OsteoEd

Common Questions

What interventions prevent falls?

Here is a mnemonic to help remember interventions that can prevent falls:

Click on any of the interventions above to learn more about them.

Shoes Good shoes should:

  • Be easy to tie securely
  • Be flat-soled (no high heels)
  • Have non-skid traction with a wide base

Alcohol (Avoid)

  • Alcohol adversely affects both alertness and balance.
  • Even light alcohol should be avoided if a patient is at high risk.

Visiting Nurse

  • Order a home visit to evaluate the following:
    • Floors Tack down loose throw rugs and secure electrical cords.
    • Lighting Provide better lighting in stairs and hallways.
    • Stairways Secure slippery runners and loose banisters.
    • Bathroom Add grab bars near toilet and bath, floor mats, and shower chair.
    • Kitchen Assess for slippery wax on floors and whether things are easy to reach.
  • Home safety assessments have been proven to reduce falls (1).

Eyesight

  • Poor visual acuity causes falls.
  • Bifocals are especially dangerous.

Sedatives (Avoid)

  • Use of sedatives can increase the risk of falls significantly (6).
  • Benzodiazepines are the biggest offenders.
  • Also beware of muscle relaxants and pain medications.

Balance

  • Consider a physical therapy evaluation.
  • Consider whether a cane, a walker, or balance training is needed.

Orthostasis

  • If patients have orthostasis, instruct them to sit on the edge of the bed for 5 minutes before rising.
  • Is it possible to stop anticholinergics?
  • Is it possible to decrease blood pressure medications?

Night Lights

  • Are there night lights in the home?
  • If not, there is even more chance that a visiting nurse home visit will help.

Exercise

  • Weight-bearing exercise increases bone density (2).
  • Exercise has been proven to reduce falls (3).
  • Exercise programs are cost-effective (4).
  • Tai Chi has been shown to prevent falls (5).
  1. Cumming RG, Thomas M, Szonyi G, et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: A randomized trial of falls prevention. J Am Geriatr Soc 1999; 47(12): 1397-402.
  2. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. JAMA 1994; 272(24): 1909-14.
  3. Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA 1995; 273(17): 1341-7.
  4. Rizzo JA, Baker DI, McAvay G, Tinetti ME. The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care 1996; 34(9): 954-69.
  5. Judge JO, Lindsey C, Underwood M, Winsemius D. Balance improvements in older women: Effects of exercise training. Phys Ther 1993; 73(4): 254-62; discussion 263-5.
  6. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: A systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 1999; 47(1): 40-50.
Last updated 2006-07-30