Falls prevention for older people

Falls prevention means reducing the chance that an older person falls, by addressing the things that make a fall more likely. Some of those are about the person, such as strength, balance, eyesight and medication, and some are about the environment, such as lighting, flooring and stairs. The important point, and the reason it is worth taking seriously, is that most falls are not random accidents. They have identifiable causes, and many of those causes can be changed.

Falls matter more than people expect. A fall can mean a fracture, a hospital stay and a long recovery, but the less visible consequence is often the bigger one: after a fall, many people become afraid of falling again, so they move less, which weakens the muscles that keep them steady, which makes another fall more likely. That cycle can take away independence faster than the original injury.

What actually causes falls

Falls usually result from several factors combining, not one cause. The main ones worth checking:

Muscle weakness and poor balance. The single most important modifiable factor. Leg strength and balance decline with inactivity, and the decline accelerates after illness or a hospital stay.

Medications. Some medications cause drowsiness, dizziness or low blood pressure on standing. The risk rises with the number of medications taken, and sedatives, sleeping tablets, blood pressure medications and some antidepressants deserve particular attention.

Vision. Uncorrected vision, cataracts, and a common trap: multifocal or bifocal glasses, which distort depth perception when looking down at steps and can make stairs genuinely more dangerous.

Blood pressure drops on standing. Feeling lightheaded when getting up from a bed or chair is a specific, treatable problem, not simply "getting up too fast".

Feet and footwear. Foot pain, poor nail care, and unsuitable shoes. Loose slippers and walking in socks on hard floors are frequent culprits.

Continence. Rushing to the toilet, particularly at night, is a very common circumstance for a fall.

The home itself. Poor lighting, loose mats, clutter in walkways, steps without rails, slippery bathrooms.

Alcohol, dehydration and poor nutrition, all of which affect steadiness.

Practical steps that work

Exercise is the most effective single measure. Not gentle stretching, but exercise that specifically challenges balance and builds leg strength, done regularly and progressively. Programs designed for older adults, including many run through community centres and physiotherapists, are built around this. Tai chi is well regarded for balance. The key is that it continues; benefits fade when the exercise stops.

Get a medication review. Ask a GP or pharmacist to review everything, including over-the-counter products and supplements. Ask directly: "is anything here making falls more likely, and could any of it be reduced or stopped?" This conversation alone resolves a surprising number of cases.

Have eyes tested. Annually, or sooner if anything has changed. If the person wears multifocals, ask the optometrist about a separate pair of single-vision distance glasses for walking and stairs.

Sort out the feet. Well-fitting, flat, enclosed shoes with a firm sole and a back, worn indoors as well as out. Treat foot pain rather than working around it; a podiatrist is worth seeing.

Fix the obvious hazards today. Remove loose mats, clear walkways, improve lighting, and put a lamp or motion-sensor light on the route from the bed to the toilet, which is where a large share of night-time falls happen.

Address night-time toileting. A commode or urinal by the bed, and reviewing evening fluids and diuretic timing with the GP, can remove the rush entirely.

Consider structural changes. Grab rails in the bathroom and rails on steps are among the highest-value changes. See our guide to home modifications for older people for how to get them assessed and funded.

Keep eating and drinking well. Dehydration causes dizziness, and inadequate protein accelerates muscle loss.

Getting a falls assessment

If someone has fallen, nearly fallen, or has become fearful of falling, ask the GP for a falls risk assessment. Do this even if there was no injury; a near-miss is a warning worth acting on.

The GP can check blood pressure sitting and standing, review medications, look for underlying causes, and refer on. Referrals typically go to a physiotherapist for strength and balance, an occupational therapist for a home assessment, a podiatrist for feet and footwear, or a geriatrician or falls clinic where the picture is complex. Our guide to what a geriatrician does explains when that referral is worth asking for.

To arrange ongoing support at home, contact My Aged Care on 1800 200 422. Recovery support after a hospital stay is covered in our guide to transition care after hospital. You can also browse health and wellbeing services near you on Our Mate.

If a fall happens

Do not move someone who may have hurt their head, neck or back, or who is in significant pain. Call 000.

If they are unhurt and able to get up, help them do so slowly, ideally by rolling to their side, getting onto hands and knees, and using a sturdy chair to rise. Then tell the GP, even if nothing appears to be wrong. A fall is information about an underlying cause, and it is a strong predictor of another fall. Head injuries in particular need medical review, especially for anyone on blood-thinning medication, where symptoms can appear hours or days later.

It is also worth discussing how the person would call for help if they fell alone and could not get up, whether that is a personal alarm, a phone kept on them rather than across the room, or a daily check-in from someone.

Frequently asked questions

What is the most effective way to prevent falls?

Regular exercise that specifically challenges balance and builds leg strength is the single most effective measure. It works best when it continues over time and gradually increases in difficulty, and it is most effective combined with a medication review, an eye test and removing hazards at home.

Should I see a doctor after a fall even if I am not hurt?

Yes. A fall usually points to an underlying cause such as a medication effect, a blood pressure drop, weakness or a vision problem, and having fallen once is a strong predictor of falling again. Seek medical attention promptly for any head injury, particularly for anyone taking blood-thinning medication.

Can medications increase the risk of falling?

Yes. Sedatives, sleeping tablets, some blood pressure medications and some antidepressants can cause drowsiness, dizziness or low blood pressure on standing, and risk generally rises with the number of medications taken. Ask a GP or pharmacist for a review rather than stopping anything yourself.

What should older people wear on their feet to avoid falls?

Well-fitting, flat, enclosed shoes with a firm sole and a supportive back, worn indoors as well as outdoors. Avoid loose slippers, backless footwear and walking in socks on hard floors. Treat foot pain rather than adapting your walking to avoid it.

Who can assess falls risk in Australia?

Start with a GP, who can check blood pressure sitting and standing, review medications and look for underlying causes. They can refer to a physiotherapist for strength and balance, an occupational therapist for a home assessment, a podiatrist for feet, or a falls clinic or geriatrician for more complex cases.