Improperly used, a walker can lead to a fall.

Falls are a huge health hazard for older adults. They are a major reason for hospital admissions and nursing home placements and the leading cause of injury-related death for people over the age of 65.

Most falls occur at home - usually in the bathroom, bedroom or kitchen - says Cleveland Clinic physical therapist Amy Cassady. However, she adds, "Knowing the situations and conditions that put a person at risk for falls, and then fall-proofing the home, will significantly decrease their chances of a fall."

Actions and situations that can lead to a fall:
• Turning quickly
• Reaching or stretching for out-of-reach items
• Walking in a dim-lit area or where the floor is slippery
• Improper use of walkers, canes, step ladders or stools
• Wearing slip-on shoes, rather than those that lace up and have a firm, flexible sole
• Using sleep aids that leave you tired or groggy in the morning
• Taking one or more medications whose side effects/interactions make you unsteady on your feet

Conditions that cause falls:
• Visual problems, especially cataracts and glaucoma
• Diabetes, circulatory or neurological problems that cause loss of sensation in feet and ankles
• Muscle weakness due to de-conditioning that comes with constant inactivity or long hospital stays
• Conditions - a stroke, an inner ear disorder, dizziness - that impair balance or gait
• Conditions - depression, painful arthritis, an overactive bladder - that interfere with getting a good night's sleep

Room-by-room assessment and modifications
Once you know the situations and conditions that can cause falls, do a home assessment and make changes or modifications that decrease their risk. First, make sure that major routes throughout the house are navigable by:
• Tucking/tacking all electrical cords out of the way
• Taking up all throw rugs
• Making sure furniture isn't creating barriers or areas where sharp turns are necessary
• Making sure all rooms are well-lit
• Installing higher-wattage bulbs in hallways
• Getting a cane or walker if necessary

In the bathroom:
• Install grab bars on the wall near the toilet
• Install grab bars in the shower/tub area
• Put non-skid strips or a non-skid mat in the shower/tub area
• Install an elevated toilet seat
• Install a night light

In the bedroom:
• Make sure that the most-used routes - to the door, closet and bathroom - are clutter- and barrier-free
• Install bed rails if necessary
• Install a night light
• Install a pressure-sensitive mat at the side of the bed if there is the danger of "wandering"

In the kitchen:
• Rearrange everything - dishes, cooking spices, pots and pans, etc. - so that the most-used items are within easy reach
• Get a hand-held "reacher"
• Get a footstool with a handhold

In the living room:
• Make sure lamps, the TV remote control, and other "necessities" are within easy reach
• Make sure that seating is firm in at least one chair, and that it has armrests that can be used for "leverage" out of the chair

For stairways and entryways:
• Install higher-wattage bulbs
• Glue non-skid strips to step treads
• Add handrails or make sure those already there are securely attached

Exercise may help
Studies have shown that people who are at risk for falling can benefit significantly from an exercise program that focuses on stretching, strength and muscle building, and balance and gait training. However, stresses Cassedy, "Before beginning a program, whether it's at home on with a group, get your physician's OK."