Frailty Matters / Living with Frailty / Avoiding Falls

Avoiding Falls

Why Should You Care About Falls?

Did You Know That:

  • Falls are the leading cause of injury-related deaths and hospitalizations among all Canadians?
  • In Canada, a senior experiences a fall every 12 seconds?

Did You Know That, for Older Adults:

  • 4 out of 5 injury-related hospitalizations were because of a fall?
  • Falls are the number one cause of hospitalization due to injury—and made up 81% of all injuries resulting in hospitalization?
  • Falls made up over half of injury-related trips to the emergency room (ER), making them the number one reason for injury among older adults who visited the ER?
  • Most falls resulting in an ER visit happened at home or in a long-term care setting?
  • Estimations suggest that 1 in 3 persons 65 or better is likely to fall at least once each year?
  • The financial cost of falls is estimated at $2 billion per year?

What is the Impact of Falls for Older Adults?

Fall-related injuries are associated with:

  • Reduced independence
  • Significant disability
  • Reduced mobility
  • Higher risk of being admitted to an assisted living facility
  • Higher risk of premature death

Even without injury, falls can lead to:

  • Depression
  • Increased fear of falling
  • Loss of confidence
    • These can make daily and social activities challenging, which in turn may lead to declines in health and function and increased risk of future falls

“Falls continue to be the scourge of growing older. We think of broken bones as an inconvenient injury requiring a few weeks of casts and crutches. But for seniors, a broken hip can often mean the end of walking independently.” — Geoff Fernie, Senior Scientist and falls prevention expert at the University Health Network and the Toronto Rehabilitation Institute

How Do You Prevent Falls and Remain Independent?

Good news! There are many ways to prevent falls—the following are just a few highlights. See our “Resources” section for more information.

Modifications to Your Living Space Can Help Prevent Falls

General Home

  • Reduce clutter
  • Get rid of loose wires and cords, as well as any other obstacles
  • Consider using a cordless phone to avoid rushing to answer
  • Have good lighting throughout the house and install night lights
  • Keep a flashlight on hand
  • Get rid of mats (a tripping hazard) or make sure they are non-slip
  • Move slowly out of your bed or chair—getting up suddenly can make you dizzy
  • Ask for help with tasks that you feel you can’t do safely

Bedroom

  • Have a lamp or light switch that you can reach without getting out of bed

Bathroom

  • Put non-slip surfaces in the tub or shower
  • Install grab bars by the toilet and bath to help you sit and stand
  • Use a raised toilet seat
  • Use a bath seat in the shower
  • Wipe up moisture or spills immediately
  • Make sure there is a clear path between the bedroom and bathroom

Kitchen

  • Store kitchen supplies and pots and pans in easy-to-reach locations
  • Store heavy items in lower cupboards
  • Use a stable step stool with a safety rail for reaching high places
  • Wipe up spills immediately to prevent slipping
  • If you use floor wax, use the non-skid kind

Stairs

  • Make sure your stairs are well lit
  • Have handrails on both sides of the stairway
  • Remove your reading glasses when you go up or down the stairs
  • Never rush up or down the stairs—it’s a major cause of falls
  • Avoid carrying items when using the stairs
  • Install visual contrast strips on stairs
  • Consider installing assistive devices, such as a stair lift

Exterior

  • Keep front steps and walkway in good repair
  • Make sure steps and walkways are cleared of snow, ice, leaves
  • Mark any edges or stairs that stick out or are uneven with the rest of the surface
  • Paint steps with a mixture of paint and sand for better traction
  • Keep front entrance well lit
  • Put gardening tools, such as hoses and rakes, away when not using them

Wear Safe Footwear Indoors and Outdoors

  • Avoid walking around your living space in bare or socked feet—instead, wear running shoes
  • Make sure footwear has good treads, especially winter footwear
  • Check your treads annually to ensure they are not worn out—get new footwear if they are

Assistive Devices: Overcoming Pride

Assistive devices (such as medical equipment, mobility aids, hearing devices, etc.) ease the strains of daily activities at home, at work or at play. They allow you to maintain your quality of life when facing health challenges. That means you don’t have to compromise your lifestyle.

“Assistive devices can have a positive impact on your mental health. By living the active, social life you desire, you remain independent, self-confident and positive. Use assistive devices with confidence. You’ll become a model of initiative and good sense for others who are reluctant to enjoy their benefits!” (Division of Aging and Seniors: Public Health Agency of Canada, 2006)

For example:

  • Install handrails on both sides of your stairs and on outdoor steps
  • Use accessibility aids (e.g., handrails, elevators, ramps) when in public spaces
  • Speak to a healthcare professional to see what devices may be best for you
    • Ask to borrow a model to test it before purchasing expensive equipment
    • Some community programs offer assistance for purchasing these devices

Benefits of using assistive devices:

  • Maintain independence
  • Prevent secondary health conditions
  • Lower health and welfare costs

Stay Active

  • Physical activity is key in reducing the risk of falls—aim for 2.5 hours of moderate-to-vigorous exercise each week
  • Exercise routines should be personalized to the person’s abilities
  • Focus on balance exercises (e.g., heel-toe stands, one-leg stands, heel-toe walking) and leg-strengthening exercises (e.g., calf raises, toe raises)
  • Resistance training has been shown to reduce the risk of falls
  • A call to an older adult to encourage them to exercise can help with motivation and routine adherence

Eat a Balanced Diet

  • Eating a balanced diet may help reduce the risk of falls
  • Eat meals high in protein and fibre
  • As with osteoporosis, a diet high in calcium is recommended
  • Taking a vitamin D supplement may reduce the risk of falls
  • Stay hydrated

Get Annual Eye Exams

  • Vision assessments and updated eyewear prescriptions are an important factor in preventing falls

Seek Medical Advice

  • Have a falls risk assessment done by your family doctor and make a personalized plan for prevention and what to do if you do fall
  • Ensure your medications are reviewed by a pharmacist to see if any increase the risk of falls—only make medication changes with your doctor’s approval

What is the Connection to Frailty?

Living with frailty often results in reduced physical function and an increased risk of falls. Physical activity is a key element in both preventing and intervening in frailty, and in reducing a person’s risk of falls: “The promotion of physical activity and maintaining a healthy diet are effective means to prevent, manage, and, in some cases, reverse the level of frailty an individual may be living with” (NIA, 2018).

 

Citations

Canadian Assistive Devices Association. (2018). Assistive devices: proactive solutions for Ontario’s seniors and persons with disabilities. Retrieved from http://www.cadaonline.ca/pdf/CADA%20Brief%202018%20-%20Assistive%20Devices%20-%20Proactive%20Solutions%20for%20Ontarios%20Seniors%20and%20Persons%20with%20Disabilities%20April2018.pdf

Canadian Institute for Health Information. (11 July, 2019). Falls and vehicle collisions top causes of injury hospitalizations for seniors. [Website]. Retrieved from https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors

Koninklijke Philips N.V. (2019). Fall prevention guide: How to avoid serious and fatal injuries. [Website]. Retrieved from https://www.lifeline.ca/en/resources/fall-prevention-guide/

National Institute on Ageing. (2018). We can’t address what we don’t measure consistently: Building consensus on frailty in Canada. Toronto, ON: National Institute on Ageing. Retrieved from https://www.cfn-nce.ca/wp-content/uploads/2018/10/cfn-nia-frailty-paper-2018-09-24-1.pdf

Ontario Injury Prevention Resource Centre. (2013). Ontario regional injury data report: evidence informed practice recommendations. Retrieved from http://www.oninjuryresources.ca/publications/item/evidence-informed-practice-recommendations

Public Health Agency of Canada. (2014). Seniors’ falls in Canada: Second report. Ottawa, ON: PHAC. Retrieved from https://www.canada.ca/en/public-health/services/health-promotion/aging-seniors/publications/publications-general-public/seniors-falls-canada-second-report.html

Public Health Agency of Canada, Division of Aging and Seniors. (2006). Assistive devices info-sheet for seniors. Retrieved from http://publications.gc.ca/collections/Collection/HP24-6-2-2006E.pdf

Scott, V., Wagar, L., & Elliott, S. (2010). Falls & related injuries among older Canadians: Fall‐related hospitalizations & intervention initiatives. Prepared on behalf of the Public Health Agency of Canada, Division of Aging and Seniors. Victoria, BC: Victoria Scott Consulting. Retrieved from https://baycrest.echoontario.ca/wp-content/uploads/2018/06/Falls-related-injuries-among-older-Canadians-Fall-related-hospitalizations-intervention-initiatives.pdf

Tricco, A.C., Thomas, S.M., Veroniki, A.A., Hamid, J.S., Cogo, E., Strifler, L., Khan, P.A., Robson, R., Sibley, K.M., MacDonald, H., Riva, J.J., Thavorn, K., Wilson, C., Holroyd-Leduc, J., Kerr, G.D., Feldman, F., Majumdar, S.R., Jaglal, S.B., Hui, W., & Straus, S.E. (2017). Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. Journal of the American Medical Association, 318(17), 1687-1699. doi: 10.1001/jama.2017.15006