Prevent Falls

Anyone can fall. However, as we get older, our bodies change in ways that can increase our risk of falling. Falls are the the number one reason for injury-related deaths, hospitalizations and emergency department visits for older adults in Canada. They can have a lasting effect on quality of life, increase caregiver demands, and can lead to long-term care. To learn more about falls and what you can do to reduce your risk, please check out the sections below.

On this page

What can cause a fall

If you or someone you know has fallen, you are not alone. People fall for many reasons. Knowing your personal risks can help you take action to reduce your chance of falling.

Some of these causes of a fall include:

 History of a fall
About 30% of adults over the age of 65 will fall this year. However, people over 85 years old are at the highest risk of falling. Even a minor fall or injury may result in serious consequences. Almost everyone over the age of 85 will fall this year (they might not tell you about it). 

Learn more about how to reduce your fall risk—there can be many factors involved. These include: 

  • home safety risks, 
  • medical risks,  
  • strength risks,  
  • balance risks, and more.  

Using the Home Safety Checklist or having an Occupational Therapist assess your home can reduce fall risks. 
Problems with strength and balance
Advised to use a cane or walker to get around safely

If you have been advised to use a cane or walker or have mobility challenges, you are more likely to fall. Use the walking aid that has been recommended to you. Do you think a mobility device could help you? If so, talk to your family doctor, physiotherapist, or occupational therapist. They can help you find the right device for your needs.  

Unsteady when walking and use furniture or walls for support

Unsteadiness or needing support while you are walking are signs of poor balance. Exercise daily to build up your strength and improve your balance, as this is shown to reduce the risk of falls. Talk to a physiotherapist. They can check your strength and balance. Then, they'll suggest exercises just for you. 

Pushing up with hands to stand up from a chair, toilet, or couch

This is a sign of weak leg muscles, a major reason for falling. Muscle weakness and reduced physical fitness increases the risk of a fall by four to five times. Exercise daily to build up your strength and improve your balance, as this is shown to reduce the risk for falls. Review the heights of those surfaces that are difficult to rise from and raise them if necessary. Consult a physiotherapist. They can check your strength and balance. Then, they will suggest exercises or mobility devices that suit your needs. 
 Trip and slip hazards in your home and community

Half the number of falls happen at home. Falls on stairs and in bathrooms can cause serious injuries.

Make your plan to reduce the risk of falling with My Falls Action Plan. Also complete the home safety checklist in You Can Prevent Falls. These can help you identify and remove hazards in your home and stay safe in your community. 
 Medication side effects

Some medications have side effects that can increase your risk of falling. Talk to your pharmacist or primary care provider. They can help you learn about what medications might raise your fall risk. They can also suggest safer options.  
 Medical conditions

Chronic condition that limits my mobility, balance, or strength. (e.g., Parkinsons, diabetes, arthritis, kidney diseases, or the effects of a stroke)

Some long-term health conditions can make it harder to move, walk and keep your balance. This can lead to an increased risk of falling for older adults. Talk to your healthcare provider. Ask for tips to help you get stronger and improve your mobility and balance. You can also see a physiotherapist. They will check your strength and balance. Then, they can suggest exercises or mobility devices for you. If you're not getting enough nutrients, you can talk with a nutritionist or dietitian.   

Getting light-headed when standing up, or having episodes of vertigo

If you have postural hypotension or vertigo, you face a greater risk of falling. Postural hypotension is when your blood pressure drops when you stand up.

When you first stand up, count to 5 before taking any steps. Sit down immediately if you feel dizzy. Talk with your healthcare provider about any changes in your blood pressure.  

Shortness of breath when standing or walking

Are you losing endurance or muscle strength? If so, this can make it hard to stop a slip, trip, or stumble from turning into a fall. Talk with your health care provider about managing your shortness of breath. You may want to try an exercise program to increase your endurance.   

Acute illnesses (like infections) that cause weakness, pain, fever, nausea, or dizziness

Medications for acute illnesses can raise the risk of falling. For example, urinary tract infections are a factor in about 8% of falls. Talk to your healthcare provider about how to lower your risk of repeat infections. They can often give you tips to decrease these challenges. 

Low bone mass, osteoporosis or osteopenia

Low bone mass, osteoporosis, or osteopenia does not increase the risk of falling. They do make fractures from a fall more likely. Even a minor fall or injury can result in serious consequences. Talk with your healthcare provider about how to prevent bone loss. Review nutrition and supplements that may improve your bone density.   

Difficulty remembering or concentrating on things 

If you have cognitive impairments or dementia, you are more likely to fall. This is because you often struggle to notice and adjust to changes around you. These difficulties can make it hard for you to keep your balance.

Delirium is a state of mental confusion or disorientation. It can increase the risk of falls. Talk with your healthcare provider about your symptoms. Talk to an occupational therapist. They can help you find ways to stay safe at home.  

Consistently needing to rush to the toilet 

Rushing to the bathroom, especially at night, raises your risk of falling. If you take laxatives, you're twice as likely to fall. Consider a bedside commode or urinal for nighttime. Talk to your main healthcare provider or an incontinence expert. They can help you find ways to avoid rushing to the toilet.  
 Vision problems
Vision loss can make it hard for you to walk safely and spot dangers around you. Low vision can also affect your ability to maintain balance.
  • talk to your eye care specialist (optometrist, ophthalmologist)
  • wear prescribed corrective glasses
  • get your vision and hearing checked every year
 Footwear and foot problems

Numbness or pain in your feet can contribute to balance and gait difficulties. This can lead to falls. Talk to your healthcare provider or a foot care specialist. This includes podiatrists and chiropodists. They can help with your foot issue. Wearing supportive shoes at home is recommended.  
 Fear of falling
If you are worried about falling, you are more likely to fall. Do you feel nervous or scared of falling? If so, this can lead many adults to limit social activities and exercise. This inactivity can lead to muscle weakness, but also greater isolation. Knowing how to prevent a fall can reduce fear and promote active living. Healthy conversations can help make plans for getting support. This can lead to less anxiety.  
 Lack of exercise
Physical activity is key to preventing falls. Walking is good for your heart and lungs, but it may not prevent you from falling. Research shows that strength and balance exercises are one of the most effective ways to prevent falls.

Keep fit and improve your balance by: 

  • Doing at least 150 minutes of moderate to vigorous physical activity each week
  • Adding strength and balance activities at least two days per week
  • Doing several hours of light activity, including standing 

 Talk with your healthcare provider before you start an exercise program.
 Poor nutrition
Eating well helps keep your bones and teeth strong. Nutrient needs change as we age. Older adults need fewer calories but more of some vitamins and minerals such as calcium and vitamin D. Canada's food guide recommends eating a variety of foods every day. This will help keep food enjoyable while still providing the nutrients you need. 

A Guide to Healthy Eating for Older Adults has excellent tips and ideas. It can help you make healthy eating easy and enjoyable.

 

Back to top

What you can do to prevent a fall

The good news is that most falls are preventable. Taking action to prevent falls is one of the most important things you can do to stay independent as you get older. 

  Transcript of video: Preventing falls is easier than standing on your head

Story opens on older gentleman "Bob" doing some light calisthenics at home

NARRATOR (Authentic, Female)       

"Bob keeps himself fit. For flexibility...

...balance...

...and strength...to prevent a fall.  

 As Bob is working through his seniors' calisthenis, he begins to bend lower...lower...(surprisingly) lower. 

"One in four seniors will fall this year.

It's the leading cause of serious injury for older adults."

Bob's hands touch the ground. And then, he does something that surprises the viewer. Bob elevates into a full handstand and headstand. Music hits crescendo. 

"Preventing falls is easier than...standing on your head.

Keep it simple"

 As Bob returns to normal exercises

"Include strength and balance activities in your day"

"A message from Ottawa Public Health."

LOGO

Back to top

What to do if you fall

When you are alone  

  • Stay calm and don’t rush to get up. 

  • Make sure you are not injured before trying to move  

  • If you are injured or need help:

    • Try to get help by making a loud noise, calling out for help or crawling to the telephone and dialing 911. 

    • Use your personal emergency response system if you have one 

If you are not injured 

  • Roll onto your side. 

  • Rest while your body and blood pressure adjust. 

  • Slowly get onto your hands and knees, and crawl to a sturdy chair. 

  • Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor. 

  • From this kneeling position, slowly rise and turn your body to sit in the chair. 

  • Rest for a while before standing up 

After a fall 

  • Talk with your health care provider about the fall, even if you did not hurt yourself. It is important to determine the cause and to help prevent another one. 

  • Don't let the fear of falling prevent you from being active. Inactivity is one of the main reasons people fall. 

Video:  Report all falls:

Back to top

Transcript of video:  Report all falls

Opening shot shows a doctor's exam room. Older patient "Mary" is sitting on the exam table and a doctor is standing facing her.

DOCTOR:

"...So, have you had a fall since your last visit?" 

Mary shakes her head "No"

DOCTOR:

"...including slips and trips?"

 Mary is pensive, then remembers a series of slips and trips, seen in abstract flashback sequence.

Short sequence of 2 slips/trips (1. trip on stairs clutter, 2. bathtub slip)

Dramatic scene/music abruptly ends. 

 DOCTOR:

"Mary?"

MARY'S VOICE:

"Maybe a few..."

Mary's smile at this point, and the examination continues.

NARRATOR:

"Report ALL falls, and discuss ways to prevent them with your Doctor."

"For more information on falls prevention, contact Ottawa Public Health." 

Logo

Back to top

Learn how to prevent falls - online course

 Our revised online course Prevention of Falls in Older Adults is now available!
Go at your own pace and learn more about falls and how to prevent them.

About this free course:

This module is for anyone concerned about older adults who would like to learn valuable information regarding falls and fall prevention, such as:

  • Personal support workers;
  • Volunteers;
  • Friends and family; and
  • Older adults who support others close to them.

By the end of this course, you will be able to:

  • Understand why falls are a health problem for older adults;
  • Identify what puts an older adult at risk for a fall;
  • Include fall prevention into your daily work; and
  • Talk about fall prevention with clients and families.

This training is based on current literature, the Canadian Fall Prevention Curriculum and best practices in fall prevention.
Complete the module now

This course requires registration with OLearn, the City’s public-facing learning platform.

  • To register, select Create New Account on the login page and follow the instructions to create a username and password.
  • You are also asked to provide an email and a first and last name; this information is kept confidential as per the Municipal Freedom of Information and Protection of Privacy Act, and your email will only be used by the system to receive an automated message confirming that you have completed the course.
  • If you do not wish to create an account to complete this training module, you can access the complete course transcript.

Back to top
 Make your home safe
Half the number of falls happens at home. Falls on stairs and in bathrooms can cause serious injuries.  
Complete the home safety checklist in You can prevent falls 
Throughout your home make sure that: 
  • Pathways are clear of extension cords and other objects. 
  • Rugs have no ripples or tears. 
  • Scatter mats are removed or taped to the floor. 
  • All light fixtures have a minimum of 60 watt bulbs. 
  • Items used every day are stored within easy reach. 
  • Store heavy items in lower cupboards or shelves. 
And clean up spills when they happen. 
Transcript of video:  Prevent falls - make your home safe
STORY OPENS IN HALLWAY OF HOME.  OLDER GENTLEMAN "BOB" WALKS THROUGH FRAME AND INTO THE LIVING ROOM. EYE GLASSES ATOP HIS HEAD. Story opens in hallway of home. Older gentleman "Bob" walks through the frame and into the living room; eye glasses atop his head.Begins with quiet ambient orchestral music in the background.NARRATOR (Authentic, Female)"The edge of a rug, spilled tea, poor lighting or a cord."Suddenly, Bob slips (we don't know which is the culprit). At this moment, the video goes into "extreme slow motion". Bob's eye glasses crash into the floor.The music ramps up orchestral, similar to a song used in and Olympic figure skating routine."That's all it takes."At first, Bob appears to be falling "normally", until he begins to flip/twist in the air (in slow mo) ever so gracefully."In fact, falls account for TWENTY THOUSAND visits to local emergency rooms every year - most involving older adults.."After a gymnastic like rotation in the air, Bob gently touches down on his feet without incident. Camera switchs back to normal speed.The music turns from optimistic/dramatic to soft and serene."If only, falling was so graceful.(Pause)Prevent falls - make your home safe.        A message from Ottawa Public Health."LOGO 
Bathroom
  • Have non-slip surfaces inside the tub and shower 
  • Install well-anchored grab bars by the toilet and bath to help you sit and stand 
  • Use a raised toilet seat or over-toilet commode if toilet is too low
  • Install two grab bars in the tub or shower so that you can hold on with both hands when entering and exiting
  • Use a shower chair and hand-held shower to have a safe seated shower
  • Keep the floor clear of water or obstacles
  • Beside the bath or shower, use a bathmat with rubber backing    
  • Do not use bath oil
Bedroom
  • Install good lighting and nightlights 
  • Keep your telephone, lamp and flashlight within easy reach 
  • When getting up at night, turn on a light 
  • Get up slowly after lying or sitting to prevent dizziness 
  • Keep the path clear between the bedroom and bathroom 
  • If getting to the bathroom at night is difficult, use a bedside commode or urinal
  • If sitting up from bed is difficult, add a bedrail at pillow height
Stairs
  • Make sure stairs are well lit and have a non-slip surface 
  • Install solid handrails on both sides of the stairway 
  • Use handrails on stairways 
  • Remove reading glasses when using stairs 
  • Do not store items in the stairway 
  • Avoid carrying too many items at once when using stairs
  • Never rush up or down the stairs. It’s a major cause of falls 
Resources
Back to top
 Use Safety Aids
Safety aids can make your everyday life easier. It is important to use aids that meet your needs and fit you correctly. Your health care provider can help you choose the right equipment.
 Canes and walkers

  • Check the rubber tips and treads on your cane or walker wheels. 

  • In the winter, use an ice pick on your cane. Remember to flip it up when you go indoors. 

  • Get help paying for mobility aid if you qualify for the Assistive Devices Program. 
 Bathroom aids

  • Install well-anchored grab bars by your shower, tub and toilet for support. 

  • Have non-slip surface inside the tub and shower. 

  • A raised toilet seat or a bath seat are available if needed. 

  • A hand-held shower head makes showering easier. 

  • Walk-in tubs and bath lift are available if needed. 

  • Visit Ontario Renovates program to find out if you qualify for funding for repairs and/or home modifications. 

  • Accessible Housing by Design factsheet 
 Personal Emergency Response Systems

  • Personal Emergency Alert systems can help you and your family feel more secure about living alone.   

  • Smartphone and Smart watch Apps can help you manage your medications, connect with friends and family, detect a fall, and offers tools like a flashlight and a magnifying glass. 

Other safety aids

  • Find out about other devices at local medical supplies stores or pharmacies: reachers or grabbers, night light, large-handle utensils, pot/bowl stabilizers, first aid kits, etc.
 Who can help?
  • Talk to a health care professional, such as your doctor, pharmacist, nurse, physiotherapist or an occupational therapist to help you choose the equipment you need.  
  • If you are receiving home care services from Home and Community Care Support Services, they may be able to help.   
  • Visit www.healthcareathome.ca/contact or call 1-800-538-0520  
 Where can I buy safety aids?
  • Many are available in pharmacies, hardware and department stores, and places that sell medical supplies.
  • Some things like bathroom grab bars should be installed by a qualified professional.    
 How much do safety aids cost?
  • Costs can vary. Funding, grants, and tax credits might be available to buy more expensive equipment. An assessment is required.
 Where can I get help with costs?

Assistive Devices Program (ADP)  

Ontario Disability Support Program (ODSP)  

Ontario Renovates Program   

  • Provides limited financial assistance to low-income older adults and persons with disabilities for the required repairs and changes to the home to support independent living.   
  • Call 2-1-1 
  • Visit the Ontario Renovates Program website for more details.

March of Dimes Canada Home and Vehicle Modification Program

Home Accessibility Tax Credit (HATC)  

  • When completing your annual tax return, you may be able to claim this credit. It is a non-refundable tax credit for eligible home renovation or alteration.    
  • Visit Home Accessibility Tax Credit (HATC) website for more details.  

  *This list is not exhaustive and is current as of June 2023. 

Back to top
 Stay Safe in Winter

Winter can be a difficult time to go outside and be active. A fall on hard packed snow or ice can have a lasting effect on your health and independence.  

Here are some practical tips to help you stay safe and active in winter. 

  • Choose boots with a wide low heel and a non-slip sole

  •  If using a cane, attach a retractable ice pick. Remember to flip it up when you go indoors. 

  • Keep entrance ways, walkways, stairs and driveways clear of ice and snow. 

  • Carry a small bag of grit, sand or non-clumping cat litter in your pocket and sprinkle it on icy sidewalks, steps or bus stops. Fill your bag at City of Ottawa yellow grit boxes.  

Resources 

Back to top

Taking care of your health

Managing your health can help reduce your risk of falling.

  • Have regular physical check-ups with your healthcare provider.
  • See your healthcare provider if you have any kind of symptoms …eg. dizziness, weakness.
  • Report any falls or near falls to your health care provider. Discussing your fall can help identify why you might be falling and what can be done to help you.

Vision

Changes to your vision can affect your balance: 

  • More sensitivity to glare 

  • Harder to see where an object ends, and the background begins 

  • Extra time needed to adjust to sudden changes in light and dark 

  • Harder to judge distance and depth 

  • Watery eyes or burning/stinging dry eyes 

  • Losing your balance or getting dizzy when other people or objects are moving around you 

 What you can do 

  • Have an eye exam every year and when you notice any changes in your vision, free for adults 65+ 

  • Keep your home well lit, especially entrances and stairways 

  • Use night lights, especially in the path from the bedroom to the bathroom 

  • Give your eyes time to adjust when you move from dark to much brighter areas 

  • Protect your eyes from UV rays by wearing sunglasses 

  • Take breaks from looking at one thing, like a computer screen, to reduce the risk of eye strain 

Find an optometrist 

Hearing 

Hearing loss can affect your balance. Here are some signs to watch for: 

  • Difficulty hearing others speak 

  • Frequently asking people to repeat themselves 

  • Frustration at not being able to hear 

  • Problems hearing in noisy areas 

  • Ringing in the ears 

 What you can do 

  • Talk to your health care provider about any changes in your hearing. 

  • Protect your ears from loud sounds 

  • Use devices that can help you communicate better, such as a hearing aid. 

Foot care

Feet that are healthy and pain-free can help you stay active and independent. 

Foot problems can cause loss of balance or make you feel unstable on your feet, putting you at risk of having a fall. 

What you can do 

  • See a health care provider about foot problems and foot pain. 

  • Check your feet for corn, open sores, redness, dry skin and thickened nails. 

  • Choose flat shoes or boots that have low, wide heels and soles that grip. 

  • Avoid walking in bare feet, stocking feet or slip-on shoes with an open heel 

  • Wear supportive shoes inside your home. 

Medication 

Taking three or more medications a day can increase your risk of falling. 

Medications that can affect your balance include those for: 

  • Sleep, anxiety and depression 

  • Heart and blood pressure 

  • Dementia symptoms 

  • Arthritis and pain 

  • Bladder control 

  • Digestive, stomach and nausea 

  • Colds, flu and allergies 

What you can do: 

  • Have a MedsCheck review with your pharmacist every year 

  • Take your medications as prescribed 

  • Read directions carefully so you're aware of potential reactions with other medications 

  • Keep an up-to-date list of all your prescription and non-prescription medicines and take it to all your medical appointments. 

  • Take your expired or unused medications to your pharmacy for safe disposal. 

  • Smart phone Apps are available for medication management 

  • Talk to your healthcare provider or pharmacist: 

    • about possible side effects of prescription, over the counter, supplements or natural health products
    • if you have drowsiness, dizziness, unsteadiness or blurred vision
    • about easy ways to organize your medications.

Back to top

Resources

General Falls Prevention information:

Back to top

 Back to top

Back to the Aging Well home page

Contact Us