Care decisions and family support
Falls in Older Adults: Risk Review and Practical Prevention
By KindredMind Editorial Team
Falls are not inevitable with age, and risk often has more than one contributor. Reviewing movement, medicines, vision and the environment can identify useful changes. No checklist, device or intervention prevents every fall. [1][2]
Start with the person's actual falls, near falls, concerns and ordinary activities. A dementia diagnosis does not mean that everyone falls or that every fall has the same cause.
Review people, tasks and surroundings together
Swipe within the table to reach every column. Keyboard users can focus the table area and use the arrow keys.
| Possible contributor | Question for review | Practical follow-up |
|---|---|---|
| Strength, balance or walking changes | What movements have become difficult or uncertain? | Ask about appropriate assessment, exercise or physiotherapy |
| Medicines | Could a medicine or combination contribute to dizziness or drowsiness? | Request a clinician/pharmacist review; do not stop or change doses yourself |
| Vision | Can the person see steps, obstacles and needed information? | Arrange appropriate vision care and review the environment |
| Footwear and feet | Do shoes fit securely, and is foot pain affecting walking? | Discuss suitable footwear and professional foot care where needed |
| Home hazards | Are rugs, cords, clutter or slippery surfaces in the usual route? | Remove or adapt hazards with the person's involvement |
| Stairs and bathrooms | Is support appropriate for the actual movement? | Ask about fitted rails, grab bars, surfaces and professional home assessment |
| Lighting | Can the person see the route, including at night? | Check glare, shadows, switches and the route to the bathroom |
| Mobility aids | Is the aid appropriate, fitted and usable in this space? | Obtain assessment and training rather than buying an aid on appearance alone |
| Dizziness on standing | Does the person become lightheaded when getting up? | Report this for clinical assessment; it can have several causes |
CDC and NIA identify multiple risk factors, including balance, medicines, vision, environmental hazards and postural blood-pressure changes. The table is a review aid, not a diagnosis or an individual exercise prescription. [1][2]
Keep activity appropriate rather than abandoning it
Fear after a fall can make ordinary movement harder to resume. Ask a qualified professional about suitable strength and balance work, mobility support and the person's actual abilities. Do not turn a general recommendation to stay active into an unsafe unsupervised exercise plan. [2]
Review what happened during an ordinary task: getting out of bed, reaching the toilet, carrying food or using steps. A change should fit the movement and the person, not only make a photograph of the room look tidy.
Dementia adds questions, not one universal pattern
Memory, attention or navigation difficulties can affect how someone uses a space or an aid. Ask whether a route, instruction, unfamiliar object or change in routine creates difficulty. NIA identifies increased fall risk in some cognitive conditions; it does not mean every person with dementia will fall. [2]
Keep adaptations understandable and review them with the person and relevant professionals. A reminder to use an aid does not establish that the person can recognize or use it safely. Do not assume surveillance or restricting all movement is an appropriate substitute for assessment.
After a fall, address injury and the cause
If someone cannot get up safely, may have injured their head, back, neck or hip, or has concerning acute symptoms, seek urgent medical or emergency help. Do not attempt an unsafe lift. NHS guidance identifies serious injury and inability to get up as reasons for emergency assistance; use the appropriate local service rather than a foreign emergency number. [3]
Tell the person's clinician about falls and near falls, even if an injury was not obvious. Ask what needs assessment, what help is required now and how the ordinary activity can be approached while the plan is reviewed.
Fit the review into the wider home plan
Use the home-modifications guide for access and adaptation questions and aging in place for the wider support arrangement. A medical-alert system concerns obtaining help after an event, not preventing every fall or guaranteeing a response.
Sources and scope
Sources checked November 10, 2026. General risk-reduction and assessment guidance, not guaranteed prevention, an emergency assessment or a personalized clinical plan.
- CDC: Older Adult Fall Prevention.
- NIA: Falls and Fractures in Older Adults.
- NHS: Falls. Clinical escalation guidance; UK service numbers are not applied to other jurisdictions.