Fear of Falling and Fall Prevention Programs

Falling for the elderly is devastating and has many lasting consequences such as pain, injury, loss of independence, and costly medical bills. In fact, fifty percent of older adults who have fallen in the past year have a fear of falling. In 2005, 15,800 people 65 and older died from injuries related to unintentional falls.

A fear of falling, like most other fears is embarrassing. For this reason, many seniors do not share this fear with their families or doctors. Women are more likely to report a fear of falling, although men are more likely to die from falls.

The Impact of a Fear of Falling

A fear of falling can result in reduced activity.  People who are afraid of falling may completely stop or modify how they do things. These individuals naturally walk more slowly, however are able to walk significantly faster when asked to do so. A consequence of reduced activity is weak muscles, which could lead to or exacerbate a fall.

People of all ages value their independence, but seniors seem to be the only age group at risk of losing their independence because of a fall. In 2009, the CDC reported that people 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.

Muscles weakened due to inactivity compromise social interaction and increase the risk of isolation and depression.  A fear of falling also increases the risk of falling, and causes depression, while  depression and/or anxiety have disruptive affects on quality of life. There are also enormous financial costs associated with falling.

Financial Costs of Falling

Falls are expensive and make up a large component of health care costs. According to a 2009 report by the CDC, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion in 2000. By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars). The average cost of a fall for an older adult totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services. Furthermore, these costs did not include the long-term effects of falls such as dependence on others, lost time from work, household duties, and reduced quality of life.

Fall Prevention Programs


EnhanceFitness is an evidence-based group exercise program for older adults at all levels of fitness to help them become more active, energized, and empowered to sustain independent lives. EnhanceFitness focuses on endurance training, flexibility, balance, and strength training. Six months after the program participants exhibited 10-30% better physical, emotional, and social health scores.


FallProof is another fall prevention program that boosts balance and lowers the risk for falls. Older adults who complete the program demonstrate reduced fear-of-falling and higher physical activity levels. There are three different levels or classes to the program. Mobility I is for the older adult beginning to experience balance problems. The Mobility II program is for the senior who already has a history of falls and requires the use of walkers, wheelchairs and other aids. The third and newest addition to the FallProof program is a water based program. FallProof H2O uses the properties of water to work on balance and mobility. It is for the person who lacks the confidence in balance, or has chronic joint and limb pain.

Matter of Balance

The Matter of Balance program focuses on the fear of falling, and encourages consistent physical movement to reduce the likelihood of falling because of weak muscles.   Participants learn to view falls and fear of falling as controllable, and set realistic goals for increasing activity. Participants also realize ways they can change their environments to reduce fall the risk of falling, and learn simple exercises to increase strength and balance.

Photo credit: Pnikosis

About the Author: Ryan Malone is the founder of InsideElder Care and author of the ByFamilies, For Families Guide to Assisted Living. He regularly speaks and advises families about how to improve their aging loved one’s quality of life. Ryan is also the president of SmartBug Media, a content marketing agency that helps companies increase leads, customers and influence. You can read more from Ryan on the SmartBug Media blog or follow him on Twitter.

  • Stav

    These are some great resources. Thanks for sharing. I also wanted to mention that making your home safe should be a priority for all of us. Visiting Nurse Service of New York's blogger Debbie Stricoff just blogged about it and also shares a “how to” video on how to make your home safer: http://blogs.vnsny.org/2010/06/24/home-safety-month-%E2%80%93-not-just-at-home%E2%80%A6/

  • http://www.lighthousehomecare.com Adams Kirsten

    Fall Detection is even more important. Check out myHalo Monitoring it is the world's most reliable fall detection solution on the market. Our parents no longer need to rely on a button to signal help. Studies have shown that in 4 out of 5 falls, manually activated medical alarms are never activated. for more information about this solution check out the website below.


  • Mike Finn

    My Mom fell, I bought a fall detecter and gps tracker from mainstreetmd; http://www.mainstreetmd.net it works great, anyone with a love one at risk of falling should buy one

  • http://reallivepreacher.com Real Live Preacher

    I tried to send a message. Interested in running some of your content on our website. Really, just article titles with a link to you. If interested, email me at gordon.atkinson@itintegrity.com.au

  • http://twitter.com/RetireAtHome/statuses/19336766734 RetireAtHome (Retire-At-Home)

    Fear of Falling and Fall Prevention Programs http://tinyurl.com/2bfbgab #seniorcare #homecare

  • http://www.safehavenseniorfamilyhome.com Katie

    The fear of elders falling is also a fear for anyone that takes care of an elder. What I have done in my home is used carpet tape on all throw rugs, or larger space rugs. I do go through a lot of carpet tape as it does have to be replaced on the rugs at times, but it has been a blessing, and has even stopped me from tripping over rugs at time. Safe Haven Senior Family Home

  • http://www.caring-for-aging-parents.com Caring for Aging Parents

    Great resources. Our community rehabilitation program runs a falls prevention/agility class for seniors. One of the benefits – aside from improved mobility – is a reduction in fear of falling. Much of my work is focused on falls prevention for seniors in the community and it is a serious, costly issue. Anything that can improve mobility, reduce falls risk and decrease fear of falling is great!


  • FRE

    I am a 72 year olde man.

    This morning before breakfast, I rode my bicycle 30 miles. I've ridden up to 50 miles before breakfast. Does the risk of falling mean that I should stop riding a bicycle?

    I also ride a motorcycle. Last year, I took a 5,500 mile trip on it. Must I also stop riding a motorcycle?

    I also hike in the mountains on very difficult terrain. Should I stop?

    Must I give up things I enjoy doing to reduce my risk of falling?

  • http://www.smartbugmedia.com Ryan @ SmartBug Media

    @FRE –

    Not all, the point is that some people have a real risk of falling and these types of programs can help prevent falls from occurring. When people feel more comfortable about their balance, they have less fear.

  • http://www.myears.com My Ears

    For the elderly who fall and are unable to get up on their own, the period of time spent immobile often affects their health outcome. Muscle cell breakdown starts to occur within 30-60 minutes of compression due to falling. Dehydration, pressure sores, hypothermia, and pneumonia are other complications that may result.

    Make sure you have a plan for when accidents do occur in the home. Personal Emergency Response Systems work great for the independent seniors living on their own. Check out http://www.myears.com

  • Nona91

    In the words of George Bernard Shaw: “We don't stop playing because we grow old. We grow old because we stop playing”.


  • Danielle

    Who has a program that teaches rising from a fall? We need several different modalities to include the obese person, the limited range of motion person, specifically shoulder articulation, and knee challenges, the obese person with limited ROM.

  • Marie

    Thanks for your interesting article. I would be grateful for any advice you or your contributors can give on a relative whose fear of falling due to being dropped accidentally by her care workers when being helped to walk after recovering from a diabetic coma has resulted in her refusing to walk at all. Her health has always been poor. Yet she is only in her fifties and is practically bedridden for the last six months. She seems to have settled into a new way of life in the nursing home and cant do anything for herself. Her family seem to be more concerned about her quality of life than she is. How do we reach her? Are there any exercises which she could do in bed which could help strengthen her and maybe boost her energy and confidence?

  • http://www.smartbugmedia.com Ryan @ SmartBug Media

    My mom had a great therapist that worked with her on it. You might check to see if her primary care doc can recommend some physical therapy for her. They can come to your home. My mom had a similar fear of falling because she was dropped once, and she has worked through that and walks pretty well with a walker now.

  • Marie

    Thanks for your prompt reply Ryan.

  • http://www.facebook.com/SynergyHomeCareGreenwich Synergyhomecare Greenwich

    How surprised would you be to hear that there’s an epidemic among the elderly that is the number one cause of injury and injury related death that could easily be put in check? According to the CDC, “about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls”, “more than 433,000 were hospitalized”, “15,800 died from injuries related to unintentional falls” and these numbers are for 2005. The CDC estimates the annual cost of fall related injuries will reach $54.9 billion by 2020.

    At Synergy HomeCare of Connecticut, we have made it our responsibility to bring this issue to light and address it by offering education, support and preventative measures to minimize falls. The regularity and severity of elderly falls are especially unfortunate when one considers the inexpensive, common sense measures that can be taken to prevent many fall related injuries. There are many obstacles facing the elderly and their families, the fear of falling should not be one of them.

    As you age, falling becomes a more serious problem with increasingly poor outcomes, but falls should not be seen as an issue that only the elderly have to deal with. Fall prevention should be considered part of a healthy lifestyle; the habits you develop now will reduce the dangers of falling as you age. There are a number of preemptive measures you can take to reduce your current and future risk from falls. 

    For example, regular exercise, a balanced diet, frequent medical and vision check-ups and sensible footwear are all vital elements of fall prevention. Healthy habits today lead to a more fulfilling, safer tomorrow, and we strongly believe it’s never too early to start!

    If you or a loved on live in Greenwich, Riverside, Stamford, New Canaan, Darien or Norwalk Connecticut, Please call us for a free in-home safety and fall prevention assessment. You can call us 24/7 @ (203) 661-6969.

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