St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Dr. Larry Lake
BayView Healthcare 

Don't Get Tripped Up! Understanding Risk Factors for Falls Among Older Adults.


August 1, 2017 | View PDF

Jennifer Van Skiver, Director of Rehab, Aegis Therapies

My mother and grandmother's stories...

My mother and grandmother never gave a moments' thought to the possibility of a fall at home. Tragically they both fell at home and suffered hip fractures. Within two months they had both passed away from complications.

Did you know that 75% of all falls occur in the home?

With a few simple changes you can reduce your risk or your loved one's risk. Gram was a furniture walker. She was too proud to use a walker and relied on pieces of furniture as she moved about the house. My mother, on the other hand, suffered from diabetic peripheral neuropathy. This lead to a loss of balance while she was walking. The bottom line – both were unaware of the potential lifethreatening consequences of a fall. The loss of two very special women in my world has made the issue of falls at home very personal. As a daughter and an occupational therapy professional, it is important to me to educate as many people as possible to ensure that they don't experience the unnecessary loss of someone they love as I did.

Most fractures among older adults are caused by falls

The CDC cites "more that 90% of hip fractures among adults ages 65 and older are caused by falls. These injuries can cause severe health problems and lead to reduced quality of life and premature death." Taking the time to understand the risk factors for falls, understanding what a home safety assessment completed by an Occupational Therapist can offer, learning simple and quick fixes are the first steps to reducing falls and possibly saving a life!

Natural Risk Factors

There are many factors that play a role in the risk for falls, just as there are many interventions which can be offered to reduce the risk for falls. Inherent or natural factors can include general aging changes and medical conditions such as:

◆ Osteoarthritis

◆ Diabetes

◆ Cardiovascular disease (stroke, high or low blood pressure)

◆ Neurological conditions (Parkinson's Disease, neuropathy)

◆ Decreased reaction time

◆ Loss of sensation in the feet

◆ Proprioception (the body's ability to sense where it is in space or positional sense)

◆ Vision and hearing changes or loss

◆ Posture changes

◆ Loss of muscle strength and/or flexibility and mobility problems due to weakness or balance.

External Risk Factors

◆ Medications: sedatives, antidepressants, anti-anxiety, narcotics, corticosteroids,

antihypertensives, diabetic and some over the counter medications. Be aware of side-effects and if a drug makes you sleepy or dizzy−report that to your doctor.

◆ Environmental hazards can include obstacles, clutter, lighting and community unpredictability such as a pet under foot and uneven terrain.

◆ Improper footwear. Studies have shown that slipper-wearers are more likely to experience a

fracture versus those wearing soft soled shoes (Kerse et al, Aust NZI public health).

◆ Assistive Devices. Lack of or improper use of assistive devices such as canes and walkers.

Behavioral Factors

The most significant behavioral factors affecting fall risk include inactivity, alcohol use, medication side effects, overestimating one's ability level, taking risks (for example, someone who has poor balance, using a step stool to reach the top shelf in their kitchen cabinet) and underestimating one's ability level, by cutting back on activities and subsequently losing leg strength, balance and coordination.

What can you do?

The CDC and American Geriatric Society site from evidence based studies, that approaches to reducing falls at home are "multifactorial". Essentially, fall reduction risks are not significantly reduced when only one aspect is addressed or corrected. When approaching the idea of fall reduction many factors should be considered including: analysis of balance, transfer skills, strength and gait; footwear and management of foot problems; vision assessment and correction by an optometrist or ophthalmologist yearly; medication review for interactions and side-effects; routine physician visits for medical management; home assessment and modifications to address fall hazards; tailored program of muscle strengthening, balance retraining and gait training prescribed by a qualified healthcare professional; assessment for appropriate assistive devices and proper use. You can also contact an Occupational Therapist!

Things you can do now!

• Lighting – ensure that lighting is bright, place night lights in your bedroom, bathroom and hallways.

• Rugs – immediately dispose of throw rugs! They may be pretty but they are truly a hazard.

Make sure rugs are firmly fastened to the floor; tack down loose ends.

• Electrical cords - ensure cords and other items such as oxygen tubing are not on the floor in walking areas.

• Bathroom – place non-slip mats in the tub; install a raised toilet seat and safety tub equipment.

• Stairs – install handrails on both sides of your stairs, inside and outside and top to bottom. Make sure the rails are tight and secure.

• Kitchen – avoid the use of step stools or ladders. Store items within easy reach.

• Footwear – avoid loose fitting shoes, house slippers, especially the "flip-flop" variety. Wear shoes with a firm non skid sole.

• Furniture – remove clutter from walking areas.

• Flooring – assess for uneven or wet areas and pay particular attention to the height of doorway thresholds.

Occupational Therapy Helps Individuals

Live Life To Its Fullest!

When working with an occupational therapy practitioner or "OT", strategies, adaptation and modifications are customized for each individual to resolve problems, improve function, and support everyday living activities. The goal is to maximize potential.

OT's focus on "doing" whatever activities or occupations are meaningful to the individual. It is OT's purpose to get beyond problems to the solutions that assure living life to its fullest.

To learn more about the benefits of Occupational Therapy talk with your physician, visit or call Jennifer Van Skiver at BayView (904-829-3475). Call today to discuss the benefits of a home safety assessment by an Occupational Therapist!

161 Marine Street, St. Augustine, FL (904) 829-3475

BayView Healthcare is a private, not-for-profit comprehensive continuum of healthcare provider founded in 1920. Our superior level of services includes short-term inpatient and outpatient rehabilitation, skilled nursing at BayView Rehab at the Samantha R. Wilson Care Center, BayView Home Health and BayView Assisted Living at The Pavilion and Buckingham Smith, an Emergency Charitable Assistance Program and BayView Wellness. Caring Hands-Caring Community is a separate 501(c)3 charitable organization founded in 2004 by our parent organization. It was formed to support the exceptional services and continuum of care provided to people in need of healthcare services and financial assistance. For further information about any of the programs offered through the BayView Healthcare continuum please call (904) 829-3475.


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