Fall Risk in Older Adults

Fall Prevention

Fall prevention is not a sexy topic but as we get older (> 60 years of age) physical changes, health conditions and medications can make falls more likely. Stepping on a crack and breaking your mother’s back, is an old childhood game that we didn’t take too seriously.  Something we should take seriously: the 1 year mortality rate for seniors over the age of 60 after a hip fracture is between 14 – 58%. Therefore fall risk prevention is of utmost importance.


Footwear Style and Risk of Falls in Older Adults

The results of a study reported in the Journal of the American Geriatrics Society 16 August 2004 showed that athletic and canvas shoes (sneakers) were the styles of footwear associated with lowest risk of a fall. Going barefoot or in stocking feet was associated with sharply increased risk. Relative to athletic/canvas shoes, other footwear was associated with a greater likelihood of falling, varying somewhat by style.

What this means: Contrary to findings from gait‐laboratory studies, athletic shoes were associated with relatively low risk of a fall in older adults during everyday activities. Fall risk was markedly increased when participants were not wearing shoes.

Fall‐Risk Assessment and Management in Clinical Practice: Views from Healthcare Providers

Another study reported in the same edition of the Journal of the American Geriatric Society from the August 16, 2004 revealed the following: healthcare providers were most likely to report directly intervening with or referring older patients for gait and transfer impairments and balance disturbances and least likely to do so when encountering foot or footwear problems and sensory or perceptive deficits. Patient compliance was the most commonly reported barrier to successful direct intervention across several risk factors, whereas inadequate availability of other healthcare providers and lack of Medicare reimbursement were the most commonly reported barriers to successful patient referrals.

What this means: see your podiatrist for foot or footwear problems and any problems with numbness or loss of balance as these are the key areas that are being overlooked by other health providers.


Begin Fall Prevention now:

  1. Make an appointment with your Podiatrist for Fall Risk Assessment: (bring with you the following information)
    • Medications – that make you tired or affect your thinking
    • Previous falls – have you fallen before, near misses where you caught yourself or someone else caught you
    • Health – dizziness, joint pain, shortness of breath or numbness in feet and/or legs, loss of balance, weakness
  2. Physical activity
    • Develop a walking, water workouts, tai chi program in conjunction with your podiatrist and physical therapist.
  3. Appropriate shoes
    • Wear shoes with firm non-skid, non-friction soles.
    • Avoid wearing loose-fitting slippers that could cause you to trip.
    • Do not walk around barefoot or in your stocking feet. Your podiatrist will help you select or will prescribe appropriate shoes that will not add to your fall risk
  4. Remove hazards to make your home safer
    • Remove loose items from walkways, move furniture like coffee tables
    • Secure loose floor coverings, repair loose flooring, store things you use regularly in an easy to reach place
    • Immediately clean spills
    • Use non-slip mats in bath or shower
    • Do not take chances! Stay away from a freshly washed floor. Never stand on a chair or table to reach something that is too high.
  5. Keep your living space well lit.
  6. If your doctor suggests that you use a cane or a walker to help you walk, please use it! This will give you extra stability when walking and may help you avoid a bad fall. Use assistive devices and get help learning to use them.
  7. Do not use stairs without rails on both sides for support. If you must carry something while you are going up or down, hold it in one hand and use the handrail with the other.
  8. Know your limitations.
  9. See your physician if you have dizzy spells or fainting spells; see your eye doctor at least once a year and have your hearing tested too.
  10. When you get out of bed in the morning or at night to use the bathroom, sit on the side of the bed for a few minutes before standing up. Moving too quickly can make you dizzy, and you might lose your balance and fall. If your feet are numb from neuropathy they don’t know where they are so turn on the lights and look them onto the floor.

What to do if you fall

If you fall at home, remember:

  • Step 1. Stay quiet for a moment — don’t panic
  • Step 2. Decide whether or not to try to get up.

If you decide to try to get up:

  • Step 1. Use strong, stable furniture for support as you try to get up.
  • Step 2. Take some time to recover from your fall after you get up.
  • Step 3. Tell someone that you had a fall.
  • Step 4. Get medical advice if necessary.

If you cannot get up, or if you decide not to try:

  • Step 1: Slide or crawl to get help if you can. You might be able to reach one of the following:
      • Telephone
      • Door to the outside
      • Personal alarm device
      • Something to make a loud noise
  • Step 2: Tell someone you have fallen and need help.
  • Step 3: After calling for help, lie quietly until help arrives. Keep as warm and comfortable as you can.
  • Step 4: Get medical advice if necessary.


Foot and Ankle Surgeon Dr. Gregoy SmithDr. Gregory Smith works in two offices for your convenience– Gettysburg, PA and Hagerstown, MD.

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