- About 1 in 3 people over the age of 65 will fall in any one year. Of these, 4% end up in hospital and 1% suffer a hip fracture.
- Falls can have devastating consequences for older adults, particularly those living alone. Along with serious injury or fractures, you face a possible loss of independence and a knock to you confidence.
- Falls are also the leading cause of death from unintentional injury for both males and females aged over 75 years.
- However, there is plenty you can do to reduce your risk of falling.
- You can also make plans for what to do if you do fall and need to get help.
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Key points about falls and falls prevention
- A fall at any age can be dangerous.
- Falls become increasingly common and are far more likely to cause injury after the age of 55.
- Find out about the likely causes of falls, what you can do to help prevent them and how to plan for what to do if you do have a fall.
Some people, especially those who have had a fall, restrict what they do because of a fear of falling. While this sounds sensible, reduced activity actually puts you at a greater risk of falling. This is because it causes you to lose muscle strength and coordination.
So you don't get caught in this cycle, keep up the activities you enjoy and do them as safely as possible. The more you do, the more you can do.
Image credit: Subramaniam et al., 2022
Falls are more common as you get older due to:
- poor leg strength and impaired balance
- side effects from your medications
- other medical conditions
- eyesight problems
- nutritional deficiencies
- hazards around the home environment.
You may not notice some these factors developing. Regular check-ups with your doctor are a good way to spot them.
Each year about one-third of all New Zealanders over age 65 will fall at some time. Many of these falls result in broken bones.
You can play a role in preventing falls by doing taking the following steps:
Regular exercise is important in preventing falls. Benefits include:
- improved balance, muscle strength and flexibility
- stronger bones
- more energy
- better sleep
- better control of blood pressure, blood sugar and weight.
Lack of exercise can lead to weak legs, which increases the chances of falling. Any increased exercise is helpful.
General fitness can be improved by walking for 30 minutes most days of the week (or three 10-minute walks). You should work hard enough to breathe harder, but you should still be able to speak easily. Start with 5 minutes a day and build up if you need to.
Programmes designed specifically for balance and muscle strength have been shown to reduce the number of falls and injuries resulting from falls by between 30% and 50%. Modified tai chi classes are some of the most common ones. Tai chi is a gentle, controlled series of movements that help you develop strength, flexibility and balance. Find an exercise class near you here(external link).
If you at risk of falling, have a mobile phone nearby when you exercise. Please also stop exercising if you feel dizzy or are having chest pain, and rest if you need to.
Talk to your doctor before starting or increasing any levels of exercise if you're unsure.
Read more about staying active over 65.
Image credit: Hora Te Pai Health Services
Be mindful of your medicine
- Medications, or combinations of medications, may have side effects that can increase the risk of falls.
- Ask your doctor or pharmacist to review all your medicines for side effects such as dizziness or drowsiness.
- Ask your doctor if there are medicines any that can be reduced or stopped.
- As you get older and need more medicines, taking them correctly gets harder, so work out a system to make sure you take the right tablets at the right time.
Read more about medicines and falls risk.
Keep your vision sharp
- Poor vision can make it harder to get around safely.
- Have your eyes checked every year.
- Wear glasses or contact lenses with the right prescription strength.
Read more about eyes and aging and eye tests.
Remove hazards at home
- About half of all falls happen at home.
- Make your home safer by reducing tripping hazards and clutter, adding handrails and improving lighting.
Follow the home safety checklist below to make sure your home is safe.
Fall prevention exercises with physical therapist Lora Durkin
(Johns Hopkins Medicine, US, 2019)
'We're not going to take it' - falls prevention
(Northland District Health Board, NZ, 2014)
Staying safe on your feet at home
In this video, learn how to reduce harm from falls by staying upright and on your feet at home.
(Health Quality and Safety Commission, NZ, 2013)
Staying safe on your feet in the community
Thousands of people fall each year. Most of these falls happen in the community and are preventable. This video looks at building strength and flexibility to keep you safe on your feet.
(Health Quality and Safety Commission, NZ, 2013)
Falls prevention exercises
(NHS Morecambe Bay CCG, UK, 2021)
Falls Prevention Exercise Programme
(Belfast Health and Social Care Trust, 2020)
Limited mobility exercise video
(UHD NHS, 2021)
Otago exercise programme
Otago workout 1
(GiveFit, US, 2019)
Otago workout 2
(GiveFit, US, 2020)
Otago workout 3
(GiveFit, US, 2020)
Otago workout 4
(GiveFit, US, 2020)
Say Go - Steady as you go
( Age Concern, NZ, 2020)
About half of all falls happen at home. Make your home safer by reducing tripping hazards and clutter, adding hand-rails and improving lighting. Below are some potential trip hazards at home and how you can overcome them so you are less likely to fall at home.
Credit: Live Stronger NZ
People at risk of falls, or those who have had a fall in the past, may find it useful to have a medical alarm. These can make it easier to remain independent and continue living in your own home, especially if you live alone. They can also offer peace of mind for family members about your ongoing safety.
Medical alarms are usually worn as a pendant or wristband. You can activate the alarm if you have a fall and need medical help but can't get to the phone.
Medical alarms, keeping the phone near ground level and giving friends a spare key are useful precautions you can make in case one day you cannot get up from a fall.
If you have a fall at home stay calm and decide whether to try to get up.
If you can get up:
- bend your knees up, roll onto your side, then push up onto all fours
- crawl towards a sturdy chair
- use this support to help get yourself seated
- rest at any time, if you need to and then try again.
If you can't get up:
- use your medical alarm if you have one
- roll or crawl to the phone on the floor if you don't have an alarm
- if you're outside and don't have an alarm, call out to a neighbour if you can.
If you have had a fall, contact your family doctor (GP) as soon as possible. You must get an assessment of strength and balance to prevent further falls.
You can be referred to in-home or community classes to improve strength and balance. Please ask your GP or nurse for details of these. You can also refer yourself here(external link).
Falls prevention(external link) Age Concern, NZ
Physical activity and exercise(external link) Age Concern, NZ
Slips, trips and falls(external link) National Safety Council, US
Home safety checklist [PDF, 5.5 MB] ACC, NZ
Live stronger for longer(external link) ACC, Health Quality and Safety Commission & Ministry of Health, NZ
Age-related physical activity(external link) Ministry of Health, NZ
Love your independence(external link) Ministry of Health, ACC and HQSC, NZ, 2018
Love your strength(external link) ACC, NZ, 2019
Love your hips(external link) ACC, NZ, 2019 Samoan(external link) Tongan(external link) Chinese(external link)
Home Safety Checklist [PDF, 5.5 MB] Ministry of Health, ACC and HQSC, NZ, 2017
Physical activity for older people (65+)(external link) Ministry of Health, NZ, 2013
Falls hurt – Patient information sheet(external link) HQSC, NZ
Community strength and balance programme workout plans Level 1-2,(external link) Level 3(external link) Age Concern Auckland & Live Stronger, NZ
Mature and moving Sport Taranaki, NZ
- Sit and be fit (Level 1)(external link)
- Chair yoga (Level 1-2)(external link)
- Short Tai Chi routine (Level 2)(external link)
- Easy seated exercises (Level 1)(external link)
- Tai Chi for arthritis (Level 2)(external link)
- A 15 minute standing workout, only equipment needed is a chair and two tins of small bottles of water (Level 3)(external link)
Watch some falls prevention exercise videos above.
Credits: Healthify Editorial Team
Reviewed by: Dr Helen Kenealy, geriatrician and general physician, CMDHB
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