Falls Are the Leading Cause of Injury Death in Older Adults: How Good Care Homes Prevent Them

It usually happens in seconds. A trip to the bathroom at night, a slippery tile, a dizzy moment after standing up too fast. For an older adult, one fall can change everything that follows.

The numbers

According to the Centers for Disease Control and Prevention (CDC):

• More than one in four adults aged 65 and older falls each year. 1
• Falls are the leading cause of fatal and nonfatal injuries among adults aged 65 and older in the United States. 2
• About one in ten falls causes an injury that restricts activity for at least a day or prompts healthcare attention. This is a proportion of falls, not of people who fall. 1
• Falls are a major cause of hip fractures in older adults. 1

Fear of falling can lead people to cut back on everyday activities. Less activity can increase weakness and fall risk, so ask about safe ways to stay active. 1

Why falls happen

Falls often have more than one cause. CDC identifies these common risk factors. 1

• Lower-body weakness and balance problems
• Medicines that affect balance, including tranquilizers, sedatives and antidepressants
• Vision problems
• Foot pain or poor footwear
• Home hazards such as rugs, clutter and poor lighting

Also ask the care team about dizziness or lightheadedness, which can have medication-related or medical causes. 1

What to discuss with a care home

Ask how the home tailors prevention to each resident. These are discussion points, not a guarantee that a fall can be prevented.

• A fall risk assessment at move-in and after any change in health
• Medication reviews with a physician or pharmacist, especially for multiple prescriptions
• Exercise tailored to strength and balance. A 2019 Cochrane review found that exercise reduces falls among community-dwelling older adults; Tai Chi may help. These findings should not be assumed to apply unchanged to care-home residents. Ask what is safe for your loved one. 1
• Night lighting and clear paths to the bathroom
• Individualized bathroom assistance, including whether scheduled toileting is appropriate
• Appropriate bathroom supports, such as grab bars and non-slip surfaces; ask whether a raised toilet seat is suitable
• Prompt response to call buttons, and an honest culture of reporting near-misses

Questions to ask Tucson homes

1. How do you assess fall risk when someone moves in?
2. How many falls did residents have last month, and what did you change afterward?
3. Do you offer exercise or balance classes?
4. How do you support hydration in summer while following any clinician-prescribed fluid limits?
5. Who reviews medications, and how often?

Clear answers are a helpful starting point; also ask to see the home’s written policies and your loved one’s care plan. Compare homes in our Tucson assisted living directory.

Sources are linked beside the claims above. Prevention should be individualized with the resident’s healthcare team.