This September, many of us returned to school, work, and our familiar routines in the shadow of the ongoing COVID-19 pandemic. But a new normal for many seniors may mean more time alone and inside the home. The home represents the greatest risk for falls, with 6 of 10 falls among seniors happening at home. To mark September’s Falls Prevention Awareness initiatives, I’d like to suggest a few things to look for in order to keep your older loved ones safe at home.

Falls are the most common cause of fatal injury and non-fatal trauma-related hospital admission among older Americans. Each year, 1 in 4 people age 65+ suffers a fall, and 3 million older people are treated in the emergency department from a fall. No matter the severity of the fall, it can result in loss of independence, mobility, strength, and confidence, and can prompt a downward spiral of health.

The pandemic has prompted many of us to opt for virtual rather than in-person family visits, particularly to older loved ones whose health we don’t want to jeopardize. While a virtual visit is good for maintaining connection, you can miss the opportunity to see firsthand how your elder loved one is doing in their environment. How is their balance when they stand up from a chair? Is the path from bed to bathroom clear and free of obstacles? Do they appear to have lost weight or strength?

A professional assessment can help. A home care expert will know what to look for—in both the home environment and in the person—and can educate family members or caregivers on risks and prevention strategies. 

Here are some things you can look for to begin the process, ideally during an in-person visit (following appropriate COVID safety protocols depending on vaccination status).

The environment

Look carefully at the environment and take the following precautions.

  • Keep floors clear of clutter, including throw rugs.
  • Make sure lighting is bright enough and provides proper coverage. Adequate safety lighting is important, too, including nightlights or LED strips under cabinets or on the floor, and lining hallways and doorways. 
  • Look for opportunities to boost safety with additional handrails, including in the bathroom, at doorways, and on stairs (even if it’s only one or two steps).
  • Maintain assistive devices such as walkers or canes, making sure rubber tips are intact and continue to provide proper safety. Investigate whether additional devices would help, including a grabber to pick things up without bending down or a tray affixed to the walker. 

Mobility in action

Try to observe your elder loved one in action, however extensive or limited that action is. 

  • Fear of falling is a risk factor for falling. If you notice a loved one holding on to the wall or overly limiting mobility out of fear, have an open conversation to learn why.
    • Have they had a fall and are reluctant to tell anyone because they worry it will limit their independence? About half of all seniors who fall do not report it to their doctor, according to the CDC, and those who have fallen once are at double the risk of falling again.
    • Do they have a new underlying condition that affects mobility, balance or confidence? Additional patient education might help.
    • Is there a deterioration in strength or vision? These factors could be addressed by an exercise/rehabilitation program or visit to the eye doctor.
  • Are they unsteady when standing up from or sitting down in a chair? Rehab therapists or other home care experts can teach you and your loved one the safest method for this important transition.
  • Using the bathroom during the night can create additional risk, whether because of nighttime lighting or sleepiness. Make sure a path is properly lit, and if one is up many times during the consider a bedside commode to reduce risk of falls.

Overall health

Falls prevention is part of an overall strategy of health and wellness. Health factors that create falls risks include:

  • Medical conditions diagnoses. Cardiac issues could affect stability and balance. Diabetes can cause neuropathy in the feet. Osteoarthritis can cause pain while walking and can alter one’s gait. Make sure you and your loved one are educated on the symptoms of medical conditions at hand and know how to mitigate them. 
  • Vision. Seniors should have their eyesight checked every year, more frequently if warranted. Diminishing or changing vision can lead to falls. 
  • Medications. Certain medications, alone or in combination, can cause sleepiness or dizziness, or can affect strength and balance. Know the side-effects, and take precautions, if necessary.

While the pandemic has had us keeping our distance for more than a year, it has also spotlighted the importance of checking in on one another to make sure we remain as healthy as possible and connected to care. As we begin a return to the new normal, let’s take strategic action to make sure the older, vulnerable people in our lives remain on their feet in the safety of their homes.


  • Jennifer Brullo

    RN, MSN, MBA

    Jennifer Brullo, RN, MSN, MBA, is a Senior Vice President leading the Visiting Nurse Service of New York’s Certified Home Health Agency (CHHA). VNSNY is the nation's largest not-for-profit home- and community-based health care organization. To learn more, please visit or call 1-800-675-0391.