Falls are extremely common, especially for those aged 65 or older. It can be devastating for an individual, as well as their caregiver, when a fall occurs. But, with preventative measures, you can feel safe and secure in and out of your home. This guide will help you understand the risk factors associated with falls for seniors in Ontario, along with how to prevent them.
- Fall-related Injuries for Seniors
- Risk Factors for Falls
i) Common Reasons for Falls
– Slips and Trips
- Tips for Preventing Falls & Eliminating Risk Factors
i) Getting a Falls Prevention Assessment
ii) Home Adaptations
iii) Things You Can Do To Prevent Falls
– Education and Exercise Classes
– Falls Prevention Bingo
– Maintain a Healthy Diet
– Wear Appropriate Shoes
– Visit Your Family Doctor
– Occupational Therapy
- How to Prepare Your Home to Prevent Falls
i) Install Equipment
ii) Prevent Falls on Stairs
iii) Prepare Your Home for Winter
– Volunteer Snow Removal Services
– Government Funded Snow Removal Services
- What to Do If Your Loved One Has Fallen
Fall-related Injuries for Seniors
Unintentional falls are the leading cause of injury for Ontarians aged 65 and older. In 2017, there were approximately 135,000 emergency department visits for fall-related injuries for individuals aged 65-79, and nearly 149,000 emergency department visits for individuals aged 80 and above.
Unfortunately, a high number of Ontarians suffer from a head injury after having a fall. Head injuries can include any sort of injury to the brain, skull, or scalp; this can range from a bruise, to a traumatic brain injury. This is why preventative measures for falls are so incredibly important.
The most common types of falls result from slips and trips, falling down stairs, and falling from furniture. As you can see in the table below, as an individual gets older, he or she becomes more at risk for a fall.
*For a more comprehensive understanding of the data for fall related injuries, for individuals of all ages within Ontario, you can read Parachute’s Ontario Injury Data Report 2018.
Between 20% and 30% of seniors fall each year, making fall-related injuries a serious public health concern. The financial and direct personal costs of falls are substantial for everyone involved, including the individual that fell, their family/caregiver, as well as the Canadian government.
When a senior falls, they often require one or more of the following to aid in their recovery: personal home support, long-term care, hospital visits, joint-replacement surgery, and/or physiotherapy. This is why the financial implications of fall-related injuries on Ontario’s healthcare system are estimated to be over $2 billion annually!
After a fall, many seniors experience negative effects on their physical and mental health including:
- fear of falling
- loss of autonomy and independence
- greater isolation; immobilization
Although falls by seniors are increasing, there are ways in which seniors and their caregivers can help prevent falls in and out of the home. First, it’s important to learn about the common risk factors for falls, and the different types of falls, so that you can better understand how to prevent falls from happening.
Risk Factors for Falls
A fall can happen in any place and at any time. However, half of fall-related hospitalizations result from a fall occurring in the home. This is why it’s important for a senior’s home to be well-equipped so that the risk of falling can be greatly reduced.
Common Reasons for Falls
There are several factors that can cause a senior to fall, but two of the most common reasons are slips and trips, and as the result of side effects from medications.
Slips and Trips
Slips and trips are the main culprit for falls among seniors. They can happen as a result of any obstacle in a senior’s walking path, because of an existing chronic condition or disability, due to balance disorder, or as a result of cognitive impairment.
Biological factors such as nausea, infection, weakness, pain, and dizziness can also put seniors at risk for falls. One study revealed that infections, in particular Urinary Tract Infections (UTI), were a precipitating factor in 8% of all falls. Essentially, any factor that changes a person’s gait (walking timing, foot placement, etc.) greatly increases their risk for falling.
The risk of falling is extremely high for individuals with such chronic conditions as:
- Parkinson’s disease, a neurodegenerative disorder that affects the dopamine-producing neurons in an area of the brain called substantia nigra.
- Cardiovascular disease
- End-stage renal disease, a chronic kidney disease in which the kidneys lose their filtering capabilities.
- Chronic obstructive pulmonary disorder (COPD), a term to describe lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma.
- Bowel or bladder incontinence. Rushing and frequent trips to the bathroom increases a senior’s risk for falls.
- Osteoporosis (does not affect the risk of falling, but does increase the risk of fracture from a fall)
The side effects of certain medications, such as drowsiness, dizziness, or a drop in blood pressure have been found to increase an individual’s risk of falling. If you are taking one of the following types of medications, you may be at an increased risk for falls:
If you are taking any of the above medications and are concerned you might be at risk for falls, it is highly recommended that you visit your doctor.
Tips for Preventing Falls & Eliminating Risk Factors
In addition to the risk factors for falls mentioned above, there are other common types of risk factors to be aware of:
- Slips on ice and snow
- Falls on stairs/steps
- Falls from furniture
- Alcohol consumption
- Impaired vision
- Personal hazards (inappropriate footwear, long pants, etc.)
- Environmental hazards (uneven sidewalks, loose rugs, electrical cords)
- Bone and muscle weakness
Now that we know what risks to look out for, let’s discuss some ways in which you can eliminate these risks and help prevent falls from happening.
Getting a Falls Prevention Risk Assessment
If you’d like to reduce your risk of falls while remaining in the comfort of your home, it is highly recommended that you get a falls prevention risk assessment.
There are various health care facilities and organizations that have falls prevention programs that include risk assessments. For example, the Falls Prevention Program offered by Sunnybrook Health Sciences Centre consists of the following services:
- Home safety information session and assessment
- Consultation with a geriatrician, nurse, physiotherapist, and occupational therapist
- A six-week group exercise program, run by a registered physiotherapist, designed to improve balance, gait, and strength
- Education sessions about home safety, home exercises, and safe medication practice
The majority of seniors wish to continue living in their home for as long as possible. However, the design of your home doesn’t always configure to your changing needs. You may choose to have an Occupational Therapist perform an in-home risk assessment. The Occupational Therapist will assess your living area, and make recommendations to modify the space to help reduce your risk of falling. Adaptations such as ramps, extra lighting, or hand rails may be needed to optimize your home for fall-prevention.
If you, a family member, or a friend has the know-how and skills to implement the necessary changes to your home, the Canada Mortgage and Housing Corporation (CMHC) has provided a step-by-step guide, Maintaining Seniors’ Independence Through Home Adaptations.
Things You Can Do To Prevent Falls
If you feel that you are at risk for a fall, or if you have fallen in the past, there are various services offered by the Canadian government and non-profit organizations that can help reduce your risk of future falls. Let’s take a look!
Education and Exercise Classes
Exercise and falls prevention programs help seniors stay healthy and mobile. They focus on helping seniors learn about methods to improve balance, strength, and mobility to ultimately help prevent falls.
There are many options for seniors when it comes to falls prevention education and exercises. If you take a look in your local recreational activities magazine – commonly found at community recreational centres – there are often senior programs that include falls prevention activities.
Seniors’ Centres are also a great option. For example, the Brampton Seniors’ Centre provides exercise classes that improve strength, balance, and flexibility, along with socializing activities for seniors.
If you want to start exercising at home, you can take a look at these 10 Fall Prevention Exercises Seniors Can Do While Sitting in a Chair.
Falls Prevention Bingo
Falls Prevention Bingo is a great and fun way to learn about the risk factors of falls. There are a significant number of resources available for you or a loved one to plan a falls prevention bingo night, either at a local facility, or in your own home – all you have to do is download the provided bingo cards and follow the instruction sheet. The website also offers a discussion guide to ask players questions about falls prevention.
Maintain a Healthy Diet
Eating well is important for anyone of any age; however, in order to maintain optimal muscle and bone strength, it is crucial that you consume a healthy diet. Poor diets can lead to physical weakness and fatigue, which increase an individual’s risk of falls.
In fact, research has found that malnourished seniors who visited the hospital were more likely to report falling within that past 6 months. This means that seniors maintaining a healthy diet fall less frequently than those that don’t consider their nutritional health.
Registered Dietitians can work directly with seniors to make the proper dietary choices needed to help reduce diet-related fall risk factors. For more information, recipes, and guidance on maintaining a healthy diet, here is a plethora of information provided by Dietitians of Canada.
Wear Appropriate Shoes
Flip-flops and high heels are not exactly the most optimal styles of shoes you should be wearing if you’re worried about falling. Instead, properly fitted sturdy shoes with non-skid surfaces are the most sensible option. Not only do these types of shoes prevent slips and trips, but they can also help reduce joint pain.
Many shoe companies like Shoes For Crews understand that style is just as important as comfort, so you can actually have the best of both worlds while staying safe and secure on your feet!
Visit Your Family Doctor
Your family doctor will be able to assess whether you’re at risk for a fall. When you go see your doctor, it’s important that you discuss the following:
- What medications you are currently taking. Certain medications have side effects that can make you more prone to falling. Your doctor will then have a better understanding of this risk factor and may decide to reduce, eliminate, or change the dosage of your medications.
- Your history of falling. Give insight into where, when, and how you fell so that your doctor can make recommendations to prevent similar falls from happening.
- Health conditions. Make sure your doctor is aware of any health conditions you have, such as ear and eye disorders, which may increase your risk of falls.
Occupational Therapists help individuals improve their ability to do everyday activities such as getting dressed, walking around the house, and safely going up and down stairs. They can also help with the following:
- Create preventative and corrective measures to help individuals reduce the risk of fall-related injuries
- Educate and train individuals on how to use fall-prevention medical equipment
- Assess and provide recommendations for how living and work spaces can be modified to suit your needs.
How to Prepare Your Home to Prevent Falls
There is a wide variety of falls prevention products on the market. Recommendations from your doctor and/or occupational therapist can help you decide which equipment is best for you. Common ways in which you can acquire medical equipment include:
- Privately through a medical supply company
- Personalized assistive devices through the Assistive Devices Program (ADP). Ontario residents with a valid OHIP number and long-term disability may be eligible for this program; however, an application is required. The program provides reimbursement for medical equipment and devices from registered vendors; the client pays a share of the cost at the time of purchase and the vendor then bills the ADP for the remaining balance.
Here’s a quick overview of the types of falls prevention products that you can use in your home and how they can help prevent you from falling.
- Grab bar: Allows individuals to stabilize themselves and/or pull themselves up from a sitting position.
- Rail bariatric: Helps individuals lift themselves up from a sitting position.
- Toilet safety seat/bar: Allows individuals to safely sit or stand.
- Adjustable height bed rail: Allows individuals to safely sit in and get out of bed.
- Non-slip bath mat: Prevents slipping in the bathtub.
- Lifeline AutoAlert: A medical alert service that automatically alerts the service provider if an individual falls.
* Funding from the Ontario government may not cover all of the equipment listed, and specific eligibility criteria will determine the amount of funding provided.
Prevent Falls on Stairs
Seniors can experience an injury from walking up and down stairs because of these common risk factors:
- Lack of handrail support or not using the available handrail support
- Lack of lighting
- Uneven steps or having step coverings that are in poor repair
- Hurrying up or down stairs
- Carrying bags making it difficult to see upcoming steps
- Wearing socks that make it easy to slip
All of these risks can be prevented with a minimal amount of effort and money. Ways in which you can prevent falls while walking up and down stairs include:
- Install or fix stair handrails
- Place step lights along both indoor and outdoor steps
- Repair faulty steps/coverings
- Take your time when walking up and down stairs
- Use a stair-climbing folding utility cart to carry goods. You will only have to do one trip and you’ll be able to see the steps in-front of you
- Wear sensible non-slip shoes
Prepare Your Home for Winter
Slipping on ice and snow is unfortunately quite common for seniors. In fact, 16% of fall-related injuries for Canadians aged 65 or older were a result of walking on snow or ice. Attempting to shovel or remove the snow can also lead to a fall-related injury. This is why there are volunteer and government-funded snow removal services provided to seniors.
Volunteer Snow Removal Services
- There are numerous not-for-profit organizations that match volunteers with seniors to help keep their driveway/pathways clear of snow. For example, Leaf & Snow Buddies helps prevent slips and falls by providing shovel and salt services at no cost to seniors.
- Snow Angels consists of kind-hearted neighbours and volunteers that service people with health issues or limited mobility by clearing their driveways and sidewalks of ice and snow each winter. Snow Angels offers snow removal services in Windsor, Kitchener, Guelph, London, Hamilton, Chatham, and more.
Government-Funded Snow Removal Services
- Your city may offer snow removal services or subsidiaries. For example, the City of Toronto provides sidewalk snow clearing for seniors or disabled persons living in the care area (parts of Toronto, York and East York) at no cost. The service is free, but an application is required.
- The city of Brampton, Malton provides snow removal financial assistance for seniors; qualifying applicants can receive up to $300 to have their sidewalks cleared.
It is definitely worth calling, e-mailing, or visiting your local city office to see if you are eligible for snow removal services. They can come at no cost, and you won’t have to worry about putting yourself at risk for a fall.
What to Do If Your Loved One Has Fallen
If you are a witness to a fall, resist the urge to try and get the person up immediately; the individual may be fragile and lifting him or her too quickly can cause further injuries.
If the individual cannot get up – call for help (911). Once help is on its way, document the fall to better assist the first responders and doctors. You can also help the person get in a comfortable position and keep them warm by using a blanket or item of clothing.
If the individual appears to have the ability to get up – follow the steps below:
- Bring a chair close to the individual and help them into the recovery position.
- Bracing the individual from behind, with a firm grip on their hips, help them into a kneeling position with both hands on the seat of the chair.
- With the individual’s strongest leg in front, help guide the person up.
- With a firm grip still on the individual’s hips, help the person stand.
- Help the individual sit on the chair.
If the individual that fell has any of the following symptoms, it is recommended to visit a doctor:
- Loss of consciousness just before or after falling
- Nausea and/or dizziness
- Injuries and lingering pain
- Vision problems
For more information on what to do if you or a loved one falls, check out this informational guide.
A simple slip or trip can be critical, and sometimes we don’t realize this until after an individual has already experienced a fall. With just a bit of preparation, education, and effort, you’ll be able to help reduce the risk of falling. Just remember this F-A-L-L mnemonic:
F – Find help (provided by caregivers, the government, organizations, and volunteers)
A – Always assess (risk factors of falling)
L – Learn how to prevent (continuously educate yourself about fall-prevention)
L – Live safe and secure (be cautious, healthy, and safe)