Fall Prevention


With declining temperatures and winter coming, it’s a good time to talk about fall prevention, especially when walking outdoors in winter conditions.  According to the National Institutes of Health, almost 1.6 million older adults visit emergency rooms across the United States for fall-related injuries.  The risk of falling increases with age, and with winter conditions.   A fall can lead to injury, functional disability and even death in older adults; complications such as hip fracture, head injury or brain bleeding are of major concerns.  These events lead to emergency room visits, surgery, prolonged rehabilitation and could even result in permanent disability.  Prevention is the key.  and there are actions we can take to reduce the risk of falling ourselves and older family members or loved ones while out and about this winter.

Snow and ice present challenges for all ages, but particularly for older adults.    For example, as we age, we experience vision changes, loss of balance, decreases in sensation in our feet, and take medications that can contribute to dizziness or unsteadiness.  The good news is that there are ways to compensate for these risk factors and help us still get out and enjoy activities no matter the time of year.  Examples include making sure to hydrate and keep your fluids up in case of medications that contribute to low blood pressure, changing positions slowly from sitting to standing then walking is another good tip to avoid dizziness with position changes.  Seeing your eye doctor and keeping glasses up to date and wearing comfortable and low-heeled shoes can help with vision and sensation changes.  Finally, using adaptive equipment such as canes or walkers when prescribed by your doctor or physical therapist will also reduce the risk of falls. 

Regarding the seasonal risks, being aware and taking things slow and carefully in the winter can help prevent falls.  It’s always a good idea to dress for the weather and to consider footwear carefully.  Low, rubber soled shoes or boots will give better traction and prevent falls.  Additionally, taking things slow and allowing extra time is recommended.  Clear walkways or hire someone to help maintain sidewalks and driveways, use sand or kitty litter to help with traction, and use handrails for extra support.  When out for walks, have a phone or watch with calling function to obtain help, just in case.  When not at home and out on errands take care getting out of the car and on sidewalks and walkways where there could be untreated areas.   Avoid carrying too many things and not being able to see where you are stepping.  It the conditions are poor or stormy consider using the now ubiquitous delivery services to bring in groceries, medications or other necessities to avoid being out and about in icy or snowy conditions.  These commonsense tips apply to all of us, but particularly to older adults. 

Being at higher risk of falls doesn’t mean avoiding outdoor walks or activities, in fact staying active and mobile can help prevent falls, as can keeping up your exercise routines as the weather changes.  Consider indoor exercises on stormy winter days and keep those outdoor walks going in the winter with the proper outerwear and footwear when roads and sidewalks are clear again.  Staying flexible and being open to changing routines is key in the winter months to keeping active while staying safe!


Ana Tuya Fulton, MD, MBA is Executive Chief, Geriatrics & Palliative Care at Care New England Health System  and Chief Medical Officer at Integra Community Care Network, LLC.


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