Falls Fact Sheets

You can prevent falls:

Falls are the leading cause of injury among seniors and veterans in Canada. They account for more than half of all injuries among seniors. And while many people aren’t aware of the easy steps that can be taken to avoid falls, falls can be prevented.

In fact, falls are the most preventable risk to health among senior Canadians. Health, fitness, lifestyle choices, home repairs, the community, almost everything can play a role in falls prevention.

This series aims to create safer homes and community environments for older Canadians, and to inform seniors, veterans, their families and caregivers of the many things that can make a difference in the quality of life of the aging person.

By improving your health!

Your health is just as important as a safe environment in preventing falls and reducing the risk of injury. By improving your diet, increasing your strength and monitoring your balance, hearing, eyesight and medication, you can considerably increase your chances of avoiding falls.

Eat well

Missing meals can cause weakness and dizziness. Eating regular, balanced, healthy meals will help you keep up your strength. Canada's Food Guide to Healthy Eating* is a good source of information.

Keep fit

To prevent a decline in your mobility, strength, balance and flexibility, keep your muscles toned by accumulating at least 30 minutes of moderate physical activity most days. If possible, walk every day, even if it's only around the house and engage in activities or an exercise class that will improve your strength and balance. Contact your local seniors' centre, Legion, or local recreation department to determine what's available. Consult Canada's Physical Activity Guide to Healthy Active Living for Older Adults* for more suggestions and information.

Monitor your sight and hearing

People who cannot see or hear properly are at greater risk of falling. Be sure you wear appropriate glasses (wearing reading glasses while walking is dangerous!). Impaired hearing also puts you at risk of falling (if you don't hear traffic or children playing around you). Have your eyesight and hearing tested regularly. If you need glasses or a hearing aid, wear them!

Know your medications

Medications can cause dizziness and weakness, affecting your perception and balance, especially if not taken as prescribed or if not suitable for you. Be aware of the potential hazards and interactions of the medications you use. Ask your doctor for information on the possible side effects of all your medications and feel free to raise any questions you may have about their benefits or undesirable effects.

Practise moderation

The negative effects of too much alcohol on our sight, hearing, balance and judgement about personal safety are very clear. Whether used alone or combined with medication, alcohol use can result in dangerous falls, especially for older people. Keep to wise and moderate consumption.

By having a safe home and lifestyle!

Most falls occur at home — especially in the kitchen, on the stairs and in the bathroom. Here are some ideas to make the inside and the outside of your home a safer place for you.

Kitchen

• Eliminate throw rugs.
• Have everything within reach so that you don't need to climb; if you must climb, use a stable step stool with a safety rail.
• Wipe up any spills immediately to prevent slipping.

Stairs

• Have handrails on both sides of the stairs.
• Make sure stairs are properly lit.
• Don't put things on the stairs.

Bathroom

• Install grab bars and non-slip mats in the tub and shower.
• Use a non-skid bath mat.
• Install a night-light in the hallway and bathroom.
• Wipe up moisture or spills immediately.

Living room

• Leave generous space to move safely around furniture.
• Make sure electrical cords are out of the way.
• Ensure furniture and lamps are steady and stable.

Walkways and entryways

• Have a small bench in your entryway to help you put on and remove your boots.
• Make sure your steps and walkways are free of ice, snow, newspapers or wet leaves.
• Have a handrail installed along your front walkway if necessary.

Garden

• Put the hose away in a secure area when you're not watering.
• Make sure rakes and shovels are safely put away when not in use.
• Wear shoes that support and stabilize you.
• Have garden tools handy (in a pail or in your gardening apron pockets).
• Use a kneeling pad while weeding; rise slowly when you're done.
• Don't walk on wet grass; keep the yard, pathways and steps free of leaves and twigs.
• Make sure garden furniture and ornaments are steady and in good repair.

When going out

• Take all the time you need — plan ahead, don't rush.
• Wear footwear to prevent slipping and avoid laces that may come undone.
• Use your walking aid if needed.
• Walk slowly and carefully — be alert to sidewalk cracks, obstacles, slopes, slippery surfaces and other hazards.
• Don't load yourself down with packages; take advantage of home delivery or use a pushcart (which can also act as a walking aid).
• Be a defensive walker — watch for traffic, bicycles and rollerbladers.
• Plan your trip so that you don't have to go out during rush hour, darkness or bad weather.

Other precautions

• Don't try to do tasks that are too strenuous or potentially dangerous. Find a volunteer — a friend, a neighbour, a relative, building maintenance staff — to help you with the heavy work.
• Take care not to trip on your pet (or your grandchild's toys!) — always check the floor, the stairs, the hallway...
• Turn the lights on ahead of you while moving through the house.
• Take off your reading glasses when you're not reading.
• Use your cane or walking aid inside the house if necessary.
• Don't rush to the phone: if you have an answering service, your callers will leave a message; if not, they will call back.
• Finally, know that you have the right to be safe. If you notice any hazards or unsafe conditions, let the proper authorities know (municipality, apartment owner, seniors' centre, store staff). Cracks can be repaired; public ramps can be installed; traffic lights can have their timing changed... Reporting unsafe conditions benefits you and the entire community!

By reducing the risks!

As we get older, our bodies change and we can become more susceptible to falls. Certain risks can be eliminated and others considerably reduced by simple prevention measures.

General physical fitness

Given that our daily routines become less physically demanding as we age, we can experience reduced physical fitness, increasing the risk of falls. Maintaining or regaining physical fitness is the most effective falls prevention measure of all. All forms of exercise, formal and informal, can help maintain the strength and vitality that will protect us from injury. Consult Canada's Physical Activity Guide to Healthy Active Living for Older Adults*.

Ability to maintain balance

Balance is an important element of fitness. Tai Chi, yoga and dancing are all exercises that increase balance and steadiness — proof that keeping fit can be fun. Other factors can affect balance, including improper use of eyeglasses, misuse or disuse of assistive devices, and certain medications. Make sure you're aware of these dangers. Exercise for balance and use devices and medications appropriately.

Diet and eating habits

Regular healthy meals help keep up strength and vitality. Consult Canada's Food Guide* to ensure optimum nutrition. If you don't enjoy preparing meals by yourself, occasionally invite friends, eat out, or develop a routine that makes you look forward to your meals (candlelit table, special treat, etc.).

Precautions in and around the house

Reduce the risks of falls and injuries around the house by removing obstacles, improving access and installing aids (grab bars, night lights, etc.) around the house and garden. Consult The Safe Living Guide* to improve safety in your home.

Walking conditions

Poorly maintained sidewalks, unlit streets and icy conditions can be dangerous. Before going outside, consider whether it's completely safe. Make sure you report any unsafe conditions in the neighbourhood.

Use of medications

Be aware that medications can sometimes cause dizziness or other side effects. Read instructions and warnings carefully. Consult your doctor, pharmacist or health care worker about the possible side effects of the prescription or off-the counter medications you take. And remember that medication and alcohol can be a dangerous combination!

Note:

With a restricted budget, it can be hard to find the money for exercise classes or home improvements such as grab bars or assistive devices. Veterans should contact their nearest Veterans Affairs Canada District Office to find out about programs and services they may be eligible to receive that can improve their well-being and help them to stay in their home and community. Seniors can contact the municipality, the local health centre or their local Seniors' organization to obtain information on services available at reduced cost or free of charge.

By involving your community!

Most people aren't aware of some of the easy steps that can be taken to protect them against falls. You can help by encouraging your local community groups, social clubs, Legion and municipality to get involved in educational and program activities regarding falls prevention. You can even start your own group in the neighbourhood!

Working with friends or a local organization, you can increase the awareness of seniors, veterans and the community at large about the dangers and solutions with respect to falls. You know your own community best so you may have your own ideas on how to get the local groups involved. The following can help you get started:

• Provide available written materials on injury prevention (see Resources, Fact Sheet No.7) to your community resource centre, to Legion halls, lodges and other places where seniors congregate.
• Showcase these materials in a visible public space; also ask your municipality, library or local shopping centre to display them.
• Partner with other groups that wish to prevent falls in your community (e.g. municipal government, recreation committee, volunteer coordinator, local health centre).
• Consult members of your organization and seniors in the community to determine what needs to be done locally regarding falls prevention, and what approaches should be pursued.
• Petition your local government and businesses to remove potential hazards and to ensure the design of safer public spaces.
• Report any unsafe conditions to the proper authorities.
• Arrange to have workshop speakers such as a public health nurse or a town planner/engineer discuss their roles in decreasing risks for falls or lead a discussion yourself on how to prevent falls.
• Submit informative articles on falls prevention measures in publications that reach local seniors.
• Arrange or ask the municipality to arrange home visits by technical experts to assist seniors and veterans in identifying and eliminating risks.
• Become an advocate! Ask your municipality to design safer environments; ask that exercise programs be offered to help seniors maintain strength and balance; organize a walking program in your local shopping mall or elsewhere

Ask for the Resources Fact Sheet No. 7 to obtain material to start an injury prevention program in your community.

By following these tips!

To improve your chances of keeping safe and not falling, use the following list and post in a convenient spot for frequent checking.

• Be physically active every day — exercise for strength and balance.
• Eat regular, well-balanced meals.
• Keep your home and garden free of hazards.
• Install aids around your home such as grab bars, railings and non-slip surfaces.
• Keep your pathways and steps free of ice, snow, newspapers and leaves.
• Plan your outings to allow plenty of time — never rush.
• Use walking/balancing/hearing/seeing aids.
• Always remove your reading glasses when you're walking.
• Ask for assistance with heavy work.
• Keep an eye out for dangers and hazards; inform the proper officials of any unsafe condition.
• Manage and monitor your medications properly (check with your doctor or pharmacist).

It's a fact!

Falls are the leading cause of fatal injuries among senior Canadians and account for more than half of all injuries among seniors.

Falls are the most preventable risk to health among senior Canadians.

• Approximately 30% of community-dwelling Canadian seniors experience at least one fall each year.
  (O'Loughlin, J.L. et al. 1993. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. American Journal of Epidemiology, 137(3), 342-354.)
• Seniors' falls result in a loss of independence. In 1998/99, there were 68,897 injury admissions in the senior population accounting for 35% of all injury admissions. Seniors are more likely to be admitted to hospital from an injury as a result of a fall than any other age group. In fact, over half (56%) of all admissions due to falls occurred in persons 65 years of age or over.
  (Canadian Institute for Health Information. National Trauma Registry report, hospital injury admissions, 1998/99. Ottawa: the Institute, 2001.)
• In 1997, falls accounted for 20% of all injury deaths among adults age 65 or over.
  (Computations by Injury Section, Health Surveillance & Epidemiology Division, CHHD, PPHB, Health Canada. Analysis of Statistics Canada 1997 mortality data.)
• Nearly half of all injuries among seniors take place at home. Constructional features of a house or building such as floors, stairs and steps are identified more often in an injury than any household product.
  (CHIRPP Injury Reports. Injuries associated with falls in seniors. Summary Data for 1997. Computations by Injury Section, Health Surveillance & Epidemiology Division, CHHD, PPHB, Health Canada.) (Identification of consumer products causing injury and death to seniors. Final Report Submitted to the Product Safety Bureau, Health Canada by Valerie Howe, Prospect Consulting, March 1996.)
• Injury death rates rise steeply with age. In 1997, the injury death rates among those 65-74 were 51.6/100,000 and 455.6/100,000 among those over age 85.
  (Statistics and trends. Prepared for the Canadian Conference on Injury Prevention and Control by the Alberta Centre for Injury Control and Research, 2000.)
• Seniors who fall face a greater risk of permanent institutionalization than those who do not. According to one study, the odds of entering into care following an injurious fall was nearly triple the odds for people who had not fallen.
  (Wilkins, K. Health care consequences of falls for seniors. Health Reports. 10(4) 1999, Statistics Canada)
• In the one-year period from June 1996-97, thirty-seven per cent of veterans experienced one or more than one fall. Seventy-five per cent of veterans age 75 or older experienced an injury related to a fall. As for the oldest group, they tend to indicate more severe injuries such as loss of consciousness, sprains or fractures.
  (Computations by Micheline Charest, Planning and Negotiations Coordinator, Veterans Affairs Canada. From Table HS7A, Veterans care needs survey, Statistics Canada, 1997. Cat. no 89-554-XPE.)
• It is estimated that about 40% of falls among seniors which result in a hospital stay are attributable to hip fractures. Hip fractures are the most common type of fall injury among seniors and it is expected that the number of annual hip fractures among seniors will increase from 23,375 in 1993 to 88,214 by the year 2041.
  (The Hygeia Group. The economic burden of unintentional injury in Canada. Smartrisk, 1998.)
• It has been estimated that the annual direct health care costs of falls is $2.4 billion. Caring for seniors injured from a fall represents 41% of these costs or $1 billion.
  (The Hygeia Group. The economic burden of unintentional injury in Canada. Smartrisk, 1998.)

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