Worried about falls in an older parent or relative? If so, do you know if their doctor has considered the most useful prevention approaches?
Fall risk can be reduced, but it generally takes some thought and effort. That’s in part because most older adults have multiple factors making them vulnerable to falls.
In a previous post on this site, I explained that best fall prevention plans involve identifying a senior’s particular risks — especially risks related to health conditions — and trying to counter those.
So for instance, if an older person has diabetes and is having frequent moments of low blood sugar (also known as hypoglycemia), for fall prevention addressing the hypoglycemia is as important, if not more, as starting an exercise program.
In other words, I always recommend that aging adults and families learn to tailor their fall prevention plans. You want to focus on what are the most important modifiable risk factors for that individual person.
That said, over the years I’ve noticed that there are five approaches that I find myself using over and over again, in almost all my patients who have had repeated falls.
These five approaches are used often by geriatricians, but much less often by busy primary care doctors. Unless, that is, a proactive family asks about them.
My Five Most-Used Fall Prevention Approaches
They are:
- Medication review, followed by reducing medications that increase fall risk
- Checking blood pressure sitting and standing
- Gait, strength, and balance evaluations, often in collaboration with physical therapy
- Home safety assessment and modification, in collaboration with occupational therapy when possible
- Vitamin D
If you’d like to learn more, I go into greater detail in this article that I originally wrote for A Place for Mom: 5 Proven Approaches Geriatricians Use to Prevent Falls.
Remember, it’s always good to be proactive. If you’ve been worried about falls, and the doctors haven’t offered these approaches, I recommend you ask about these.
And if your older relative has had a fall, be sure to review 8 Things to Have the Doctor Check After an Aging Person Falls.
My grandma has been prone to falls as of late. We want to try to protect her as best we can. We didn’t know that there was so much we could do. We’ll be sure to follow the tips you gave to try and provide her with some fall protection.
I’ve really enjoyed reading your blog over the past year. I stumbled upon it when got more focused on the problems that seniors have with mobility and injuries, and I was immediately hooked by your focus on senior wellness. I really enjoyed your post about fall prevention. When dealing with senior’s like my grandparents and their friends, it was no surprise to see the same challenges facing them every day. One of the biggest problems I notice with my grandparents is their mobility starting to slow down.
Hello Dr Kernisan,
I am student and currently working on an a weareable sock with grips to prevent falls for elderly. Please give some idea about which exact parts of your sole needs grip or strength while walking and which areas on our sole slip?…………. Thankyou
As an internist and geriatrician, I’m not expert on just which part of the foot requires grip or strength. You could try asking someone specialized in physical therapy or podiatry. We do generally recommend non-slip footwear, to help reduce the risk of falls.
Can you enlighten me on your #5 on the list? How does this relate to falls?
I am trying to get a bigger picture on all the aspects of fall risks since my background is in Physical Therapy I would like more insight into the medication/medical aspects on fall risk.
Thanks
Research at one point suggested that vitamin D supplementation might help reduce fall risk in community dwelling adults, so the US Preventive Services Task Force and other experts recommended it for fall prevention, in their 2012 recommendations.
However, the latest reviews of the research are concluding that vitamin D is not actually very effective in reducing falls. The USPSTF is updating its recommendations and the draft recommends against vitamin D for falls.
I think it’s still useful for older adults to take a vitamin D supplement, mainly to prevent deficiency. It’s unclear just what the health effect of vitamin D deficiency is, but as it’s inexpensive and extremely low risk when taken as a supplement of 800-1000 IU, I still recommend it.
For more on medications and falls, see: Preventing Falls: 10 Types of Medications to Review if You’re Concerned About Falling