Falls in older adults are one of the most frequent and preventable causes of emergency admissions. In the ER, the typical injuries we see include hip fractures, vertebral fractures, head trauma, and intracranial bleeds — especially in patients on antiplatelets or anticoagulants. Most of these cases share common, modifiable risk factors: poor balance, weak lower-limb strength, impaired vision, neuropathy, polypharmacy, and unsafe home environments.

Prevention — What Families Must Implement

• Adequate lighting, especially in corridors and bathrooms; use night lamps
• Remove loose rugs, clutter, and electrical cords from walking pathways
• Install grab bars in bathrooms; ensure non-slip mats are in use
• Encourage daily walking and simple strengthening exercises (e.g., chair-stands, heel-to-toe walk)
• Schedule vision and hearing checks yearly
• Review medications regularly — sedatives, antihypertensives, and hypoglycaemic agents are common contributors to falls
• Use firm-grip, closed-back footwear; avoid loose slippers

What to Avoid

• Do not allow rushing; sudden postural changes worsen instability
• Avoid wet floors or freshly mopped surfaces
• Discourage climbing stools or makeshift supports
• Do not ignore dizziness, new imbalance, or recurrent minor falls — this warrants medical review

If a Fall Occurs — Immediate Steps

• Do not lift the patient immediately
• Assess airway, breathing, and consciousness
• Look for head injury, vomiting, confusion, slurred speech, limb weakness, severe pain, or inability to stand
• If on blood thinners, any head impact = ER visit
• Suspected hip fracture (leg shortened/externally rotated): immobilize and seek transport; avoid manipulation
• Ice packs only; no massage or heat

Prompt evaluation saves life and function. Preventing falls at home is far safer than treating trauma in the emergency department — invest in prevention, not recovery.