Falls are a major cause of injury and death among elderly people. In fact, the older the person, the more likely he is to die of a fall or its complications. In people age 75 or older, falls account for three times as many accidental deaths as motor vehicle accidents.

Factors that contribute to falls among elderly patients include lengthy convalescent periods, a greater risk of incomplete recovery, medications, increasing physical disability, and impaired vision, hearing, or mental status. For example, once impaired, equilibrium takes longer to be restored in elderly people than in younger adults. Naturally, loss of balance increases the risk of falling. Besides causing physical harm, injuries from falls can trigger psychological problems, leading to a loss of self-confidence and hastening dependence and a move to a long-term care facility or nursing home.

Falls may be caused by extrinsic or environmental factors, such as poor lighting, slippery throw rugs, highly waxed floors, unfamiliar surroundings, or misuse of assistive devices. However, they usually result from intrinsic or physiologic factors, such as temporary muscle paralysis, vertigo, orthostatic hypotension, central nervous system lesions, dementia, failing eyesight, and decreased strength or coordination.¹

In a health care facility, an accidental fall can change a short stay for a minor problem into a prolonged stay for serious and possibly life-threatening problems. The risk of falling is highest during the first week of a stay in a health care facility or nursing home. (See Who’s at risk for a fall? page 298.)