Protect Your Independence: Create a Fall Prevention Plan
by Audrey Demmitt, RN, VisionAware Peer Advisor
My vision loss has caused me to fall many times in the past. As I get older, this concerns me because I realize the potential for serious injuries. So, I decided to attend a workshop on Fall Prevention. Below are some highlights of what I learned.
Falls Are Not a “Normal” Part of the Aging Process
Many people fear falling as they age, especially if they are experiencing vision loss. Falls are common among adults aged 65 and older, with one in three experiencing a fall each year. Additionally, older individuals who are blind or have low vision are twice as likely to fall as their sighted peers (About Vision Impairment and Falls Among Older Adults | Vision and Eye Health | CDC).
Falls seriously threaten your health and well-being and can result in fractures, head trauma, and even death. A fall can land you in the hospital or a long-term care facility at great cost, threatening your independence. Falls are costly. According to the CDC, annual medical costs of falls related to older people are about $50 billion, but falls are not a “normal” part of the aging process. They are preventable.
Falls are such a great problem among older people that fall prevention experts came together to devise the 2025 National Falls Prevention Action Plan. The plan includes several references to ensure the inclusion of older people who are blind or have low vision, or their representatives, in planning fall prevention actions.
What Is a Fall?
According to the World Health Organization, a fall is any event when a person inadvertently comes to rest at a lower level, against a supporting surface, or on the ground. It happens when there is an unexpected change of position or loss of balance.
Three Questions to Consider:
- Have you fallen in the past year?
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
According to the Centers for Disease Control and Prevention (CDC) and their STEADI program (Stopping Elderly Accidents, Deaths and Injuries), answering “YES” to any of these questions means you are at increased risk for falls. STEADI was created for healthcare providers who work with older adults at risk of falling or who may have already had a fall. They offer provider training, a stay independent brochure, which has a checklist to reduce falls, and many other resources. Encourage your health care provider to check it out.
What Are the Risk Factors for Falling?
Research indicates that multiple interacting factors contribute to an increased risk of falls.
Senior man with stick falling down stair
Personal risk factors include:
- Difficulty with walking or balance
- Heart rate or rhythm problems
- A history of falls and/or a fear of falling
- Taking multiple medications (4 or more)
- Health conditions such as arthritis, stroke, diabetes, and vision problems
Environmental Conditions Contribute to Increased Fall Risk
Most falls happen due to home hazards such as:
- Inability to detect drop-offs
Actions You Can Take to Protect Yourself
The fear of falling can diminish your ability to live an active life. It can lead to less mobility, isolation, and physical decline. The following twelve actions can alleviate this fear of falling and prevent falls.
1. Begin by talking to your healthcare provider, who can help assess your risk of falling and recommend ways to reduce it.
If they do not ask about your fall history, bring it up yourself. Inform your healthcare provider if you have experienced a fall or are concerned about falling. They can order physical therapy and/or an occupational therapy evaluation to assess your strength, balance, and home safety issues if needed. These professionals can review your home for fall risks, design a training program, and suggest changes to help reduce your risk of falls. You may need to request these evaluations; most insurance plans cover these services.
2. Review your medications with your healthcare providers.
Know why you are taking each drug and the correct doses. Be aware of common side effects, such as drowsiness or dizziness. Ask to be prescribed the lowest dose possible and discuss whether any medications can be discontinued. Take your medicines as prescribed and report any side effects. Check with your provider before using herbal and over-the-counter products.
3. Engage in healthy movement.
Regular exercise improves muscle strength, balance, coordination, and flexibility. Strong core and leg muscles have an “anti-gravity” effect, protecting us against falls. Activities like walking, water classes, tai chi, Pilates, and yoga improve your overall condition and go a long way toward preventing falls. Suppose you have other medical conditions that limit your ability to participate in such activities. In that case, a physical therapist can help create a custom exercise program aimed at improving your balance, strength, and gait. Ask your healthcare provider for a referral to physical therapy.
4. Wear sensible shoes.
Evaluate your footwear for safety. High heels, loose slippers, slide-in styles, and shoes with slippery soles can cause you to stumble and fall. Do not go barefoot or walk in stocking feet. Choose properly fitting, supportive, and non-skid shoes to reduce the risk of falls.
5. Have your vision and hearing checked.
Changes in vision and/or hearing can impact your balance and increase the risk of falls. Discuss with your healthcare team any conditions you have that affect these senses.
6. Consult with a vision rehabilitation therapist and/or audiologist.
Learn strategies to keep you safe. Obtain the necessary equipment, such as a hearing aid.
7. Make modifications in your home environment to reduce fall hazards.
Many simple changes can be made to improve your independence. Learn ways to reduce clutter, maximize lighting and contrast, make necessary repairs, and reorganize your space. Check out VisionAware’s home modification section for suggestions, and try our home survey checklist. Consider obtaining a home assessment from an occupational therapist or a vision rehabilitation therapist for individuals with significant needs.
8. Light up your home.
Aging and low vision often require increased lighting. Add additional lighting in hallways, stairways, and outdoor walkways. You may need to use the highest safe wattage in fixtures. Place nightlights in the bedroom, hallways, and bathroom. Be aware of glare issues that can obscure your vision. Discover more about lighting in the home.
9. Use a mobility cane.
If you are blind or have low vision and do not use a cane, consider orientation and mobility instruction and the importance of using the white cane for fall prevention.
There are many resources to help you prevent falls. Involve family members in a conversation and brainstorm which strategies fit your needs.
Some programs are offered through the Area Agencies on Aging in each state. “Stepping On” and “A Matter of Balance” are two national evidence-based programs for older adults. The Matter of Balance program has a low vision translation.
12. Consider getting a medical alert device.
Especially if you live alone, consider a medical alert device with fall detection features. Alternatively, Apple watches can also detect falls.
Conclusion
Prevent a debilitating fall. Take steps to eliminate the fear of falling, allowing you to live safely and confidently. The saying “An ounce of prevention is worth a pound of cure” by Ben Franklin is certainly true when referring to a fall. Make a plan to practice fall prevention and protect your independence.
Learn More
Fall Prevention: Now Is the Time to Take Action – ConnectCenter
Six Steps to Prevent a Fall
Older Adult Falls | Fall Prevention | Injury Center | CDC
Mayo Clinic Fall Prevention
The Best Medical Alert Systems with Fall Detection (2025)