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Preventing Falls and Fractures (5234)

Preventing Falls and Fractures (5234) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Neuro, Rehab


Preventing Falls and Fractures

Falls and fractures are not a certain fact of
growing older. Many can be prevented. To
reduce your risk of falls and fractures, there
are things you can do.
 Make personal changes in your
lifestyle or physical well-being.
 Consider using walking aids or other
assistive devices.
 Take steps to maintain or improve
your bone health.
 Make changes in your home.

Talk with a member of your health care
team about how to prevent falls.

Personal changes
Many falls result from personal or lifestyle
factors that can be changed. A member of
your health care team can assess your risk of
falling and suggest ways to prevent falls.
You might be referred to someone else who
can help. Also, let a member of your health
care team know if you’ve fallen or almost
fallen. Here are some changes you might
 Be physically active.
 Have your medicines reviewed.
 Have your blood pressure checked
when lying down and standing up.
 Get a vision check-up.
 Choose safe footwear
Be physically active
Regular physical activity is a first line of
defense against falls and fractures. It
strengthens muscles and increases flexibility
and endurance. Your balance and the way
you walk may change, decreasing the
chances of a fall. Work with a member of
your health care team to plan a program that
is right for you.
A supervised group program can help.
Exercises done at home can also reduce your
risk of falls. Whether done with a group or
on your own, be sure your program becomes
more challenging over time.

Tai Chi is one type of exercise that may help
improve balance and control. This exercise
uses slow, flowing movements to help
people relax and coordinate the mind and
body. It can also boost your self-
confidence. Dancing and other rhythmic
movements can help as well.

Mild weight-bearing exercise, such as
walking or climbing stairs, may help slow
bone loss. Having strong bones can prevent
fractures if you do fall.

Your health care provider or a physical
therapist can check your walking and
balance. They might do a “Get-Up and Go”
test. This simple test shows how steady you
are when you get up from a chair. The test
also is used to check your walking ability.

Benefits of being active
 Reduce your risk of falls and harm.
 Improve how well you sleep.
 Decrease pain and disability from
 Avoid bone weakness and muscle
 Help your heart and lungs to work
their best.
 Improve blood flow and prevent
 Increase energy and endurance.
 Improve your mental well being.
 Promote independence.


Medicine review
Find out about the possible side effects of
medicines you take. Some medicines might
affect your coordination or balance, or cause
dizziness, confusion, or make you sleepy.
Some medicines do not work well together,
adding to the side effects of each.

Bring your prescribed and over-the-counter
medicines with you when you visit your
clinic. Also bring any vitamins, minerals,
and herbal products you are taking. Ask if
any of your medicines or over-the counter
products could increase your risk of falling.
Ask if you no longer need to take any of
your medicines or if the doses might be
decreased. Never stop taking your
medicines unless you talk with your health
care team first.

Limit the amount of alcohol you drink.
Even a small amount can affect your balance
and reflexes.

Blood pressure checks standing and
Most often your blood pressure is checked
when you are sitting. However, some older
people have normal or increased blood
pressure while seated, but their blood
pressure drops too much on standing. There
is no way to know unless you check.

A member of your health care team should
check your blood pressure and pulse after
you have been lying down for at least 5
minutes and again after you get up. If it
drops too much when you get up, ask if any
of your medicines should be decreased or if
you should make other changes. Other
things can help.
 Drink more water.
 Get up more slowly.
 Pump your feet or hands before
getting up.
 Wear special stockings.

Get a vision check-up
Have your vision tested regularly or if you
think it has changed. Even small changes in
sight can make you less stable. Wear your
eyeglasses or contacts so you can see your
surroundings clearly. Keep eyeglasses clean
and check to see that the frames are straight.
When you get new glasses, be extra cautious
while you are getting used to them. If you
use reading glasses or multi-focal lenses,
take them off when you are walking.

Choose safe footwear
The soles of our feet have nerves that help
us judge the position of our bodies. To work
correctly, our feet need to be in touch with
the ground and our shoes need to stay
securely with the foot as we take each step.

It is vital to select your footwear carefully to
help prevent falls. Wear sensible, low-
heeled shoes that fit well and support your
feet. There should be no marks on your feet
when you take off your shoes and socks.
Your shoes should fully surround your feet.
Wearing only socks or wearing floppy,
backless slippers or shoes without backs can
be unsafe. Also, choose shoes with non-slip
soles. Smooth soles can cause you to slip on
waxed or polished floors.

Helpful devices
Use of assistive devices can prevent harmful
falls. These devices include canes, walkers,
and “reachers.” A physical or occupational
therapist can help you decide which devices
might be helpful and teach you how to use
them safely. Talk with your doctor or nurse
about having a physical therapist assess your
device needs.

A cane or walker can help you feel more
stable when you walk. Walking aids are
very helpful when you are in places you do
not know or where walkways are uneven.
You may have a choice of different types of
canes. Some have grips made of foam or
that fit the shape of your hand. Many canes


can be adjusted, but some cannot. A
physical therapist can advise you about
which cane to choose. Be sure the length
fits you well. Your elbow should be at a
comfortable angle. A cane that is too short
may make you unsteady. A cane that is too
long is harder to use. If you use a cane, be
sure to learn how to walk with it the correct

If you are at risk of falling, a member of
your health care team might suggest using a
walker. A walker will help you stay
balanced by giving you a wide base of
support. Be sure to choose a walker that fits
you and gives the level of stability that is
best for you. Use it when needed and use it
properly. The types of walkers vary. Some
walkers have two wheels so the walker
should not roll away from you. These
walkers work well if you need to put weight
on the walker when you move. Other
walkers have four wheels and brakes for
going down inclines. You can add a basket,
tray, or pouch to some walkers to carry
items. These accessories will make it more
convenient to use the walker.

A “reacher,” or “grabber,” can also help
prevent falls. This simple tool lets you take
lightweight items from high shelves, from
the floor, and other places. Use a reacher
rather than standing on a stool to get
something from above.

When bending over to pick up items from
the floor or a lower level like a step or low
shelf, use one hand on counter top, furniture,
or a walker for support. When able, use a
reacher to pick up lightweight items.

Another helpful device is a portable
telephone or cell phone. Carry the phone
with you from room to room. When it rings,
you won’t have to rush to answer it.

Bone health
You can help prevent fractures by
maintaining the strength of your bones.
Having healthy bones won’t prevent a fall.
If you fall, though, having healthy bones can
help prevent hip or other fractures that may
lead to a hospital or nursing home stay,
disability, or even death. You are never too
old to improve your bone health.

Osteoporosis makes bones thin and more
likely to break. It is a major reason for
fractures in women past menopause. It also
affects older men. If bones are fragile, even
a minor fall can cause fractures.

At any age, you can take steps to keep your
bones strong. Be sure to consume adequate
amounts of calcium and vitamin D. People
over age 50 should consume 1,200 mg of
calcium daily by eating calcium-rich foods
and taking calcium supplements.

Good sources of calcium in your diet
 dairy products such as low-fat milk,
yogurt, and cheese
 orange juice, cereals, and other foods
fortified with calcium
 dark green, leafy vegetables such as
broccoli, collard greens, and bok
 sardines, salmon with bones,
soybeans, tofu, and nuts such as

Vitamin D helps your body absorb calcium.
Exposure to sunlight causes your body to
make vitamin D. Many older people do not
get enough vitamin D this way. Eating
foods with vitamin D and taking
supplements can help.

As you grow older, your need for vitamin D
increases. People ages 51 to 70 should
consume at least 600 international units (IU)
of vitamin D daily. People over age 70
should consume at least 800 IU daily. Talk


with a member of your health care team
about how much vitamin D you need.

Good sources of Vitamin D in your diet
 herring, sardines, salmon, tuna
 liver
 eggs
 milk and foods fortified with
Vitamin D
 Vitamin D supplements

Physical activity is another way to keep your
bones strong. Try to get a total of at least 30
minutes of activity a day. This does not
need to be 30 minutes at one time but can be
shorter sessions multiple times a day. For
example, three 10 minute sessions would
meet this need. Find time for things like
walking, dancing, stair climbing, gardening,
and weight-lifting.

Talk with your doctor or nurse about having
a bone density test. This safe, painless test
assesses your bone health and risk of future
fractures. Medicare and many private
insurers cover this test for eligible people.
Women over age 65 and all men over 70
should have a bone density test.

A member of your health care team can also
advise you about whether you should
consider taking prescription medicines to
improve bone health. These medicines can
slow bone loss, improve bone density, and
lessen the risk of fractures.

Quit smoking and limit alcohol use to
improve your bone health. Smoking and
heavy alcohol use can decrease bone mass
and increase the chance of fractures.
Maintain a healthy weight. Being
underweight increases the risk of bone loss
and broken bones.

If you fall
Whether you are at home or somewhere
else, a sudden fall can be startling and
upsetting. If you do fall, stay calm. Take
deep breaths to try to relax. Remain still on
the floor or ground for a few moments. This
will help you get over the shock of falling.
It will also give you time to decide if you are
hurt before getting up. Getting up too
quickly or in the wrong way could make an
injury worse.

If you think you can get up safely without
help, roll over onto your side. Push yourself
up into a seated position. Rest again while
your body and blood pressure adjust.
Slowly get up on your hands and knees, and
crawl to a sturdy chair.

Put your hands on the chair seat and slide
one foot forward so that it is flat on the
floor. Keep the other leg bent so the knee is
on the floor. From this kneeling position,
slowly rise and turn your body to sit in the

If you are hurt or cannot get up on your
own, ask someone for help or call 911. If
you are alone, try to get into a comfortable
position and wait for help to arrive.

If you have problems with balance or
dizziness and are often alone, consider
getting a personal emergency response
system. This service, which works through
your telephone line, provides a button or
bracelet to wear at all times in your home.
If you fall or need emergency help for any
reason, a push of the button will alert the
service. Emergency medical services will
be called. There is a fee for medical
monitoring services, but your safety is worth
the cost.

Carry a cordless phone or cell phone with
you as you move about your house. It could
make it easier to call someone if you need
help. You might also put a telephone in a
place that you can reach from the floor in
case you fall and need help.


Be sure to discuss any fall with a member of
your health care team. Write down when,
where, and how you fell so you can discuss
the details. You can then be assessed as to
the cause of the fall. Knowing the cause can
help you plan to prevent future falls. You
may need to see a physical or occupational
therapist who can suggest changes that may
lower your risk of falls.

Many older people who have fallen are
afraid of falling again. Even if a fall doesn’t
cause injury, the fear of falling again might
prevent you from doing the things you enjoy
or need to do. Fear of falling also might
cause you to stay at home away from your
friends, family, and others.

Your muscles and bones can weaken over
time without the physical activity that comes
with doing daily tasks or exercise. As a
result, you could become more -- not less --
likely to fall.

Simple changes can help make your home
safer. The Health Facts For You “Home
Safety-Preventing Falls” offers some tips
for preventing falls at home.

Source: NIH Senior Health: National
Institutes of Health, National Institute on
cation/osteoporosis 6/26/17 Reprinted with

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 12/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#5234.