Healthy Aging and Fall Prevention

There are many actions you can take to reduce your risk of falling, including physical activity to improve strength and balance, managing medications, eating healthy, using assistive devices, making your home safe, staying socially connected and looking after the health of your feet, eyes and mouth.

Physical activity – improving strength and balance

Exercise is the most effective intervention to reduce the risk of falls among older adults. Exercises that improve strength and balance can significantly improve bone, muscle and neurological weakness. Weight-bearing activities, where you are up on your feet, such as walking, dancing, hiking, golfing, climbing stairs, bowling, gardening and jogging, can all help reduce your risk of falling.

Strength and balance exercise, combines with a multi-component assessment including a medication review, vision screening and physical exam has significantly reduced fall risk and rate in community dwelling older adults. Balance exercises can be delivered in various safe yet challenging ways through home and group exercise programs. Strength training exercises are an integral component of fall prevention. Along with a direct reduction in fall risk, lower limb muscle strengthening exercises are also believed to improve flexibility, functional capacity and balance.

• Adults 65 years or older should get at least 150 minutes of moderate-to-vigorous intensity aerobic physical activity per week
• Exercise programs that include a significant challenge to balance, such as Tai Chi, and consist of more than three hours per week of exercise have greater fall prevention effects than general exercise or strength training alone
• Strength training exercises that have proven to be effective in reducing the risk of a fall include exercises that target lower limb strength which older adults perform as part of their daily activities such as the sit-to-stand exercise.

For your safety, always check with your doctor before starting a physical activity program.

For more information about physical activity, visit Physical Activity or refer to:

• Canadian Physical Activity Guidelines for Adults: 18-64 years
• Canadian Physical Activity Guidelines for older Adults: 65 Years & Older

Medication Safety

• Managing your medications helps to prevent falls. Taking four or more prescription drugs can increase your risk of falling
• Use one pharmacy for all of your medications and keep an up-to-date list of all of your medications with you
• Use a dosette or blister pack to help you organize your pill schedule and keep track of what you are taking
• Be sure to keep a list of all your medications with you, including any over-the-counter medications, vitamins, minerals and herbal supplements
• Review all of your medications with your health care provider or pharmacist annually or whenever you have concerns about your medication; visit Ontario's MedsCheck program to see if you qualify for a free, one-on-one appointment with a pharmacist to review your medications

For more information about medication safety, read the factsheet about Over-the-Counter Medications on the Injury Prevention Resources page.

Healthy eating

• Enjoy eating healthy by including a variety of vegetables and fruits, whole grains and protein-rich foods to help supply the nutrients you need as you age
• Eating a healthy diet of foods with calcium and vitamin D such as lower fat milk, yogurt and/or fortified beverages can build and maintain strong bones and teeth that can help prevent muscle and bone loss which may reduce your risk of falling or breaking your bones. If you are 51 years of age or older, talk to your doctor about taking a supplement with 400 IU (10 µg) of vitamin D every day
• Eat more frequent, smaller meals and snacks throughout the day to keep your energy levels up and reduce weakness, dizziness and fatigue
• Don’t forget to drink water! Your sense of thirst may decline as you age, so ensure that you, drink water often during the day and with each meal and snack. Although water is your best choice, milk, 100% juice, soup, tea and coffee also count towards your total fluids
• Be food safe. As we age, it becomes harder for our immune systems to fight off harmful bacteria, viruses or parasites. Take extra care when preparing, cooking, and storing food to prevent illness and read the Food Safety for Older Adults booklet for more information
• Learn more about eating well by visiting Canada’s Food Guide. You can also visit Health Connect Ontario or call 811 to speak to a registered dietitian for free, confidential advice and information on nutrition and healthy eating

Home safety

Home safety is important to prevent falls as nearly half of falls happen in and around the home. Prevent falls at home in the following ways:

• Remove clutter, keep paths and stairways clear and well-lit
• Remove loose carpets and rugs
• Repair uneven walkways outdoors
• Use proper lighting and nightlights
• Use grab bars or elevated toilet devices in the bathroom
• Take your time, don’t rush and be sure your pets are not underfoot
• Use devices like canes, walkers and wheelchairs if needed. Contact an occupational therapist and physiotherapist for advice on using your mobility device safely

For more information on home safety, read Your Guide to Fall Prevention or contact your Home and Community Care Support Services to inquire about home care services and resources.

Social connectedness

Being socially connected to other people and part of a community is essential to physical and mental health and well-being and can help older adults lead longer, happier lives.

Positive mental health can help older adults cope and recover from difficult stressful life situations, such as a chronic illness. Engaging in meaningful social activities, getting outside and enjoying nature and regular physical activity and having a sense of control over life can improve mental health in older adults

Here are some ways to stay connected to the people in your life:

• Get connected. Meet up with friends, volunteer or join a local community program
• Discover opportunities in your community to join a group and share your skills and experiences
• Manage stress by sharing your feelings with supportive family or friends
• Enjoy a trail walk or visit a park
• Do things you enjoy and that make you feel happy

Talk with your health care provider if you no longer enjoy doing your usual activities or have been feeling sad lately.

Eye Health, Hearing, Oral Health and Foot Health

• Eye health: The risk for developing eye conditions and diseases increases with age and can affect balance and increase the risk of falling. Older adults should visit an eye care professional yearly and with any vision changes to maintain eye health and ensure timely treatment
• Hearing: Age-related changes to the inner ear can affect hearing and balance and increase the risk of falling. Have your hearing checked regularly
• Oral health: Oral health is directly linked to overall health. Poor oral health can lead to poor nutritional intake and increase the risk for falling. Get regular dental checkups
• Foot health: Always wear proper fitting shoes with good ankle and foot support. If you notice any changes to your feet or have difficulty caring for your toenails, consult a health care provider or podiatrist to treat your feet

All adults 65+ should be screened ANNUALLY (or anytime they have a fall) for fall risk. This can be done alone or with a caregiver, community-based program, primary care provider or allied health professional.

Complete the Fall Risk Self-Assessment Tool to find out if you, or someone you know, are at risk of falling.

For a more comprehensive fall risk assessment, including information about risk factors for falls and to learn what you can do to prevent a fall, read Your Guide to Fall Prevention

For information on fall prevention and group exercises, assessment, management and treatment and other resources in York Region, visit falls.centralhealthline.ca

Resources to guide fall prevention decision making for older adults, caregivers, and clinicians

• Older Adult Fall Risk Screening Tool for Clinicians: Tool to customize the approach and guide clinicians through fall risk screening, assessment, intervention and follow-up.
• Which Exercise Program is Best for me?: Resource to guide selecting community-based fall prevention programs and services for older adults.
• Fall Prevention Resource for Adults 65+ and Caregivers: Overview of recommended actions to engage older adults in determining their own fall prevention plan of care.
• Integrated Fall Prevention Clinical Practice Model: Fall prevention model to guide clinicians’ decision-making across the health continuum that includes strategies and resources.

Step Ahead to Fall Prevention in Older Adults

Step Ahead to Fall Prevention in Older Adults is offered as an e-learning or in-person training program for agency staff, personal support workers and caregivers based on fall prevention research and best practice. The training will examine age-related changes and modifiable risk factors associated with falls and will enable participants to incorporate fall prevention strategies when working with older adults. A certificate of participation will be provided upon completion.

e-Learning

This online e-learning module has been developed in partnership between York Region Public Health and Toronto Public Health. This FREE, interactive module can be completed in approximately 90 minutes, and can completed at your own pace Click here to register for e-learning

In-Person

This half day training is facilitated by Public Health Nurses. Participants will examine age-related changes and modifiable risk factors associated with falls that will enable them to incorporate fall prevention strategies when working with older adults. Participants will engage in group learning activities and discussions to strengthen their fall prevention knowledge and skills.

To discuss an in-class workshop opportunity for your group, contact Access York at: 1-877-464-9675 | TTY 1-866-512-6228.

Good health is an important factor for quality of life in retirement. To achieve optimal health, adopt healthy lifestyle choices before and after retirement.

For adults who are thinking about retirement, the Fit to Retire booklet addresses the four health factors essential to chronic disease prevention and fall prevention including: staying connected socially and physically active, healthy eating and stress management.

According to the Public Health Agency of Canada, age-friendly communities are communities that modify, build, and put in place policies, services and structures that support and enable people to age actively. By including older adults in, all aspects of community life, age-friendly communities provide opportunities for people of every age, stage and ability to live safe, healthy, meaningful and active lives in their own community or home.

Features of an age-friendly community may include:

• Green spaces, walkways, pathways and cycling paths that are accessible, clean and safe
• Benches with armrests in public spaces and along pathways and trails
• Public buildings that are well-lit with level entryways and well-maintained pavements that are barrier-free
• Housing and public transportation options for older adults that are affordable and accessible
• Social clubs and programs for older adults that promote social connection and provide opportunities to interact with younger generations
• Walking or Tai Chi groups and access to volunteer opportunities
• Snow and ice removal from entrances, steps and other paved areas
• Longer pedestrian signal crossings at road intersections with visual and audio cues

For more information and to learn what you can do to make your community more age-friendly, refer to the Age-Friendly Communities fact sheet and other age-friendly communities resources found in our Resources section or directly below.

Age-Friendly Resources

• World Health Organization’s Global Age-friendly Cities: a guide
• Checklist of Essential Features of Age-friendly Cities
• Public Health Agency of Canada: Age-Friendly Communities
• Seniors Health Knowledge Network: Age-Friendly Communities Planning Outreach Initiative
• British Columbia Age-Friendly Communities: Age-friendly BC video series
• Creating a More Inclusive Ontario: Age-Friendly Community Planning Guide for Municipalities and Community Organization