Staying stable and safe

April 16, 2024
Women doing yoga.
As we age, we lose balance and walk differently. It’s a potent mix that creates potential for falls.

This past September was tough on Lilianne Fuller. She fell twice, the first time breaking her nose and sustaining a mild concussion when, as she was getting out of a car, her feet became entangled with her purse, which she’d left on the floor. 

The second time, she’d just arrived in the Leonardo da Vinci–Fiumicino Airport in Rome for the “trip of a lifetime.” Hurrying to the baggage carousel, Fuller tripped over the lip of a children’s play area. “I literally went airborne,” she says. “It happened so quickly.” 

The Langley, B.C., resident and retired materiel management and finance clerk with Agriculture Canada, fractured a wrist and elbow in the latter fall, although the extent of her injuries wasn’t detected until she got home. 

Fuller has recovered physically, but the accidents, both preventable, “made me much more hesitant when walking, almost a little bit afraid.” 

As a senior, Fuller isn’t alone in suffering the potentially serious consequences of falling. According to the Public Health Agency of Canada, between 20 and 30 per cent of seniors have one or more falls each year and falling is the leading cause of injury-related hospitalizations among those 65 and older. 

A serious fall can result in a diminished quality of life because of pain or long-term disability, loss of independence, including premature admission to a long-term care facility and isolation due to disability or fear of falling again. 

Social costs include not only billions of dollars each year in health-care expenses, but the incalculable losses to our communities when otherwise healthy, contributing people are abruptly sidelined. 

Why do we fall? 

Age brings less muscle mass, reduced balance, poorer vision and slower reaction time, according to José Morais. He’s a professor of medicine at McGill University, director of the university’s division of geriatric medicine and creator of an online exercise program to help reduce the risk of falling among frailer seniors. 

The danger of falling increases steeply as we hit 75 and especially 80, he says, with multiple factors coming into play. “If you lose balance, you have to recover as soon as you can, but if your reaction is delayed you’ll find yourself on the ground.” 

Morais says trying to navigate a cluttered home heightens the chance of falling. Personality can be another pitfall: “Some people keep taking risks. We see men, despite their advanced age, trying to clean gutters.” 

Throw in aching joints that restrict movement, ill-fitting or slippery footwear, cognitive impairment, poor lighting in stairwells or elsewhere and rushing to the bathroom thanks to incontinence, and it’s small wonder more seniors don’t wind up on a downward trajectory. 

Falling isn’t inevitable 

Most falls are both predictable and preventable, according to sources such as the B.C. Injury Research and Prevention Unit. 

To prevent falling, first assess your risk. An online assessment like the one offered by the B.C. unit is a simple, fast tool with yes/no statements such as “I have some trouble stepping up onto a curb” and “I take medicine to help me sleep or improve my mood.” If your score shows you’re at risk of falling, it’s time for action, including speaking to your health-care provider about next best steps. 

Exercise, which does everything from rebuilding muscles, especially in the legs where age-related deterioration is common, to strengthening bones and reducing the risk of a fracture if you do fall, is key to safety. In fact, exercise that improves strength and balance is the single most effective falls prevention strategy, according to the B.C. unit. Just be sure to speak to your doctor before starting an exercise program if you have an underlying medical condition. 

Regular exercise also enhances cardiovascular health, spurs appetite and improves sleep — all important to continuing good health as we age — according to Morais.  “It’s the best pill there is.” 

Exercise programs to reduce seniors’ risk of falling (Fuller has signed up for one) are ubiquitous, from online varieties to free, community-based classes such as the STAND UP! Falls Prevention Program for independently living seniors offered through public health agencies in Ontario and Quebec. Yoga, Pilates and Tai Chi can also improve balance, strength and flexibility. Walking, which costs nothing, is another exercise strategy to combat the risk of falling and provides 80 per cent of the benefits of running, according to Morais. 

Exercise also helps stave off the fear of falling that can grip seniors. As we perceive a loss of steadiness, we move and do less, Morais says. That diminishes strength, balance, flexibility and, as in Fuller’s case, self-confidence, sinking us further into dangerous non-activity. “It creates a vicious circle.” 

Frail seniors can benefit from “safe,” an acronym that stands for “senior adult fitness exercises.” Developed by McGill under Morais’ direction, the online program comprises a series of at-home exercise videos to reduce the risk of falling. The program decreases falls by up to 40 per cent, Morais says. 

Falls-proofing the home 

Our homes can be a minefield of falls hazards. Scatter rugs with toe-snagging fringes (we don’t lift our feet as high when we age); bathtubs and showers without grab bars; an ancient step stool with no safety rail; poorly lit stairwells — they’re all accidents waiting to happen. 

For more tips on fall safety at home, check the Veterans Affairs Canada guide.

If you do fall, take your time getting back up. Call for medical assistance if you are hurt or can’t get up. And tell your doctor about the fall in case there’s a medication or other issue. 
For Fuller, falling was a wake-up call to be more aware of her surroundings and slow down. “I’m 68 and I’ve got a lot more years left, I hope. I travel and I want to be physically active, so I figure I better be doing that on two feet, not four.”

Fall prevention resources 

BC Injury Research and Prevention Unit
National Institute on Aging
Safe: Senior adult fitness excercises
Parachute, Canada's national charity dedicated to injury prevention
Veterans resources

Five days to preventing falls

Monday: Ditch slippery footwear in favour of anti-slip slippers, shoes and boots. 
Tuesday: Schedule an eye exam. Age-related conditions such as macular degeneration can reduce visual acuity and increase the danger of falling. 
Wednesday: Check medication for side effects, including dizziness and sleepiness, that increase the risk of falling. Talk to your doctor if the side effects concern you. 
Thursday: If you use an electric toothbrush, improve your balance by standing on one foot with the other leg raised at a 90-degree angle. Alternate legs every 30 seconds. Make sure you have something to grab if you start to topple. 
Friday: Do you have a healthy diet and drink plenty of fluids? That will help maintain muscle strength and strong bones and ward off dizziness and lack of co-ordination.

This article appeared in the spring 2024 issue of our in-house magazine, Sage. While you’re here, why not our back issues too?