Falls Prevention

Dedicated to preventing adults ages 65 and older from falling

Summary Overview

Falls are often seen as an inevitable part of aging, but what about aging increases the risk of a fall? There are numerous physiological, psychological, and environmental factors that increase the likelihood of having a fall. Understanding how these factors play a role in a fall occurring gives you the power to prevent it from happening.


Knowing the many reasons a fall may occur gives you the ability to reduce your personal risk factor and help you stay on your feet. The following risk factors are organized by physiological, psychological, and environmental factors.

Physiological Risk Factors:

Muscle Strength - As people age the ability to retain muscle strength is diminished. Not only does your muscles maximum strength decrease but your ability to build new muscle and maintain current muscle is also affected. Muscle strength, especially in the legs, impacts your ability to maintain your balance when moving around.

Stride or Gait – The way you walk plays an important role in determining your risk of having a fall. It is common for stride length to shorten which shrinks the base of support you need to keep your balance. This, in combination with less bend in the knees and hips and a tendency to bend over or hunch while walking, shifts your center of balance increasing your fall risk.

Postural Hypotension – While most of us are worried about our blood pressure being too high, postural hypotension, a sudden drop in blood pressure, occurs when rising from a standing or sitting position. This drop in blood pressure can cause dizziness or even a temporary loss of consciousness.

Reaction Time – How quickly you respond to a situation decreases over time. The pathways from your brain that tell the rest of body what to do just can’t move the message as fast as it used to. This makes recovering your balance after a stumble or avoiding an obstacle more difficult.

Vision and Hearing – Being able to see and place yourself in your environment is important to maintaining your balance. Vision can dramatically worsen in the span of a few months without the person realizing before it is too late. Hearing loss reduces the brain’s ability to keep track of potential obstacles and increases reaction time.

Medication – There are four common prescription errors that can lead to an increase in fall risk.

  • Taking medication at the wrong time of day or not spreading out medication throughout the day.
  • Taking more than one of the same medication that have different names.
  • Taking expired medication.
  • Taking medications that cancel out or counter act other medications

Psychological Risk Factors:

Fear – Once someone has had a fall or near fall experience it is common for them to fear being in a similar situation. This can lead to someone developing anxiety or depression which increase the risk of having another fall.

Avoidance – People who want to avoid having a fall often try to avoid situations where a fall can happen. This can lead to avoidance of physical activity which is necessary to maintain and reduce fall risk.

Embarrassment and Burden – Admitting that you have concerns about falling can be embarrassing. This cause people to hid this from their families and doctors. By talking about their concerns, it is common to believe that they are creating a burden on those who they are seeking help from.

Environmental Risk Factors:

Home Safety – There are numerous potential trip hazards laying around the house that might go unnoticed for years. Items such as rugs, cords, and even pets increase the likelihood of a fall every day.

Inclement Weather – Especially here in Spokane, weather can play an important role in falls prevention. Ice, mud, wind, or extreme heat can all increase your risk of having a fall.

Spokane or Washington Specific Data


Prevention Tips:
  • Be more active. Increasing your physical activity is the best way to stay fall free. For the best result, join a fitness class that emphasizes leg strength and balance. You will probably make some friends while you are at it. For a list of classes in your area check out Steady as We Go.
  • Get a medicine reconciliation. Download and fill out this Medication Tracking Card and take it to your local pharmacist. They will make sure that you are taking all the right medication and help you create a schedule if needed.
  • Stay up to date with your doctor visits. Make sure to get checked up annually by your primary care physician, optometrist, ear, nose and throat doctor, and podiatrist. Each doctor can provide you with their own advice and make sure you are at a low risk of falling.
  • Eliminate hazards at home. Here is a checklist (need to link to pg 28 please) of how to perform a home safety check. It is best if this can be performed with family or a friend to help you make some difficult decisions. If you are not able to perform your own safety check, the local fire department will often come out and help you.
  • Talk about your concerns. No one will know or be able to help address your fall concerns unless you let them know. Talk to your family, friends, and all healthcare professionals about falls prevention. Helping you be fall free now is much better than having to help you after you have had a fall.

  • In 2010, falls were the leading cause of injury-related hospitalizations in Washington State, with more than 20,000.
  • Falls were the third leading cause of injury-related deaths, with more than 823 deaths.
  • In Washington State from 1999-2010, the fall hospitalization rate among older adults was stable. However, because of the population growth among older adults, the number of hospitalizations increased by 23 percent from 1999 to 2010.
  • In 2012, there are 888,861 residents age 65 or older. That number is projected to reach 1.2 million by 2020.

How to Prevent Falls

Medication Tracking Card