Fighting Falls: Preventing Dangers in the Home

Falling is the leading cause of injuries and injury-related deaths among Americans aged 65 or older. In 2021, 38,000 Americans in this age group died as the result of a fall, according to the U.S. Centers for Disease Control (CDC). The CDC also found that unintentional falls led to more than 3 million hospital visits that year by Americans 65 or older. Despite these daunting numbers, a great deal can be done to prevent falls or lessen their consequences.

"Falling is a huge risk that leads to many hospitalizations as well as deaths," says Christopher Towler, a clinical associate professor of physical therapy at Clarkson University in Potsdam, New York. Towler completed his doctorate in physical therapy at Clarkson in 2009 before going into clinical practice. He developed significant expertise in home health care and hospice care before returning to Clarkson as a full-time professor and is an expert in cardiopulmonary physical therapy and geriatrics.

"The older we get, the more damage is done when we fall," Towler says, noting that many measures can minimize the risk of potential falls. The most likely place for older Americans to suffer a serious fall is, unfortunately, their own home. Much of prevention, Towler notes, requires a mix of common sense and diligence. "It can be as simple as picking up throw rugs and any obstructions around the house," Towler says.

Being mindful of animals, too, can contribute to a safer home environment. Tripping over one's pets is a surprisingly common cause of home injuries.

"Lighting is also important," he says. "Make sure you turn your lights on and you wear good shoes." Check for loose tiles inside and outside the home as well. That is another frequent cause for falls.

"Many people end up with houses that are chopped up into many different levels. As you change elevation, that can become a hazard. Think about what you can do to minimize these changes in your home," he advises.

For those who have the misfortune to fall, several strategies can help people brace themselves in such circumstances. According to Harvard Medical School, people should bend their elbows and knees when they start to fall. Rigid arms and legs are much more likely to sustain serious injuries in the case of a fall. Landing on the meat of the butt or thighs is also preferable. Slapping the ground with open palms and outstretched arms can also displace the energy from a fall.

"Falls happen so many different ways and in different directions. If you can hit something softer and avoid hitting your head, that's a great strategy, but it's not always practical," Towler says.

And for the many Americans whose parents move in with them as they age, Towler offers several recommendations to prevent falls in the home.

"Do an inventory of what your place looks like with an eye toward potential hazards," Towler says. Be mindful that walkers and wheelchairs may become a part of your parents' routine.

If possible, make their primary bathroom one that does not require them to climb stairs. Walk-in and sit-down showers further mitigate the potential for a fall. Bathrooms have the reputation as one of the most dangerous rooms in the house, but Towler notes that people often exercise more caution there as a result.

"The danger is mitigated a little bit by people realizing that things can be wet and slippery. People often take extra care there. Falls certainly happen there but the rest of the house shouldn't be neglected either," he says.

A physical therapist can help a homeowner make an assessment of potential hazards too. "If someone is at the point where they need an assistive device like a walker or a cane, physical therapists help make sure that the right device is proscribed and fit appropriately and used appropriately because there is a technique to using these things," Towler says. Unfortunately, the device itself can become a hazard if it is not the proper size for its user.

If someone suffers a fall and requires physical therapy or undergoes physical therapy to prevent future falls, many of the goals are similar. Improving balance, reaction time and strength are key to any such therapy. But those improvements may take some time.

"It is a process," Towler says. "Usually, to build strength, you are making a four-to-six week commitment. Knowing, too, that the time you spend with your physical therapist is only part of the time. The PT exercises need to be a part of your home routine."

"You have to challenge your balance to make it better but by doing this you put yourself in a position where your risk of a fall increases, so make sure you have someone there to do that appropriately and to help catch you in case you fall," he continues.

Towler says staying mobile and everyday movement is important.

"On your own, the biggest thing is staying active and exposing yourself to the everyday things of life where you can experience those challenges and hopefully overcome them," Towler says.

For Towler, the most rewarding aspect of his job is seeing people make progress through such a process. In tangible ways, he sees improvements to his clients' quality of life such as those who get back to their favorite activities that were previously limited by their fears of falling.

By adopting a "prevention mindset," more older adults may be able to overcome the genuine threat posed by falls.