Preventing Falls: Mission Possible

Understanding why we fall and how to avoid it

handEach year, one in three Canadian seniors will fall at least once, reports Health Canada. Hip fractures top the list of injuries. About one-fifth of injury-related deaths among seniors are due to a fall. But it’s not all doom and gloom, says Jane Hall, an occupational therapist with Baycrest’s Falls Prevention Program.

“Falls are not inevitable; they are not caused by aging, and they are not accidents. Often, falls result from a combination of factors, many of which are preventable.”

Anything from your physical surroundings to vision and balance problems to a lack of social support can set you up for a fall.


Environmental risks include lack of hand rails, obstacles, unsafe stairs, lack of rest areas and poor lighting.


Biological reasons include health conditions such as Parkinson’s, stroke, a drop in blood pressure when you quickly move from lying to sitting, or sitting to standing, arthritis and osteoporosis, poor hearing and vision problems, which include reduced contrast sensitivity (being less able to make out edges).

Behavioural factors are risky behaviours that result from cognitive decline, inattention, slowed mental processing speed, medications that decrease alertness, and inappropriate use of aids like walkers. “For example, some people use their walker when they’re out, but park it like a car once they get home,” explains Hall.

Economic conditions A person may need a stair glider or wheelchair lift but cannot afford it. Good nutrition may be lacking, since healthy food can cost more. Lack of social support and living alone increase isolation and decrease opportunities to participate in programs in the community.

Role of Brain Changes

Age-related brain changes can increase fall risk, as Hall explains:

  • Perceived fall risk, or the fear of falling, is a major psychological factor that leads people to stop going out and doing things, which speeds up cognitive decline. Staying put also decreases muscle strength, leading to problems with coordination, balance and reaction time.
  • The righting reaction, the ability to catch yourself and regain balance when you lean forward too much, slows down.
  • The sense of touch decreases, so you can’t feel your foot placement as much.
  • Attention span decreases, making it harder – for example, to walk and talk at the same time.
  • The brain’s ability to process information declines, so you can’t react as quickly or make split-second decisions.
  • The sensory system in the ears that controls balance, movement and spatial awareness, suffers too, causing hearing deficits, balance problems and dizziness.

The good news, says Hall, is that you can slow down mental and physical decline. Her advice: get out of the house as much as possible, and keep moving by joining a seated exercise class.

Fall-Proof Your Home

  • Remove scatter rugs, which are a tripping hazard.
  • Put hand rails on stairwells and grab bars in bathrooms for extra support; use a rubber tub mat.
  • Clear out clutter so it’s easier to navigate around the home.
  • Increase lighting, especially making sure hallways and stairwells are well-lit; install nightlights.

Related links

The Falls Prevention Program at Baycrest.