Falls

Falls are the leading cause of injury and accidental death in older adults. According to the Illinois Behavioral Risk Factor Surveillance Survey, persons with disability are at higher risk of injury from falls than persons without disability. In some persons with developmental disabilities, the degenerative changes seen in aging can occur as early as age 35. Therefore, adults with intellectual and developmental disabilities have an even greater risk for falls.

Physical factors related to each individual can increase risk for falls. These include:

• Poor vision
• Poor balance and weak muscles
• Poor judgment in knowing the difference between safe and dangerous activities or conditions
• Medications that cause dizziness, sleepiness, and affect judgment, coordination and balance
• Osteoporosis, a disease that makes bones weak and more likely to break easily

Environmental factors also can increase fall risk. Environmental factors include:

• Slippery floors
• Loose carpets or unstable rugs
• Poor lighting
• Poorly fitting footwear
• Lack of surfaces to grab
• Seat heights that are too low, including beds, chairs and toilets
• Assistive devices that have worn tips or structural defects

The best way to prevent falls is to make changes in several areas, including taking a look at what puts you at risk, making changes in the home, physical therapy/exercise, reviewing medication with your doctor and changing daily activities. The following are tips that may help lower the risk for falls.

• Have good lighting. Use bright light bulbs, and add lights that can be turned on by a switch near the doorway and close to the bed. Another option is to install voice or sound-activated lamps. Keep a flashlight at bedside. Use night lights.
• Keep stairways safe. Be sure that stairwells are well lit and have handrails on both sides. Fluorescent tape may be placed on the edges of the top and bottom steps. 
• Keep bathrooms safe. Install grab bars beside tubs, showers and toilets. Use a rubber bath mat in the shower or tub. Consider using a shower chair in the shower. 
• Keep rugs in place. Check that all carpets and rugs have skid-proof backing or are tacked to the floor, including carpeting on stairs. Place non-skid mats or carpet on all surfaces that may get wet.
• Avoid clutter. Keep rooms free of clutter, especially on floors. Keep cords and wires out of walkways. Arrange your furniture and other objects so they are not in walkways.

• Be careful to avoid things that cause dizziness. Some medications cause dizziness, and certain drugs may interact and increase fall risk. Being very cold or very hot can cause dizziness. Getting up too quickly can cause blood pressure to drop causing a person to feel faint. 
• Have eyes and hearing tested often. Even small changes in sight and hearing can put a person at risk for falling. Take time to get used to new glasses.

• Use assistive devices, if needed. Use a cane, walking stick, or walker for balance when walking. Use a shoulder bag, fanny pack, or backpack to leave hands free. Use a reach stick to reach things that are too high. If a step stool must be used, make sure it is stable and has a handrail on top.
• Keep things handy. Keep objects that are used often within easy reach. Keep a telephone nearby. Consider purchasing a portable phone that can be taken from room to room. 
• Wear proper shoes and clothing. Wear rubber-soled, supportive, low-heeled shoes, even at home, to avoid slipping. Do not walk in socks, stockings or backless slippers. All footwear should fit well and be slip-resistant. Ensure that clothing is not too long or too loose. 
• Look for differences in floor or ground levels. When outside, 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.
• Avoid wet or icy surfaces. Walk on grass when sidewalks are slick. Spread salt, sand, or kitty litter on icy areas by doors.
• Get plenty of sleep and limit alcohol. A person who is sleepy is more likely to fall, and even a small amount of alcohol can affect balance and reflexes.

The National Center on Physical Activity and Disability recommends balance training and flexibility exercises to reduce the incidence of falls among people with disabilities. It is important to stay physically active. Regular exercise makes muscles stronger and helps keep joints, tendons and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis. A person should always check with a physician before beginning any exercise routine. For more information on exercises that can help with balance and flexibility to reduce falls, visit the National Center on Health, Physical Activity and Disability web site (see RESOURCES in the right-hand column) or call 800-900-8086 (voice and TTY).

For more information also visit the National Center for Injury Prevention and Control (see RESOURCES in the right-hand column) or call 800-232-4636 or 888-232-6348 (TTY).

To learn more about the Illinois Disability and Health Program, or to receive this fact sheet in accessible formats, contact the Illinois Department of Public Health, Disability and Health Program, at 217-782-3300, TTY 800-547-0466. 

This fact sheet was supported by Grant/Cooperative Agreement Number U59DD000271 from the U.S. Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

• National Center on Health, Physical Activity and Disability
• National Center for Injury Prevention and Control