The risk of getting harmed from a fall increases as we get older, and after becoming 75, the risk of ending up with significant injuries is even higher. The problem of falling in elders is so common that every year on September 22nd, the first day of fall, the National Falls Prevention Awareness Day takes place. The purpose of this special day is to increase awareness and discussion about how to prevent and reduce falls among elders and their caregivers. 
The following includes 10 key strategies to get you started. The more strategies that you or a loved one incorporates into his or her daily life, the greater the reduction in fall risk.

1. Exercise Regularly
To prevent falls, a combination of strength and balance training is recommended. Yoga, Thai Chi and ballroom dancing are additional exercises that help maintain balance. 

• Exercises should be done on a regular basis; approximately 3 to 4 times per week (at least an hour per session). 
• To avoid injury, always check with the doctor before engaging in an exercise program. It’s also important to not over exert during exercise; if you experience any excessive muscle soreness or tiredness, it’s probably your body telling you to cut back.
• For elders with diseases (such as diabetes, stroke, Parkinson’s disease, arthritis, etc.) having a physical therapist recommend and monitor a specific exercise program is advised; this can help avoid injury as well.

2. Eat a Balanced Diet
A healthy diet reduces the risk of certain diseases (high blood pressure, stroke, heart disease, osteoporosis, diabetes, etc.) that are associated with increased fall risk. 

• Foods low in fat but crammed with vitamins, minerals and protein, such as fresh fruits and vegetables and lean meats are recommended. 
• Nutritional and vitamin supplements are beneficial in elders with specific health conditions. Taking any type of supplement should be done only under the guidance of a doctor or qualified nutritionist. 

3. Wear Sensible Shoes
Paying attention to the type and fit of footwear is important, as footwear can either interfere with or support safe walking and balance. 

• All shoes and slippers worn by elders should fit properly (i.e., not too tight or loose) and their soles should be slip resistant. In general, stability is improved with shoes that have a thin and firm sole. Footwear with thick soles, such as sneakers or running shoes, can interfere with safe balance.   

4. Take Time for Friends
Social isolation is associated with feelings of depression, anxiety, etc, which in turn increases one’s risk of falling. 

• Socializing is a way of preventing loneliness, depression, etc. Spending time with friends is a strong factor in protecting elders from falling. There is no magical number of hours or days of the week for socializing; the most important aspect is that you like the person (s) and activity. 

5. Do Home Safety Checks
Up to 50% of falls occur because of hazards in the home, such as poor lighting, slippery floor surfaces, sliding rugs, etc.

• The best way to evaluate the safety of the environment is to observe the elder as they walk about, climb stairs/steps and transfer (from beds/chairs/toilets, get in/out of tubs/showers, on/off toilets, etc.) and notice whether the environment interferes with safe walking, balance and transfers.
• It’s especially important to remove any clutter from walkways and stairways. Clutter in one of the most common causes of tripping, loss of balance and falling.

6. Have Vision Checks
Poor vision is a significant risk factor for falls and hip fractures. 

• Elders should have their vision checked at least annually, but certainly right away if they’re experiencing a problem with their vision.
 
7. Be Aware of Your Medications
Medications (both prescription and over-the-counter) are one of the leading causes of falling. The risk is greatest in those elders with multiple chronic diseases who are taking multiple medications; adverse effects are the result of side effects from a single drug or drug-drug interactions. Here are 3 important tips: 

• If you have multiple doctors who are prescribing medications, make sure that one doctor takes responsibility for making sure that your drugs are right and the dosages are correct. 
• When getting a drug prescription from the doctor, ask: What are the side effects I should be aware of?’ and “If I experience a side effect, what should I do?”  
• Purchase ALL drugs from a single pharmacy that has a reliable pharmacist who can provide drug education/instructions and spot any drug problems that may have been missed by the doctor.  

8. Use Mobility aids
Mobility aids, such as canes, walkers, shower/tub grab bars and the like are designed to support one’s balance and help avoid falls.  

• It’s important that elders with functional problems (walking, balance and transfer impairments) use appropriate mobility aids/equipment to avoid falling. Physical and occupational therapist are good sources of information about mobility aids.

9. Know Why You’re at Fall Risk 
Falls have many causes. Being aware of why you are at fall risk is vitally important. 

• If you’re experiencing problems with walking and balance, have your doctor perform a fall risk assessment to find out why and what specific preventive measures to take. 

10. Ask Why Your Fall Happened
Having one or more falls is the greatest predictor of future falls. 

• In order to prevent the next fall from happening, it’s important that doctors know the circumstances of your fall. It’s helpful to provide the doctor with the following information: When did the fall occur (date/time of day)?; Where did the fall occur (bedroom, stairway, bathroom, etc.)?; What were they doing at the time of the fall (walking, reaching/bending, transferring off the toilet, etc.)?; and Any symptoms just prior or at the time of the fall (tripping, dizziness, difficulty seeing, etc.)? Armed with this information, the doctor will be better able to help find out why you fell and how to best avoid any more falls.    

Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. To learn more, check out the Doctor’s professional profile on LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Tideiksaar at drrein@verizon.net