signs, take action now to prevent further injury, and help your parent maintain their independence. This guide will cover the factors involved, what room-by-room checklist should look like, effective fall prevention exercises, and what to do in case your parent falls and how to protect them in the future. It’s time to put your mind at rest.

Why Falls are so Dangerous for Aging Parents

If a fall happens to a 35-year-old, they are usually only left with an aching ego. A fall experienced by a 75-year-old might result in a broken hip, a traumatic brain injury, or the start of their decline into dependency. Here’s what we know:

• One in five falls causes serious injury including broken bones or a head injury (CDC)
• More than 95% of hip fractures result from a fall, followed by rehabilitation.
• Falls represent the most frequent cause of traumatic brain injury among the elderly.
• If a senior falls once, the chance of them falling again is doubled.

Beyond the injuries, falls also have a psychological impact. Many seniors who have experienced one or more falls become afraid of falling and stop moving as much. The result is a reduction in strength and loss of mobility and balance, creating the so-called “fear-of-falling cycle” and can have a more damaging impact in less time.

That’s why fall prevention is so important for seniors. It is much easier to avoid falls than recover from them. If your parents live in an assisted living facility, you should ask the administration what they have in place and stay involved with the care to reduce their isolation.

Common Risk Factors to Watch For

Falls generally don’t happen as the result of a single cause, but rather are brought about when a number of risk factors interact with one another. Keeping in mind the potential for these fall causes can help you avoid future accidents when you visit your parents.

Physical changes:

• Muscle weakness – Muscle mass typically begins to diminish by age 30, and by age 70, many individuals have lost 25-30% of their strength.
• Balance problems – Several factors influence your sense of balance – your inner ear, vision, and even the nerve endings in your feet, and all of these are more likely to decline with age.
• Chronic conditions – Diabetes, arthritis, Parkinson’s disease, and heart conditions can all make a person more unsteady. If your parent also has dementia, you’ll need to be extra careful to explain the risks – see how to talk to a parent with dementia.
• Foot problems – Bunions, neuropathy, and ill-fitting shoes make it more difficult to stay balanced, even in people with otherwise intact balance.

Medical factors:

• Medications – A variety of medications can lead to dizziness or drowsiness (e.g., high blood pressure medication, sedatives, antidepressants, antihistamines). These risks increase significantly if your parent has four or more prescriptions.
• Vision changes – Vision that’s not properly corrected, cataracts, and glaucoma can all lead to a decreased ability to spot potential hazards and to a decreased ability to determine depth.
• Hearing loss – Research has shown that hearing loss increases a person’s risk of falling; that’s probably because your inner ear is an important factor in your balance.
• Vitamin D deficiency – Vitamin D deficiency weakens bones and muscles. The National Institute on Aging recommends that adults over the age of 70 get at least 800 IU of vitamin D per day.

Environmental hazards:

• Throw rugs that could trip a person, cluttered walkways, poor lighting, slippery bathroom surfaces, or the absence of handrails in critical areas.
• Pets in your parent’s feet, electrical cords blocking the path to walk around, wet floors.

While you may be seeing any of these in action in their home during visits, here are more signs your aging parent needs help at home.

Room-by-Room Home Safety Checklist

The best fall prevention is in the home. Use this checklist to walk through your parent’s house. Better yet, walk through their home together, so it doesn’t feel like you’re scrutinizing their home, but rather collaborating with them on improving their home safety.

Bathroom

The most frequent and most serious home falls happen in the bathroom due to wet surfaces and hard porcelain.

• Add grab bars near the toilet and in the shower or tub.
• Put non-slip mats in the tub and on the floor around the tub.
• Consider a shower chair or bench and a shower hand held.
• Install a raised toilet seat if your parent has trouble getting up and down.
• Make sure the bathroom has a night light for middle-of-the-night trips to the bathroom.

Bedroom

• Make sure a lamp is available within arm’s reach of the bed.
• Keep a clear path from the bed to the bathroom (no clutter, electrical cords, or rugs).
• Ensure the height of the bed makes it easy to get in and out of (i.e., that the feet of your aging parent will reach the floor when sitting at the edge of the bed).
• Secure or remove any loose rugs

Kitchen

• Store items you use often on shelves you can reach easily — no stretching or standing needed
• Take away step stools, or swap them out for step stools with handholds
• Wipe up spills as soon as they happen; floors should be dry at all times
• Boost lighting in the kitchen, particularly over the stove and sink area

Stairs

• Fit both sides of stairs with handrails
• Light up each step, preferably with lights that activate when you step
• Put non-skid strips on the stairs if the surface is slick
• Take anything that’s on steps and put it somewhere safe

Living Areas

• Secure or remove any throw rugs, or tape them down
• Ensure there’s a clear pathway, free of furniture, shoes or clutter
• Tape or tack down the corners of any loose carpets
• Position furniture so that your parent can hold on as they move through the room

Outdoors (Often Forgotten)

The typical “home safety for the elderly” lists stop at the front door, but many of the elderly falls happen outside.

• Fix uneven steps, sidewalks and walkways
• Get handrails installed on the porch steps and any ramps
• Provide exterior lights at the mailbox, the garage and along the walkways
• Clear the walk of leaves, ice and hoses
• Check that the driveway, walk and path between the car and front door is smooth and lit

7 Fall Prevention Strategies That Actually Work

While home improvements can minimize the potential for falls, you should also consider these steps, which focus on your parent themselves.

1. Get Them Exercising for Their Balance and Strength

Exercises for strength and balance may be the single most helpful measure you can take to prevent falls. The National Institute on Aging recommends that older adults exercise at least three days a week for balance and strength. Consider some of the following options:

• Tai Chi — Some studies have found it to reduce falls by as much as 50 percent in the elderly. Many senior centers provide free or low-cost Tai Chi classes
• Chair yoga — You can develop strength and flexibility without having to focus on your feet
• Walking — A daily 20-minute walk helps build leg strength and improve coordination
• The Stepping On program — This evidence-based workshop has been found to reduce falls by 31 percent

The older adult should engage in at least 12 weeks of consistent workouts to start to see a drop in fall risk. Encourage your parent to start now.

2. Take Stock of Their Prescriptions With Their Doctor

Ask your parent’s doctor or pharmacist to review all drugs — both over-the-counter medications and prescriptions — as well as supplements, at least once a year. Taking four or more prescription medications can lead to a dramatically higher fall risk, and drug-drug interactions can result in dizziness you may not even be aware of. Make absolutely certain your parent has this step covered, as less than half of all falls among seniors are even reported to their physician.

3. Schedule Annual Vision and Hearing Tests

A bad prescription for glasses or untreated hearing loss can create hidden trip-and-slip hazards. An annual eye exam checks for changes in depth and peripheral vision, so that updated prescriptions are in play, which can make a huge difference. The same goes for your parent’s hearing, because balance is directly connected to the inner ear.

4. Wear the Right Shoes for the Job

There are a few things you should watch out for, such as loose slippers, soles worn down to the tread, and walking barefoot on hard surfaces, all of which lead to the majority of fixable falls. Here are the criteria of great walking shoes:

• Rubber, non-slip soles
• Low heels and a wide base of support
• Shoes that lace up, or have a Velcro closure — don’t wear slip-ons
• A stiff heel counter to support the ankle

5. Boost Nutrition and Vitamin D Intake

Nutrients make a big difference to muscles and strong bones. Be certain that your parent is consuming an appropriate amount of vitamins, including calcium, protein, and Vitamin D. Many seniors are deficient in Vitamin D because they don’t spend as much time outside these days. This easily can be tested with a blood test; and if it’s low, a Vitamin D supplement is cheap and easy to take. Even if your parent doesn’t live near you, sending them care packages with healthy treats can be a good step in the right direction.

6. Use Assistive Tools (With No Shame)

If your parent doesn’t use them, canes or walkers do nothing for you and them. Many older people have negative attitudes toward their use because it implies they are weak. Instead, you could compare it to eyewear. Canes are just like reading glasses. Also, make sure they are fitted (by a medical professional — preferably a physical therapist) to make them as easy to use as possible, and ensure that your parent uses them every time they walk, not just when they are feeling off balance.

7. Get Some Techy Tools

There are technological ways to help prevent and handle falls that many competitor guides fail to include:

• Medical alert systems — A wearable device with a button your parent can press in case of a fall (some newer ones even have fall detection)
• Motion sensor lights — Lights that turn on automatically when your parent wanders from bed to bathroom
• Home smart video cameras — A way to keep an eye on them from afar (with their OK)
• Video doorbells — To avoid rushing to the door, another leading cause of falls

If they’re reluctant to embrace technology, our post on helping aging parents with tech has great conversation tips on this. Also, if you are the one dealing with them and your own children, you are part of the sandwich generation and that’s OK — asking for support is also a good step in that direction.

How to Talk to Your Parent About Fall Prevention

Here is where most guides don’t even bother going, although it’s what you need! You can buy all the grab bars in the world, but if your parent won’t let you install them, nothing will change.

Why they’re fighting it: Fall prevention discussions often make it seem like getting old. Your parent might see your suggestion “You need grab bars in the house” as an admission that “You can’t take care of yourself.” That is a threat to their autonomy, and that is what they are fighting.

Try these techniques:

• Start with facts, not opinions. “I read that 1 in 4 people over 65 fall every year, which is pretty scary.” It sounds like you’ve learned something, rather than judging your parent.
• Talk about the house. “This bathroom could use better light” can feel less threatening than “You can’t see in this bathroom” (i.e., you will fall).
• Ask for help with something. “I know I need to make this place safer, would you mind walking me through and showing me what you’re most afraid of?” This puts them in an expert role.
• Do something to make your house more accessible together. Offer to go buy and install the grab bars for you, or make a day of it a project you do together. Involvement is key.
• Pick one or two items on the grab bar and lighting checklist. It’s much harder to say no to “we’ll grab this today” than to a 15-item list. Try bathroom and stairs first, then revisit it.

If your parent simply will not discuss safety changes with you (even those that you will do yourself), you’re in good company. Read more about what to do when your elderly parent refuses to accept your help here.

What to Do If Your Elderly Parent Falls

No matter how well-prepared you are, sometimes an accident happens. The most important thing to know is how to respond.

When you witness a fall (if you are at the time, and your parent allows you to):

1. Do not overreact. If you are calm and they’re not in danger, they will be less freaked out.
2. Assess the situation. Don’t try to move your parent to their feet right away — if there’s a head injury or they can’t move, they could be seriously injured. Ask them if they hurt and, where it hurts, how much they hurt. (Ask them to rate the pain on a scale of 1 to 10, and also see if they can answer questions properly).
3. If you determine your parent is capable of getting up without major pain, help them roll to a side position, then onto their hands and knees. Have them lean on something stable, like a chair, and lift themselves gradually. If it’s safe for both parties to do this, you can help hold their back or arms to assist.
4. If they have a head injury, aren’t able to get up on their own, or if they appear to be too dizzy or confused, call 911.

When you don’t witness a fall:

1. Make sure your parent has a plan to summon help (whether it is a phone in every room, a medical alert service, or a neighbor or friend who checks in daily).
2. Set up a fall action plan with your parent before they need you to act (where do they have their medical info, who should you call first, etc.)
3. Stay on top of their daily activities. If you make it a habit to stay in frequent touch, when they deviate from a pattern of living, you are likely to notice it early (see our guide on Hug Letters for connecting at a distance).

If your elderly parent experiences a fall, no matter how minor you think it is, it is best to call their doctor immediately and report what happened. It’s not a medical embarrassment—a fall is a medical event

• Talk to the doctor about a fall risk assessment (the CDC’s STEADI program has free tools)
• Examine what triggered it. Carpet? A change in prescriptions? Dim lights? Don’t treat the symptom. Treat the cause.
• Be alert to symptoms that develop after, such as headache, dizziness or confusion after a few days that could indicate a more serious injury

Frequently Asked Questions

Are falls common in elderly adults?

Extremely common. The CDC reports that more than one in four adults aged 65 and older fall each year, resulting in 3 million emergency room visits and over 300,000 hip fracture hospitalizations annually. Falls are the leading cause of injury death in this age group.

Which fall-prevention exercises are effective for older adults?

Tai chi, the most thoroughly tested and well-studied exercise, cut fall risk by up to 50% in clinical trials. Other useful options: chair yoga, walking programs, water aerobics, and organized balance exercises. The critical component: repetition—at least three times a week for 12+ weeks, for lasting results.

What should I do when my elderly parent is repeatedly falling?

Multiple falls is a red flag for a medical issue. Ask your parent’s physician for a full fall risk evaluation—a drug review, a look at vision and hearing, blood pressure, a balance screen. Use the checklist to review the home. And if the falls don’t stop, it’s likely time to look at a move to in-home care or [an assisted living community].

Does Medicare pay for fall prevention?

It does. It covers a yearly wellness appointment that includes fall risk screening, physical therapy for balance, some home safety assessments (as directed by a physician) and medically required equipment, like canes and walkers. Ask your parent’s physician, or contact Medicare, to learn what is covered by a specific plan.

Keeping Your Parent Safe Starts with Staying Connected

Fall prevention should not be treated as a single project. It is a conversation. A checklist that’s checked repeatedly by season. And a relationship where your parent feels that when a change in how they feel, they can tell you about it.

It starts this weekend with one room: Install a grab bar. Swap in a new lightbulb. Dispose of that “never had a problem” throw carpet your mother insists on. Small changes today prevent the phone call you never want to get.

And if you’d like to stay close between phone calls, a once-monthly family newsletter through Hug Letters lets your parent keep in touch with the grandchildren, the pup, the remodel in the kitchen—the daily life they miss. It may not keep them from falling, but it is the regular contact to keep you on top of a possible change.