Older people

How to prevent falls in older people at home

A fall is the thing that most often turns independent living into a hospital stay, and then into a much harder conversation about the future. The good news is that most falls are preventable, and most of the prevention is cheap or free. Here is what actually helps for an older person living at home in Ireland, and how to plan for the fall that happens when nobody is in the room.

Why falls matter so much

Falls are the most common cause of injury in older people, and the effects go well beyond the injury itself. A fall can knock a person’s confidence so badly that they stop moving around, which weakens them further and makes the next fall more likely. Breaking that cycle early is the whole game. The aim is not to wrap someone in cotton wool, it is to remove the avoidable risks so they can keep doing the things they want to do.

Fix the home hazards first

Most falls at home happen for boring, fixable reasons. Walk through the house and deal with these:

• Loose rugs and mats. They are the classic trip hazard. Remove them or fix them down with non-slip backing.
• Clutter on the floor and on the stairs. Clear walkways, and never leave items on the steps to be carried up later.
• Poor lighting. Stairs, landings and the route from the bedroom to the bathroom should be well lit. Movement-activated night lights are cheap and take the guesswork out of a dark hallway at 3am.
• Trailing flexes and phone chargers across a walking route.
• The bathroom. Wet floors and low toilets are a common fall point. Grab rails beside the toilet and in the shower, a non-slip mat, and a raised toilet seat make a real difference.
• The stairs. A secure handrail, ideally on both sides, and a clear step edge you can actually see. If the stairs themselves are becoming the danger, a stairlift removes the risk entirely.

Some of this you can do in an afternoon. The bigger items, grab rails, a level-access shower, a stairlift, are often funded, which we come back to below.

Look after the person, not just the house

The home is only half of it. The other half is the body and the routine:

• Keep moving. Gentle strength and balance activity, done regularly, is one of the best-proven ways to cut falls. It does not need to be a gym. Ask the GP or public health nurse about local strength-and-balance or falls-prevention classes.
• Get eyesight checked once a year. A change in vision, or new glasses that take getting used to, both raise the risk. The Treatment Benefit scheme covers eye tests for many people.
• Review medications yearly. Some medicines, and especially combinations of them, cause dizziness or drowsiness. Ask the GP or pharmacist for a medication review.
• Mind footwear. Well-fitting shoes or slippers with a firm sole and a back to them beat loose slip-ons every time.
• Watch for dizziness on standing. Standing up slowly, and mentioning any lightheadedness to the GP, can catch a treatable cause.

Plan for the fall that happens anyway

Even with everything above in place, falls still happen. The question that keeps families awake is not really “will she fall”, it is “what happens if she falls and I am not there”. It is worth having an honest answer before you need one.

The first step for many older people is the Seniors Alert Scheme, a free monitored pendant alarm for eligible over-65s. Press the button and a monitoring centre answers and calls for help. It is genuinely useful and worth applying for. Its limit is in the name of the problem though: it only works if the person is conscious and can reach and press the button. The falls families fear most, a fall that knocks someone out or leaves them unable to move, are exactly the ones a press-button pendant cannot answer.

That is the gap some families close with a device that does not wait to be pressed. A fall-detection watch that raises the alarm automatically senses a hard fall and alerts a nominated contact on its own, without anyone pressing anything. It is bought privately rather than through any scheme, so the sensible way to think about it is simple: if the worry in your house is “what if she cannot press it”, that is the gap it is designed to fill.

The grants that pay for a safer home

Several of the changes above are funded, so cost need not be the reason they do not happen:

• Housing Adaptation Grant, up to 40,000 euro for stairlifts, level-access showers, grab rails, ramps and larger adaptations, with the percentage covered depending on household income.
• HSE aids, appliances and assistive technology, grab rails, raised toilet seats, walking aids and similar equipment, free on assessed need.
• Mobility Aids Grant, a focused grant of up to 8,000 euro for a specific set of works such as grab rails, ramps and stairlifts.

If you are not sure which of these fits, the grant finder will tell you what the household is likely to qualify for in about a minute.

Common questions