Day-to-Day Care


General:  Fall Prevention




A fall occurs when there is an unintentional change in position resulting in landing on the floor or ground.  It is often the result of cumulative risk from both physiological and environmental factors.  Physiological factors include normal aging and the presence of acute or chronic conditions.  Environmental factors refer to unsafe surroundings and any events that can trigger a fall, such as improper use of walking aids.


Though fall can happen to anyone, it is more vulnerable to the sick persons and the elders.  The risk of being seriously injured in a fall also increases with age.  Among people 65 years and older, falls are the leading cause of injuries and deaths.  Besides causing physical harm, injuries from falls can also result in psychological problems which lead to a loss of confidence in independent mobility and increasing dependency on others.


Preventing falls begins with identifying the risks While it is difficult to change some physiological risk factors, it is important that caregivers understand how these factors can contribute to the risk.  In contrast, it is easier to control the environmental factors to eliminate or reduce the risk of fall.


Who is at Risk?


Anyone with the following conditions has a higher risk of fall:


Age 65 or older

Poor general health with a chronic disease

Muscular weakness particularly of the lower limbs

Decreased sensation in extremities such as stroke

Gait and balance disorders

Failing eyesight

Hearing impairments

On medications such as anti-hypertensive and sedative

Altered mental status

Urinary frequency or diarrhea

History of falls


Measures to Prevent Fall at Home


As we know that fall occurs due to various factors, it is important to identify the potential causes so that appropriate measures can be implemented.  Below are interventions to prevent fall at home; some of these measures may be relevant to your care plan:


Identify the risk factors that may contribute to fall.  Alert all caregivers about the person's risk of falling and define interventions you have implemented.

Provide a safe environment at home.  For examples, keep the path from the bed to the bathroom clear of clutter to prevent falls during the night.  If you spills, clean up as soon as they happen to prevent slips.  To learn more on safe home environment, please refer to Room Safety Measures.

Medications often cause fatigue or confusion which increases the risk of fall.  These  medicines include blood pressure pills, heart medicines, diuretics, muscle relaxants, and sleeping pills.  Reinforce the need to rest in bed after taking such medicines.  If you find that your care recipient is extremely 'sleepy' after medications, inform your doctor.  He may want to review the dosages.

Ensure that the person wears clothes that fit properly.  Pants that are too long can cause him to trip.

If the person has frequent urge to eliminate, scheduled toileting routine will prevent him from rushing to the toilet., hence reducing the risk of fall.

Provide the person with a call signal such as a bell if he is not well to move about.  Encourage him to request for assistance whenever needed.  Place his commonly used items within easy access.

To prevent postural hypotension which causes giddiness, especially if the person is taking a blood pressure medication, instruct him to change positions slowly e.g. lying to sitting, and sitting to standing.  A good practice is to sit on the edge of a bed or chair for a few minutes before rising.  This is also helpful to avoid loss of balance.

Instruct the person to ambulate in well-lit areas and to use handrails if needed.  When necessary, accompany him during ambulation.

Provide the person with nonskid footwear.  Replace slippers that have stretched out of shape and are too loose.  Do not allow the person to walk in socks or stockings.

Provide ambulatory aids if the person is weak or unsteady on feet.  Consult your occupational therapist or physiotherapist on the appropriate aids or equipment that would assist the person at home.  Learn and reinforce the correct use of mobility aids and ambulation techniques to the person.

Do not rush the person.  Allow adequate time for him to complete his task.

Encourage the person to perform active range-of-motion exercises to improve muscles flexibility and coordination.  This would reduce his risk of falls as they help to improve his strength and balancing.  However, please seek professional advice prior to commencing any exercises.

Ask your doctor for a referral to an occupational therapist who can help you devise other ways to prevent falls in your home.  Alternatively, you can engage a physiotherapy and occupational therapist to conduct a comprehensive fall risks assessment at your home.  Click here for a list of therapists home visit in Singapore that may also provide fall risk assessment at your home.


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