Falls are the leading cause of injury-related hospitalisation for older Australians, and most of them happen at home doing ordinary things: getting up in the night, stepping out of the shower, reaching into a low cupboard.
The useful thing about that is how much of it can be changed. Not all of it. But more than most families expect.
Falls are rarely about one thing
People tend to explain a fall with a single cause: the rug, the dark hallway, the dodgy knee. In practice, falls usually happen when several smaller factors line up. Strength and balance have slipped a little, the light is poor, the medication causes a bit of dizziness when standing, the slippers have no grip, and the path to the toilet at 2am has a step in it.
This is why a proper falls assessment looks at the person and the environment together, rather than just handing over a pamphlet about tripping hazards.
What raises the risk
- A previous fall. The strongest single predictor of a future fall is having had one.
- Reduced leg strength, particularly difficulty standing up from a chair without using the arms.
- Balance problems or unsteadiness when turning.
- Medications. Several at once, or ones affecting blood pressure, sleep or mood.
- Vision changes, including new glasses and multifocals on stairs.
- Foot pain and footwear. Sore feet change how you walk, and slippers are a common culprit.
- Fear of falling. It leads to moving less, which reduces strength, which raises risk again.
- The home itself: steps, poor lighting, loose mats, clutter, no rails where they are needed.
What actually reduces falls
The evidence here is unusually clear, and it is not what most people assume.
Exercise is the strongest single intervention, specifically balance and strength training, done regularly and progressed over time. Walking alone is good for many things but does relatively little for balance. The programs that work challenge balance deliberately and get harder as you improve.
Home modifications work for people at higher risk, particularly where someone has already fallen or has a condition affecting mobility. Rails at the steps, a rail in the shower, better lighting, removing a hobbed shower lip.
Medication review by a GP or pharmacist, looking at whether everything on the list is still needed.
Vision and foot care, both straightforward and both frequently overlooked.
A quick check around the house
- Can you get from the bed to the toilet at night with the lights on the whole way?
- Are there mats that slide, curl at the edges or have a lip?
- Is there something solid to hold at every step or level change, inside and out?
- Can you get out of the shower without holding a towel rail or the tap? Neither is designed to take weight.
- Are the things you use daily between hip and shoulder height, rather than on the floor or above your head?
- Are the shoes worn indoors enclosed, with a back and some grip?
The conversation nobody wants to have
Plenty of people hide a fall, because admitting it feels like the first step toward losing independence. Families often notice bruises before they hear about the fall itself.
It helps to frame it the other way around: the point of the assessment is to keep someone at home longer, not to move them out. A rail and a stronger pair of legs are what independence looks like in practice.
How we help
Our falls prevention physiotherapy focuses on balance and strength with a program that progresses. Our occupational therapy home safety assessments look at the actual house rather than a checklist, and lead into home modifications where they are warranted. Podiatry handles the foot pain and footwear side.
This can be funded through NDIS, Support at Home and aged care packages, or privately. With a GP Chronic Condition Management Plan, standard physiotherapy appointments at our Darra clinic are bulk billed.
Call (07) 3187 5018, or send an enquiry and we will call you back.
General information only. If someone has had a fall with injury, loss of consciousness or repeated falls, see a GP promptly.
