Falls are the leading cause of injuries among seniors in Hawai‘i. The risk and frequency of falling increase with age. Every 5 hours a senior in Hawai‘i suffers a fall that results in the senior being hospitalized. One in three adults 65 years or older in the US suffers a fall each year. Falls can affect seniors in many ways. Falls can result in bruises, sprains, broken bones, and/or head injuries. Falls account for 87% of all fractures among people aged 65 years or older. It can cause injury and their ability to live independently decreases. It can also limit confidence and the ability to live a comfortable life.

What are the causes of falls in seniors?

For people aged 65 years or older, 60% of fatal falls occur in the home, 30% in public places and 10% in health care institutions. Falls can be caused by many factors which are associated with health and aging conditions. Predictors of falls include a previous fall, poor posture, poor balance, prolonged bed rest, muscle weakness, mobility problems, loss of sensation in the feet, vision changes, dehydration, and drug interactions. Chronic health conditions such as arthritis, osteoporosis, stroke, Parkinson’s disease, urinary incontinence, diabetes, and heart problems may predispose to falls. Review of physician prescribed and over the counter medications, alcohol consumption, and marijuana use, may provide information that can be useful in decreasing the occurrence of falls. Environmental hazards such as slippery surfaces, poor lighting, and tripping obstacles also play a contributing role in falls.

Is there a role for therapy and exercise?

Home safety evaluations conducted by a physical therapist or an occupational therapist are invaluable in the prevention of falls. There is no charge for home safety evaluations by medical insurance, if the evaluation is prescribed by a physician. Senior participation in community fall prevention exercise programs and educational classes help prevent in-home falls. Tai Chi is excellent in decreasing the number of falls and fear of falling. Studies have shown Tai Chi to improve functional balance and physical performance in physically inactive seniors.


Home Modifications:

Home safety is very important in preventing falls and disabilities. Some falls can be prevented by use of the following.

  • Non-slip flooring.
  • Install stair railing and/or stair climber.
  • Eliminate area rugs that shift or curl.
  • De-clutter the living spaces and footpaths throughout the home.
  • Provide a roll-in or curb-less shower stall.
  • Install grab bars in the shower and tub areas.
  • Appropriate height toilet seat.
  • Lights in hallways as well as closets.
  • Replacing door knobs and faucets with lever type handles.
  • Increase the width of doorways to 32 inches or more to accommodate the use of a wheelchair or walker.
  • Installation of a smoke detector and fire extinguisher according to code.
  • Setting of hot water heater thermostat at 110˚F or lower.

Lifestyle Changes:

  • Have your vision & hearing checked regularly.
  • Talk to your doctor or pharmacist about the side effects of your medication.
  • Limit your intake of alcohol.
  • Use caution when getting up from eating or sleeping.
  • Use a cane or walker to help maintain your balance.
  • Wear supportive, rubber-soled shoes.
  • Maintain a regular exercise program to improve strength and tone