NAELA News: Falls Prevention Conversation Guide for Caregivers

January 26, 2018

Caregivers, let’s talk about keeping you and your family safe and active.

It seems like common sense — everybody falls, no matter what age. However, for many older adults, an unexpected fall can result in a serious and costly injury. The good news is that most falls can be prevented. As the caregiver, you have the power to reduce your loved one’s risk of falling, and your own fall risk as well.

You can be a partner and a participant in falls prevention.

This conversation guide has many purposes. Use this guide as a tool of empowerment in your role as a caregiver. Use it if you or the person you are caring for has had a fall, is experiencing decreased mobility, is unsteady on their feet, or is fearful of falling. When needed, use it to talk with other members of your family or health care professionals about creating a falls prevention action plan.

Many people think falling is common as we age. The truth is, older adults can improve balance and strength. Taking action to address the risk of falling is an important way to stay healthy and independent as long as possible. Falls prevention activities are beneficial to everyone across the lifespan, and they can be fun!

Why is falls prevention important?


  • Falls are the leading cause of fatal and non-fatal injuries for older Americans. 1 in 4 older adults falls each year.
  • Every 11 seconds, an older adult is treated in the emergency room for a fall.
  • Every 19 minutes, an older adult dies from a fall.

Falls result in injuries, such as hip fractures, broken bones, and head injuries. In fact, more than 2.8 million older adults are treated in emergency departments annually because of a fall, resulting in over 800,000 hospitalizations.

The average hospital cost for a fall injury is over $30,000. Falls, with or without injury, carry a heavy burden on quality of life. After a fall, many older adults develop a fear of falling and, as a result, limit their activities and social engagements. Fear of falling can result in further physical decline, depression, social isolation, and feelings of helplessness.

Research has shown that after a care recipient’s first fall, caregivers report a significant increase in caregiver burden, fear of falling, and depression.

Why is this guide important for caregivers?

Caregiving can be a challenging role. Research has shown that the toll on the family caregiver’s health appears to increase over time. If you can prevent a fall, whether it is you as the caregiver, or the person you are caring for, you can save time, stress, and money.

1 in 5 caregivers reports a high level of physical strain as a result of their caregiving duties.

More than 8 out of 10 (84%) caregivers state that they could use more information on or help with caregiving topics.

Caregivers most commonly want information about keeping their loved one safe at home (42%) and about managing their own stress (42%).

A majority of caregivers help their loved one with at least one activity of daily living (59%), most commonly helping their care recipient get in and out of beds and chairs (43%). Three in five care recipients have a long-term physical condition (59%).

Staying healthy as we get older improves our day-to-day life. Those who are less physically active are at higher risk of falling. Strength and balance exercises, properly managing medications, regular vision checks, and making the living environment safer are some of the steps you and your loved one can take to prevent a fall.

The most common risk factors that can result in a fall:

PHYSICAL RISK FACTORS: Changes in your body that increase your risk for a fall

BEHAVIORAL RISK FACTORS: Things we do or don’t do that increase our falls risk

ENVIRONMENTAL RISK FACTORS: Hazards in our home or community

The key is to know where to look.

MUSCLE WEAKNESS, BALANCE, AND GAIT PROBLEMS: As we age, most of us lose some strength, coordination, flexibility, and balance — primarily through inactivity, making it easier to fall.

VISION: In the aging eye, less light reaches the retina, which makes it harder to see contrasting edges, tripping hazards, and obstacles.

MEDICATION USE: Some prescription and over-the-counter medications can cause dizziness, sleepiness, dehydration, or interactions with each other that can lead to a fall.

ENVIRONMENT: Most older adults have lived in their homes for a long time and have never thought about simple modifications that can keep it safer as they age.

CHRONIC CONDITIONS: More than 90% of older adults have at least one chronic condition like diabetes, heart disease, or arthritis. Often, these increase the risk of falling because they result in lost function, inactivity, depression, pain, or use of multiple medications.

Here are some steps you can take to prevent a fall.

Falls prevention is a team effort. There are others who want to help you maintain your and your loved one’s mobility and reduce the risk of falling and injuries. Below are three steps designed to help you most effectively prevent a serious injury, stay healthy, and maintain an independent lifestyle. Use the information gathered in these steps to:

  • Start a conversation with the person you are caring for to determine if they are at risk for a fall.
  • Identify whether you may be at risk for a fall and develop an action plan to ensure you are a strong and healthy caregiver.

Step 1: Is it time to talk about falls prevention?

This checklist will help determine if you or the person you are caring for is at risk for a fall and if further action is needed. It is meant to be answered individually. Answer the questions for yourself first, then answer them for the person you are caring for. An individual score of 4 or more points indicates that person may be at risk for a serious fall in the future.

Step 2: Talk about falls prevention with others.

If you or the person you are caring for is at risk of falling based on the questions in Step 1, the next step is to have a conversation with family, friends, or those in the community who may be supportive. Use the checklist in Step 1 to take notes of your observations and bring them up at doctor appointments or when talking to anyone else who is in a position to help. The table on the right is designed to help start a conversation with the person you are caring for.

Step 3: Develop a falls prevention action plan.

This last step provides seven strategies you can take immediately to create a falls prevention action plan.

Download the complete guide. (PDF, 13 pages)