One fall can be an accident. Two or more in a few months usually means something has changed, such as strength, balance, vision, medicines or memory. Therapy and home changes help, but when falls keep happening, the bigger question is whether your loved one has enough supervision. If they can't reliably use a walker, manage medicines or get help after a fall, they may need someone with them more of the day, or a move to a place with help on site. A care manager can look at the whole pattern and help your family decide.
Most families focus on the injury after a fall: the bruise, the stitches, the X-ray. Unicity Care Management care managers ask a different question first. How many falls has there been in the last six months?
The answer usually tells us more than any single fall does. This article explains why falls happen, why they tend to repeat, and how to tell when the plan needs to change.
Why do older adults fall?
Falls usually come from several things at once, not one cause. Common ones include:
- weak muscles, especially after an illness or a hospital stay
- balance problems
- numb feet from nerve damage
- vision changes
- side effects from medicines
- blood pressure that drops when standing up
- memory or thinking changes
- hazards at home, like rugs, stairs or poor lighting
Fixing one of these lowers the risk. When several are present, the risk stays high even with therapy. The CDC reports that more than one in four older adults falls each year, and that falls are the most common cause of traumatic brain injuries in older adults.
Why do falls tend to repeat?
The pattern often goes like this: a fall, an emergency room visit, a hospital stay, a few weeks of rehab, then home. Within weeks, another fall.
Each hospital stay leaves an older adult a little weaker and often more confused. Rehab rebuilds strength, but it doesn't change who is around when your loved one stands up at night.
When do falls point to a supervision problem?
Falls are telling you something bigger when:
- there has been more than one in a few months
- your loved one can't remember how a fall happened
- medicines aren't taken the same way every day
- balance is still poor after therapy
- your loved one won't use a walker or cane
- help at home is on and off
At this point, grab bars and night-lights still matter, but they aren't enough. The question becomes how much of the day your loved one needs someone nearby.
How do memory changes affect fall risk?
Even mild memory or thinking changes raise fall risk. They can affect:
- noticing hazards
- knowing personal limits
- remembering to use a walker every time
- taking medicines on schedule
- making safe choices when tired
Falls sometimes show up before anyone has a dementia diagnosis. If your loved one is falling and seems more forgetful, mention both to the doctor.
What's the risk of waiting?
It's natural to treat each fall as a one-time event. But each one carries a risk of a broken bone or a head injury. Some people become afraid to move after a fall, which makes them weaker. The next fall can be the one that causes a permanent loss of independence.
The CDC also notes that fewer than half of older adults who fall tell their doctor. Ask your loved one directly, and ask whoever helps them.
Is more help at home enough, or is it time for assisted living?
Ask:
- Is someone available during all waking hours?
- Is someone needed overnight?
- Can caregivers safely help with getting up and moving?
- Are medicines managed the same way every day?
- Can the house be changed to match your loved one's needs?
For some people, home care aides make home safe again. For others, assisted living, with caregivers on site day and night, is steadier. The deciding factor is how reliable the help is, not how much anyone wants your loved one to stay home.
What questions should your family ask now?
- How many falls have happened in the past six months?
- Were injuries avoided by good supervision, or by luck?
- Is the walker or cane used every time?
- Is memory or judgment part of the picture?
- Can the current help at home keep going for the long term?
The CDC's fall prevention resources include a short online checkup your loved one can take with you.
How can a care manager help?
A Unicity Care Management nurse or social worker can assess your loved one's fall risk, review medicines with the doctor and pharmacy, check the house and recommend the right level of supervision. If assisted living makes sense, our Placement Services are free to families.
Our goal isn't to take away your loved one's independence. It's to keep a fall from taking it away first.
Key points
- Two or more falls in a few months usually means something has changed.
- Falls come from several causes at once: strength, balance, vision, medicines, memory and the house.
- More than one in four older adults falls each year, according to the CDC.
- Rehab rebuilds strength. It doesn't add supervision.
- Choose between home care and assisted living based on how reliable the help is.
Talk it through with a care manager
If you aren't sure what your loved one needs next, a care manager can help you sort it out before decisions get made under pressure.
Schedule a Free ConsultationQuestions families ask
Should every fall be reported to the doctor?
Yes. Even a fall without an injury can point to a medicine problem, an infection or a change in balance. The CDC notes that fewer than half of older adults who fall tell their doctor.
Can medicines cause falls?
Yes. Some medicines cause dizziness, sleepiness or a drop in blood pressure. Ask the doctor or pharmacist to review every medicine your loved one takes.
Will a medical alert button solve the problem?
It helps your loved one get help after a fall. It doesn't prevent falls, and it only works if your loved one wears it and remembers to press it.
My loved one refuses to use a walker. What can we do?
This is common. A physical therapist can make sure the walker fits and is the right type, and a care manager can talk with your loved one about what matters to them.
Does assisted living prevent all falls?
No setting can prevent every fall. Assisted living means help is close by, falls are noticed sooner and medicines are managed the same way every day.
Please note: This article is general information, not medical, legal or financial advice. Coverage rules and eligibility change and differ by state. Talk with your loved one's doctor, an elder law attorney or a financial professional about your family's situation. If your loved one is in danger right now, call 911.
Sources
- Facts About Older Adult Falls, Centers for Disease Control and Prevention
- About Older Adult Fall Prevention, Centers for Disease Control and Prevention
