The Fall That Changes Everything — And How to Prevent it
No one plans for a fall. There’s no warning sign or alarm that goes off before it happens. One moment, your loved one is walking to the bathroom at two in the morning. Next, they’re on the floor, desperate for help.
Throughout my career, I’ve seen this exact story play out more times than I’d like to count. What strikes me every time is how preventable most falls are, not with expensive medical equipment or a complete home renovation, but with attention to small things that are so often overlooked.
Why Falls Matter More Than Most Families Realize
Falls are the leading cause of injury-related hospitalization in adults over the age of 65. The real impact goes far beyond the hospitalization itself.
Example: A hip fracture leads to surgery, which leads to weeks of rehabilitation, which ultimately leads to a level of dependence that did not exist before the fall.
Many older adults never fully return to their prior level of independence after a serious fall. The trajectory shifts. Sometimes permanently.
And then there’s fear. After a fall, many older adults become afraid of falling again. They move less. They avoid activities they used to enjoy. They become more isolated. That fear alone can accelerate decline faster than the injury itself.
For families, a fall is often the event that forces a conversation no one was ready to have. Conversations about safety, independence, and what might come next. It doesn’t have to be this way. Let’s talk about a solution.
What We Look for When We Walk Into a Home
One of the first things we assess when visiting a client isn’t their medication list or their blood pressure. It’s their environment. The home itself tells a story about risk, and most families are surprised by how many hazards are hiding in plain sight.
The floors. Throw rugs are one of the most common fall hazards we encounter. They slide, bunch up, catch the edge of a shoe or a walker, etc. Hardwood floors with loose rugs, bathroom mats without non-slip backing, and unsecured runners in hallways are fall hazards. Luckily, the fix is super simple: remove them or secure them with non-slip pads or double-sided tape.
The lighting. Many falls happen at night, on the way to the bathroom or the kitchen. If the path from the bedroom to the bathroom is dark, the risk of a fall increases significantly. Nightlights plugged into outlets along that route, motion-activated lights in hallways, and a lamp within easy reach of the bed can make an enormous difference. Adequate lighting is one of the cheapest and most effective fall prevention measures there is.
The bathroom. Also known as the highest-risk room in the house. Approximately 80% of in-home falls occur in the bathroom. Wet surfaces, awkward transitions in and out of the tub or shower, and no grab bars to hold onto all increase the risk of a fall. We look for grab bars installed near the toilet and inside the shower, non-slip floor surfaces, and the method of entrance into the shower or tub. If your loved one is using a towel bar for balance or support, that is a red flag. Towel bars are not designed to support body weight and can pull right out of the wall. The installation of grab bars and non-slip floor mats is a great start to minimizing fall risk in the bathroom.
The stairs. Stairs are manageable for most older adults when the environment supports safe navigation. Are handrails present on both sides? Are they sturdy? Is anything stored on the stairs (shoes, books, laundry) that creates an obstacle? Are the edges of the steps clearly visible, or do they blend together in low light?
Footwear. Yes, footwear in the house. This one often surprises people. What your loved one wears on their feet inside the home matters. Socks on hardwood floors are slippery and are just as much of a risk as a wet bathroom floor. Worn-out slippers that have no traction and shoes that are too loose can catch on carpet and rugs. Proper-fitting, non-slip footwear is a simple change that meaningfully reduces risk.
The Medication Factor
Not all fall risks are environmental. Some are pharmaceutical.
Many common medications prescribed to older adults can cause dizziness, lightheadedness, or drops in blood pressure, especially when standing up. Blood pressure medications, sedatives, sleep aids, antidepressants, and even antihistamines can all increase fall risk. When someone is on multiple medications, these side effects can compound.
We review our clients’ full medication list with fall risk in mind and recommend that families not utilizing our services do the same with a physician and/or pharmacist. It’s a conversation that doesn’t happen as often as it should, and sometimes a simple adjustment, such as changing the timing of a dose or switching to an alternative medication, can significantly reduce risk.
If your parent or loved one has started a new medication recently and seems unsteady or mentions feeling dizzy, don’t brush it off. Bring it up with their provider.
What Families Can Do Right Now
You don’t need a professional assessment to get started, though one can certainly help. Here’s what I’d encourage any family to do in the next few days:
Walk through your parent’s home with fresh eyes. Don’t walk through as their child who’s been there hundreds of times. Walk through as if you’re seeing it for the first time, looking specifically for anything that could cause a trip, slip, or loss of balance.
Check the path from the bedroom to the bathroom at night. Turn off the lights and walk it yourself. If you can’t see clearly, neither can they.
Look at the bathroom. Are there grab bars? Non-slip surfaces? A way to get in and out of the shower safely?
Look down at the floors. Loose rugs, clutter, cords running across walkways. Remove or secure anything that could catch a foot.
Ask about their shoes. What are they wearing around the house? If it’s socks or worn-out slippers, it might be time for a change.
Ask about dizziness. Have they been lightheaded recently? Unsteady? Have they had any near-misses they haven’t mentioned? Most older adults will not volunteer this information because of the worry it might bring to their family or the fear of losing independence in their home.
Prevention Is Quiet Work
Fall prevention is one of the most valuable things a family can invest in for an aging parent. It preserves independence, it avoids crisis, and gives everyone involved something that’s hard to put a price on: peace of mind.
Augustus Osgood BSN, RN
