Fall Prevention for Seniors: The Fall Risk of Stairs

fall prevention

Canada’s population is aging, and over the past decade, the number of over 65-year-olds has increased from around 5 million to 6.8 million. By 2036, experts predict that the number of seniors will reach 10.47 million… the vast majority of whom plan to age in place; to stay in their homes for as long as possible.

The problem is, most homes were not designed with elderly occupants in mind and can pose a serious risk of falling. Falls are, in fact, the leading cause of injuries at home, resulting in 85% of injury-related hospitalization of seniors and 95% of all hip fractures.

Where do elderly falls occur?

Unsurprisingly, stairs are the most common places where falls occur (25.7%), followed by the bedroom (14.8%) and the bathroom (14.4%). Every year in Ontario alone, falls on stairs account for almost 25,000 emergency department visits and around 5,000 hospitalizations. However, falls on stairs are preventable with some fall risk assessment, planning and possible modifications.

Why are stairs a fall risk?

So, we know stairs are where we are most likely to fall, but let’s look at why. According to experts, there are three main factors.

Firstly, and perhaps most typically, are what professionals call behavioural factors. That includes not concentrating on the stairs, carrying something, running, wearing unsuitable footwear or being unfamiliar with the stairs.

Next, there are environmental factors. Here is where the design and maintenance of the stairways may affect the user. Think of the handrail, does it offer support? Is it well positioned? What about the lighting on and around the stairs? Is it bright enough to see clearly? And have a close look at the top and bottom stairs – these are often a different height to the others, which could lead to a misstep if you’re not paying attention. 

The final contributing factor would be related to the user’s health. Someone who has reduced vision or an inactive lifestyle, or if they are feeling drowsy, weak, or dizzy, may be more likely to fall.

Should Seniors Stop Using Stairs?

In short: no. Unless problems with mobility mean they pose a risk, or a doctor advises you not to use the stairs due to any health issues. Although stairs can be a hazard, it doesn’t mean they should be avoided, just that extra care needs to be taken when using them, and seniors may want to consider investing in an aid to give them that bit of extra support.

There are, in fact, health benefits of using stairs. Climbing up and down the stairs counts towards the 30 minutes of recommended daily physical activity. It also builds up leg power, which can help older people maintain their muscle mass and ease of movement. So, as long as any fall risks are assessed and reduced, using the stairs can be beneficial.

What Can Be Done to Overcome Fall Risks?

The risk of elderly falls can be minimized by carrying out a fall risk assessment and making modifications to the home as well as behaviour. First, let’s look at what measures can be taken to make a home more accessible for seniors. Small changes throughout the property such as lowering light switches as well as shelves and cupboards or adapting bathrooms by adding grab bars or installing a walk-in bathtub can certainly make a home more accessible. 

For stairs, there are several options. A lift device such as a stairlift or a home elevator can be particularly useful for seniors with reduced mobility. A new product called the Assistep has been widely accepted as a means to bridge the needs of those requiring a little more help on the stairs, www.assistep.ca.
Other smaller modifications include adding a second handrail or installing visual contrast strips at the edge of the stairs. Consulting with an occupational therapist who can advise on what modifications are most suitable for each individual case is also recommendable.

To reduce fall risks based on behavioural factors, stairs must be used with care. The environment around stairs should also have good lighting, and stairs should be free of any obstacles. Slippers or indoor footwear should be sturdy and have good grip and seniors should avoid carrying too much so that handrails can be used for extra support.

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