Falls become more common as people age, but they should not simply be dismissed as an unavoidable part of getting older. A fall can affect an older adult’s mobility, confidence, independence and overall quality of life. For someone already living with a serious or life-limiting illness, the effects may be even more significant.

Falls are also extremely common. According to the Centers for Disease Control and Prevention (CDC), more than one in four adults age 65 and older falls each year. Falling once also doubles a person’s chance of falling again. Falls are the leading cause of injury among adults age 65 and older, resulting in approximately 3 million emergency room visits each year.

September brings additional attention to this issue as it is the National Falls Prevention Awareness Month, with a specific Falls Prevention Awareness Week being observed this year from September 21-25th, 2026. The goal is an important one throughout the year: helping older adults, caregivers and families recognize fall risks and understand that many falls can be prevented.

Understanding elderly fall prevention starts with knowing why older people fall, what those falls can mean and how families can reduce risks while still supporting comfort, mobility and independence.

Why Are Falls So Dangerous for Older Adults?

A fall that causes a minor injury in a younger person can have much greater consequences for an older adult. Aging can bring changes in bone strength, muscle mass, balance and recovery time. Chronic or advanced illnesses can make someone even more vulnerable.

Falls can lead to:

• Broken bones and fractures, particularly hip fractures
• Head injuries and traumatic brain injuries
• Increased pain
• Emergency room visits or hospitalization
• Reduced mobility
• Difficulty completing everyday activities
• Loss of independence
• Fear of falling again

The CDC reports that falls are the most common cause of traumatic brain injuries and nearly 319,000 older adults are hospitalized for hip fractures each year.

The effects are not always limited to the initial injury. An older adult who is afraid of falling again may begin walking less or avoiding activities they previously enjoyed. Over time, decreased activity can contribute to additional weakness and reduced mobility, potentially increasing the risk of another fall.

Why Do Elderly People Fall?

There is not one simple answer as to why elderly people fall more often than younger folks. As people age, increasing factors contribute to the likelihood of experiencing a harmful fall. In many cases, several physical, medical, medication-related and environmental factors contribute at the same time.

For caregivers, understanding these risks is an important part of fall prevention for seniors.

Physical and Health-Related Risk Factors

Changes in strength, balance and overall health can make it more difficult for an older adult to safely move around their environment.

The Three Oaks Hospice Care Team identifies several common risk factors to watch out for, including:

• Muscle weakness and general decline
• Impaired mobility or an unstable gait
• Fatigue and low endurance
• Cognitive impairment
• Orthostatic hypotension, or a drop in blood pressure when standing
• Sensory deficits
• A history of previous falls

Vision, hearing and reflexes may also change with age. Conditions affecting the heart, nerves, feet or blood vessels can interfere with balance and walking as well.

Medications and Changes in Health

Certain medications can cause side effects such as dizziness, sleepiness or confusion. For someone who is already experiencing weakness or difficulty walking, those effects may increase the likelihood of a fall.

The Three Oaks fall prevention program specifically identifies medications as a potential fall risk – particularly medications that affect the central nervous system. Medication reconciliation is also included as part of the program’s post-fall evaluation process.

Caregivers should not stop or change medications on their own. Instead, medication concerns can be discussed with the patient’s physician, nurse or hospice care team, which can help coordinate medication and symptom management as part of the patient’s overall plan of care. Learn more about hospice care at Three Oaks Hospice

Environmental Fall Hazards

Sometimes the environment contributes to the problem. Common hazards include loose rugs, electrical cords, clutter, slippery surfaces and poorly lit hallways.

For someone using oxygen equipment, a walker, wheelchair or other medical equipment, keeping commonly traveled pathways clear becomes especially important. Objects that are used frequently should also be placed within easy reach so the person does not have to stretch, climb or walk unnecessarily.

When Elderly Adults Start Falling Repeatedly

One fall does not necessarily mean that an older adult is experiencing significant decline. However, new or repeated falls should prompt a closer look at what may have changed.

Caregivers may notice:

• New or worsening weakness
• Changes in walking or balance
• New medications or dosage changes
• Dizziness or blood pressure changes
• Increasing confusion
• Vision changes
• Greater difficulty getting in or out of a bed, chair or bathroom
• Progression of an underlying illness

Even if there is no obvious injury, tell the person’s health care provider about the fall. The National Institute on Aging recommends reporting falls because they may alert the provider to a new medical concern or an issue involving medications, eyesight or mobility that can be addressed.

For older adults with advanced disease, repeated falls may also be one of several signs that care needs are changing. The care team can evaluate those changes and determine whether additional support is appropriate.

What Should You Do When an Older Adult Falls?

Seeing a loved one fall can be frightening. The immediate instinct may be to help them stand up as quickly as possible, but it is important to first determine whether they may be injured.

Immediately After the Fall

1. Stay with the person and remain calm. Give them a moment to recover from the shock of falling.
2. Do not immediately pull them to their feet. Moving too quickly could worsen an injury.
3. Check for signs of injury. Ask about pain and determine whether they appear able to move safely.
4. Get medical help when needed. If the person appears injured or cannot safely get up, seek help.
5. Notify the appropriate health care or hospice team. For hospice patients, follow the patient’s individualized care plan and contact the hospice team for guidance.

It is important to understand that remaining still briefly after a fall can be vital in determining whether an injury has occurred. If a person is injured, it is best to get professional help before attempting to move them in a way that could cause further harm.

After the Immediate Situation Is Under Control

Rather than treating the fall as an isolated event, consider what may have contributed to it.

Ask questions such as: What was the person doing before falling? Were they dizzy, weak or confused? Did they hit their head? Was there a rug, cord or other hazard nearby? Have their medications changed? Has walking become more difficult? Have there been previous falls?

Those details can help the care team determine whether changes are needed to the environment or care plan.

Fall Prevention Strategies for Older Adults

Effective fall prevention in the elderly is not necessarily about limiting movement. Instead, the goal is to identify risks and make everyday movement as safe as possible.

The following fall prevention strategies are based in part on the Three Oaks Hospice Fall Prevention Kit.

1. Create a Safer Environment

Remove loose rugs, wires, clutter and other tripping hazards. Keep hallways and frequently used pathways open, particularly around medical equipment.

Good lighting is also important. Make sure bedrooms, bathrooms, hallways and stairs are adequately lit, including during the night.

2. Provide Help With Mobility

Some older adults may need help transferring from the bed to a chair, getting into the bathroom or standing from a seated position.

Use walkers, wheelchairs and other prescribed mobility aids correctly. If a person can no longer safely support themselves during a transfer, caregivers should ask the care team for guidance rather than attempting a difficult transfer alone.

3. Keep Everyday Essentials Within Reach

Place frequently used items such as phones, water, remote controls and personal belongings where they can be reached easily.

Comfortable, nonslip footwear can also help provide greater stability. The Three Oaks Hospice Care Team recommends nonslip shoes or socks with grips for patients at risk of falling.

4. Add Safety Features Around the Home

Depending on the person’s needs, safety additions may include:

• Grab bars
• Handrails
• Bathroom safety equipment
• Appropriate mobility or transfer equipment

Bed rails or other bedside supports may be appropriate in some situations, but they are not right for every patient. Talk with the care team before adding them so the patient’s individual mobility and safety needs can be considered.

5. Pay Attention to Changes in the Person

Fall prevention is an ongoing part of caregiving, not a one-time home safety project.

Watch for new weakness, dizziness, fatigue, confusion, changes in walking, medication-related drowsiness or changes in vision. A prevention strategy that worked several months ago may need to change as the person’s condition changes.

Fall Prevention for Older Adults Receiving Hospice Care

People receiving hospice care may experience additional fall risks related to advanced illness, including declining strength, fatigue, cognitive changes, medication effects and reduced mobility.

In hospice, the goal is not simply to eliminate every possible risk by restricting a person’s activity. Care should balance safety with comfort, dignity and the patient’s individual abilities and goals.

A hospice team may help families by:

• Evaluating changes in mobility and fall risk
• Reviewing medications
• Identifying environmental safety concerns
• Supporting safer transfers and mobility
• Updating the care plan as the patient’s needs change
• Helping caregivers understand what to do after a fall

Because hospice care is interdisciplinary, nurses and other members of the care team can communicate about changes and adjust support as the patient’s condition evolves.

Three Oaks Hospice’s Safe Steps, Gentle Care Program

Recently Three Oaks rolled out the Safe Steps, Gentle Care fall prevention approach across select locations to help identify risks, educate caregivers, and support patients if a fall occurs. You can download our fall prevention kit here.

Helping Your Loved One Stay Safe Without Taking Away Independence

Preventing falls does not necessarily mean preventing an older adult from moving.

In fact, becoming excessively fearful of another fall can sometimes cause a person to become less active. Reduced activity can contribute to further loss of strength and mobility, potentially making future falls more likely.

The right balance will be different for every person. Whenever possible, caregivers can support safe movement while providing assistance where it is needed. As someone’s health changes, the amount of support they need may change too.

For hospice patients in particular, decisions about mobility should reflect the person’s condition, comfort, preferences and individualized care plan.

Talk With the Care Team About Fall Concerns

Caregivers do not have to figure out why a loved one is falling or create a prevention plan by themselves.

If your loved one has started falling, seems increasingly weak or has become less steady on their feet, talk with their health care team. Identifying changes in mobility, medications, cognition or the home environment may help reduce risks and make everyday care safer.

At Three Oaks Hospice, our interdisciplinary care teams work with patients and families to provide personalized support centered around comfort, dignity and quality of life. If your loved one is living with a terminal illness and you have questions about hospice care, contact Three Oaks Hospice to learn how our team can help.

Three Oaks also provides specialized resources and support for those who have served.Learn more about hospice resources for veterans.

Frequently Asked Questions About Falls in Older Adults

Why do elderly people fall so often?

Older adults may fall because of several factors working together, including muscle weakness, balance or gait changes, medications, dizziness, cognitive impairment, vision or hearing changes and hazards in the home. A previous fall can also increase the likelihood of falling again.

What happens when an older person falls?

Some falls cause little or no injury, while others can result in fractures, head injuries, pain, hospitalization or reduced mobility. A fall may also cause fear of falling again, which can lead someone to become less active and potentially lose additional strength.

Does falling mean an elderly person is declining?

Not necessarily. A single fall can happen for many reasons. However, new or repeated falls can indicate changes in strength, balance, medications, vision, cognition or an underlying medical condition. Caregivers should report falls to the person’s health care provider so potential causes can be evaluated.

How can you prevent falls in the elderly at home?

Fall prevention for seniors can include removing tripping hazards, improving lighting, installing appropriate grab bars or handrails, keeping commonly used items within reach, using mobility aids correctly and monitoring for changes in strength, balance, medications or vision.

What should you do after an elderly person falls?

Stay with the person and determine whether they appear injured before trying to move them. Get medical help if they are hurt or unable to safely get up. Afterward, notify their health care provider or hospice team and discuss what may have contributed to the fall so future risks can be addressed.