Fall prevention for seniors at home

Most falls happen at home, and most of them have a cause you can find and fix. A loose rug, a dark hallway at 2 a.m., a new pill that makes someone a little woozy when they stand up. This guide walks through what the CDC and the National Institute on Aging recommend, room by room, so you can make your parent's home safer this week.

How common are falls in older adults?

More common than most families expect. According to the CDC, more than one in four people age 65 and older falls each year, and falling once doubles the chance of falling again. In 2024, emergency departments recorded about 4.5 million visits for older adult falls, and falls among adults 65 and older caused over 43,000 deaths, making them the leading cause of injury death in that age group.

Hip fractures are a big part of the story. The CDC reports that nearly 319,000 older adults are hospitalized for hip fractures each year, and falls caused 88% of emergency visits and hospital stays for hip fractures. Falls are also the most common cause of traumatic brain injury in older adults.

There's a quieter cost too. The NIA notes that many older adults become afraid of falling and start avoiding walks, shopping or time with friends, even though staying active helps prevent falls.

What causes falls in older people?

Usually it's several things at once. The NIA lists these risk factors:

Weaker eyesight, hearing and reflexes
Conditions such as diabetes, heart disease or problems with the thyroid, nerves, feet or blood vessels, which can affect balance
Incontinence or other conditions that cause a rushed trip to the bathroom
Mild cognitive impairment and some types of dementia
Loss of muscle mass (sarcopenia), balance and gait problems
Blood pressure that drops when standing up (postural hypotension)
Painful feet and unsafe shoes, such as backless shoes or high heels
Medications with side effects like dizziness or confusion, and taking more medications overall
Hazards in the home

If your parent lives with a condition that affects movement or thinking, the risk is higher. Our guides on Parkinson's care at home and stroke recovery at home cover the balance issues specific to those conditions.

A room-by-room home safety checklist

The CDC's STEADI program (Stopping Elderly Accidents, Deaths and Injuries) publishes a free checklist called Check for Safety. Here's what it asks you to look for, with a few practical notes.

Floors and walkways

Clear a straight path through every room. If you have to walk around furniture, move it.
Remove throw rugs, or secure them with double-sided tape or a non-slip backing.
Pick up papers, shoes, books and anything else on the floor.
Coil or tape lamp, phone and extension cords next to the wall. Add an outlet if cords have to cross a walkway.

Bathroom

Put a non-slip rubber mat or self-stick strips on the tub or shower floor.
Install grab bars next to and inside the tub, and next to the toilet. Towel racks aren't built to hold a person's weight.

Stairs and steps (inside and outside)

Keep everything off the stairs, always.
Fix loose or uneven steps.
Make sure there's a light and a light switch at both the top and bottom. Glow-in-the-dark switches help.
Replace burned-out bulbs right away (ideally someone other than your parent does this).
Secure loose carpet on every step, or remove it and use non-slip rubber treads.
Have handrails on both sides of the stairs, running the full length.

Bedroom

Put a lamp within easy reach of the bed.
Light the path from the bed to the bathroom. Nightlights that turn on by themselves after dark work well.

Kitchen

Move things used often to lower shelves, about waist high.
If a step stool is needed, get a sturdy one with a bar to hold. Never use a chair.

Lighting throughout the house

Lighting shows up in nearly every section of the CDC checklist. Walk the house at night with the lights your parent actually uses, and you'll spot the dark patches fast.

Which medications raise fall risk?

The CDC's STEADI program for pharmacists points out that many older adults take medicines for sleep problems, anxiety, high blood pressure or chronic pain. Side effects from these drugs can cause drowsiness, loss of balance, changes in vision and slower reaction time, all of which raise the risk of falling. The NIA adds that the more medications a person takes, the more likely they are to fall.

Don't stop or change any of these on your own. Instead:

Keep an up-to-date list of every medication, including over-the-counter drugs and supplements.
Bring the list (or the bottles) to their doctor or pharmacist and ask for a review focused on fall risk.
Mention any dizziness, sleepiness or unsteadiness, even if it seems minor.
Ask the doctor whether vitamin D makes sense for them, as the CDC suggests.

The NIA also suggests standing up slowly and asking the doctor to check blood pressure both lying down and standing.

Why do vision and footwear matter?

Seeing clearly and walking comfortably both prevent falls. The CDC's guidance for family caregivers recommends:

An eye exam at least once a year, with glasses updated as needed
A foot check by their healthcare provider once a year, and a conversation about proper footwear or whether a foot specialist would help

For people who wear bifocals or progressive lenses, the CDC suggests asking about a separate pair of distance-only glasses for walking outside.

On shoes, the NIA recommends nonskid, rubber-soled, low-heeled shoes that fully support the foot. No walking on stairs or floors in socks, or in slippers with smooth soles.

Can exercise like Tai Chi prevent falls?

Yes. The CDC says activities that strengthen the legs and improve balance, like Tai Chi, can prevent falls. The NIA adds yoga, Pilates and strength training with weights or resistance bands as options, and recommends at least 150 minutes of physical activity a week for bone health. Check with their doctor about the right type of exercise first. A physical or occupational therapist can also help choose and fit a cane or walker, which the NIA says should be the right size and used correctly.

Free fall prevention classes in metro Atlanta

The Atlanta Regional Commission runs HealthMatters Workshops across metro Atlanta, currently offered at no cost through grant funding. Two focus on falls:

A Matter of Balance, an 8-week workshop that helps people become less fearful of falling and make practical changes to stay active
Tai Chi for Arthritis and Falls Prevention, offered as an 8-week or 16-week workshop

You can find upcoming sessions on the Empowerline calendar or call Empowerline at (404) 463-3333. Empowerline can also help you find a Certified Aging in Place Specialist for a home assessment.

What should you do after a fall?

The NIA gives these steps for the person who has fallen:

Breathe. Stay still for a few moments to get over the shock.
Check for injury. Getting up too fast or the wrong way can make an injury worse.
If it seems safe to get up, roll onto one side and rest while blood pressure adjusts. Get onto hands and knees and crawl to a sturdy chair.
Rise into the chair. Hands on the seat, slide one foot forward flat on the floor, keep the other knee down, then slowly rise and turn to sit.
Get help. If they're hurt or can't get up, call someone or call 911. If alone, get as comfortable as possible and wait.

Every fall should be reported to their doctor, even if nothing hurt. The NIA notes a fall can point to a new medical problem or an issue with medications or eyesight that can be corrected. The CDC also tells family caregivers to let the provider know if a parent is worried about falling or seems unsteady.

To prepare, the NIA suggests keeping a charged phone on them at all times, arranging daily contact with family or a friend, and considering a medical alert button or a smartwatch with fall detection.

How a caregiver helps prevent falls at home

Much of fall prevention is daily follow-through, which is hard to do from across town. An in-home caregiver can:

Stay close during bathing, toileting and getting dressed, when many falls happen
Give standby support when your parent walks with a cane or walker, and help with sitting, standing and routine transfers within their training and the care plan
Keep walkways clear and everyday items within reach
Make sure nonskid shoes are on and lights are on
Give medication reminders so doses aren't doubled or skipped (caregivers remind; they don't give medication)
Drive your parent to eye exams, doctor visits or a Tai Chi class
Notice changes in balance, mobility or how they're managing, and tell the family

Overnight care can help when most of the risk is the walk to the bathroom at night. Respite visits give a family caregiver time to rest without leaving a parent alone.

Tale Circle Care provides in-home care across metro Atlanta, including Peachtree City and Fayette County, Marietta, Roswell and Johns Creek. If you'd like to talk through what would help in your parent's home, call (346) 278-3018. If you're not sure yet whether your parent needs help, our guide on signs a parent needs help at home is a good place to start, and this comparison of care options in Georgia explains how home care differs from home health.

Common questions

Who is most at risk of falling?

Adults 65 and older, and especially anyone who has already fallen, since one fall doubles the chance of another. Risk also rises with weak legs, balance problems, dementia, vision changes and certain medications.

Are grab bars really necessary?

The CDC recommends grab bars next to and inside the tub and next to the toilet. Towel bars and sink edges aren't designed to hold body weight.

Should my parent use a walker?

Ask their doctor or a physical therapist. The NIA says the right device, sized correctly and used properly, helps prevent falls, and a borrowed one should be checked for fit.

Sources

This guide is general information for families, not medical advice. Ask the person's doctor about their care, and call 911 in an emergency.