Falls are scary, and they can be disabling in both direct and indirect ways. Directly, they often cause injuries that can make it difficult to move and function normally. And then indirectly, they can create a significant fear of falling in many individuals, which in turn leads to less movement and activity which can then further increase the risk for another fall. Any way you slice it, falls can do some serious damage to the lives and independence of older adults.

So if you or someone close to you is in the “at–risk” population for falling, you may very well be interested in taking action to somehow lower the chances. There is a variety of steps one can take to work towards reducing their fall risk, but perhaps the most direct and effective solution is to see a physical therapist for specific guidance.

Physical therapists are experts of human movement that specialize in finding ways to help patients move more effectively and confidently. As such, they are perfectly equipped to identify which older adults are at risk for falls and then guide them through the steps needed to improve their health and modify their lives in ways that will prevent falls from occurring.

From screening, to assessment, to prevention
The first step of the fall prevention process is determining whether or not someone is at risk for falling. This is done by an initial screen, which can be given to anyone over the age of 65 and typically consists of three questions:

1. Have you had 2 or more falls in the last 12 months?


2. Have you fallen recently?


3. Do you have any difficulty with walking or balance (the therapist will also examine this briefly to make a determination)?

If the answer to any of these questions is “yes,” then the patient is considered to be in the “high risk for falls” category. From here, a much more thorough assessment is needed, which will include a detailed interview about medications the patient is taking, their fall history, and a physical examination to evaluate balance, strength, mobility, and other factors. This assessment allows the physical therapist to more accurately understand the actual risk for a fall and the impairments present in each patient that need to be targeted.

Based on these findings, the therapist will then create a personalized fall-prevention program to begin right away. Every program is therefore unique according to the patient’s specific impairments and abilities, but research has shown that the best prevention strategies include a variety of different exercises, particularly those that aim to improve balance and strength. As patients repeatedly perform these types of exercises, their reaction times will become more automatic, which will consequently reduce their risk for falls. Part of the program will also involve recommendations for regular physical activity in order to boost fitness levels, which is key for fall prevention.

Lastly, a physical therapist will educate patients and provide specific instructions on how to reduce or eliminate hazards in the home environment and elsewhere. Below are some of the most common tips physical therapists usually provide:

• Conduct a walkthrough of your home—or have a friend/family member do it—to identify possible hazards that may lead to a fall, then make necessary changes


• Install handrails on both sides of all stairways, avoid clutter and putting any items on the floor, remove throw rugs and make sure your home is well–lit


• In bathroom, use nonskid mats, a raised toilet seat and grab bars as needed


• If you’re supposed to use a walking assistive device, be sure you’re using it properly and at all times, both in and out of the house


• Get your eyes checked once a year, and get adequate calcium and vitamin D


• If you’re taking numerous medications, learn the side effects and if there are any interactions that can increase your risk of falling


• Wear shoes with nonskid soles and consider using Velcro or Spyrolaces


• Take your time, be patient and ask others for help with difficult, risky tasks

While the power to prevent falls is ultimately in your hands, seeing a physical therapist will be extremely helpful for guiding you and to identify the safest approach to keep you on your feet.