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Elderly womans feet walking at home with

Steps for strong bones: 5. Home safety and fall prevention

What causes falls?

Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton.  In addition to the environmental factors listed below, falls can also be caused by impaired vision or balance, chronic diseases that affect mental of physical functioning, and certain medications, such as sedatives and antidepressants.  It is important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait, and that they discuss these changes with their doctor. 


Protective responses, such as reflexes and changes in posture that break the fall, can reduce the risk of fracturing a bone.  Individuals who land on their hands or grab an object on their decent are less likely to fracture their hip, but they may fracture their wrist or arm.  Although these fractures are painful and interfere with daily activities, they do not carry the high risks that a hip fracture does. 


Changes in muscle mass and body fat also can play a role in falls.  As people get older, they lose muscle mass because they have become less active over time. The gradual loss of muscle strength, which is common in older people but not inevitable, also plays a role in falling.  Muscle-strengthening exercises can help people regain their balance, level of activity, and alertness no matter what their age. 


Vision changes can also increase the risk of falling.  Diminished vision can be corrected with glasses. Often, however, these glasses are bifocal or trifocal so that when the person looks down through the lower half of her or his glasses, depth perception is altered.  This makes it easy to lose one’s balance and fall.  To prevent this from happening, people who wear bifocals or trifocals must practice looking straight ahead and lowering their head.  For many other older people, vision changes cannot be corrected completely, making even the home environment hazardous.

Home safety = Preventing falls = preventing fractures

A senior woman fell to the ground, She h

Preventing Falls Indoors

  • Be careful on highly polished floors that become slick and dangerous when wet.

  • Use plastic or carpet runners when possible.

  • Keep rooms free of clutter, especially on floors.

  • Keep floor surfaces smooth but not slippery.

  • Wear supportive, low-heeled shoes even at home.

  • Keep electrical and telephone cords and wires out of walkways.

  • Avoid walking in socks, stockings, or slippers, unless they have rubber soles.

  • Be sure carpets and area rugs have skid-proof backing or are tacked to the floor.

  • Be sure stairwells are well lit and that stairs have handrails on both sides.

  • Consider placing fluorescent tape on the edges of the top and bottom steps.

Preventing Falls Outdoors

  • Use a cane or walker for added stability, especially in bad weather.

  • Wear rubber-soled shoes for traction.

  • Walk on grass when sidewalks are slippery.

  • In winter, use salt or kitty litter to sprinkle on slippery sidewalks.

  • Identify community services that can provide assistance, such as 24-hour pharmacies and grocery stores that take orders over the phone and deliver.  It is especially important to use these services in bad weather.  ‘Use a shoulder bag, fanny pack, or backpack to leave hands free.

  • Stop at curbs and check their height before stepping up or down.  Be cautious at curbs that have been cut away to allow access for bikes or wheelchairs.  The incline up or down may lead to a fall.

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