Video: “Fall Prevention 101” by Talking With Docs, featuring Dr. Paul Zalzal and Dr. Brad Weening, orthopedic surgeons.
What This Video Teaches
Two orthopedic surgeons walk through five changes that reduce fall risk. What’s notable is what isn’t on their list: nowhere do they suggest doing less.
They explain why partway through. After a fall, people become afraid of falling. The fear changes how they live — they move less, and being less active makes them less conditioned, which raises their risk of falling again. One of the surgeons calls it a vicious cycle. He describes a patient in his own clinic who fell twice in the six weeks after hip fracture surgery.
That’s the frame for everything below. Four of these five changes remove a hazard. The first one makes you stronger. It’s the most important for exactly that reason.
According to the CDC, more than one in four adults aged 65 and older reports a fall each year, and falling once doubles the chances of falling again. Fewer than half tell their doctor.
What Reduces Risk
- Structured strength and balance training
- A home checked for trip hazards, and shoes that stay on your feet
- A medication review that looks at everything you take together
- Current vision and hearing
- A properly fitted cane or walker, used when it’s recommended
The Five Steps
1. Join a structured exercise program
Action: Look for a falls prevention program near you. These are usually run through hospitals, community centres, or physical therapy clinics, and they’re led by a physical therapist who shows you which exercises and balance drills to do. Many hospitals run one; ask your doctor for a referral.
Why it matters: This is the best-supported intervention in fall prevention, backed by trials rather than a single study. It works on three things at once — strength, mobility, and balance. Balance in particular tends to get neglected in general fitness advice, and it’s the one most directly tied to staying upright.
It’s also the only item on this list that leaves you more capable than it found you. Everything else removes something dangerous. This adds something protective.
2. Assess your home
Action: Walk through each room specifically looking for hazards: throw rugs, extension cords, clutter, pet and grandchild toys, and the transitions between different floor surfaces. Check your staircases — curved stairs, where each step changes depth depending on where you place your foot, are a known problem.
Wear shoes that fasten and stay on. Loose slippers and flip-flops are exactly what they sound like. If you wear laced shoes, keep them tied. If you live somewhere that ices over, treat your own driveway and walkway as a hazard.
Occupational therapists provide formal home assessments, and you may be offered one when leaving a hospital. You can also do a useful version yourself.
Why it matters: These fixes cost you nothing in independence. Removing a rug takes five minutes and changes nothing about how you live. Avoiding the room the rug is in changes a great deal.
3. Review your medications
Action: Ask your doctor or pharmacist to review everything you take — prescriptions, over-the-counter, supplements — in one sitting, as a whole list. Ask two questions directly: which of these raise my risk of falling, and is there anything here I no longer need?
Why it matters: Medications accumulate. They get added one at a time over years, often by different prescribers, and nobody looks at the whole list. Sedatives, sleep aids, and blood pressure medications can all cause dizziness or lightheadedness, particularly on standing up quickly. Interactions become more likely the more medications are involved.
The surgeons single out benzodiazepines, noting these should rarely be prescribed after 65 because the fall risk is so high.
This is the most overlooked item on the list. A loose rug is visible. A prescription written three years ago by a doctor you no longer see is not.
4. Get your vision and hearing checked
Action: Book regular eye exams and keep your prescription current. If you have cataracts, ask whether surgery is appropriate. Have your hearing tested on the same schedule.
Why it matters: Vision is the obvious one — you trip over what you don’t see. Hearing is less intuitive, and it surprises people. Hearing is closely tied to balance and spatial orientation, so hearing loss affects your stability directly, not only your conversations.
5. Use a cane or walker properly if you need one
Action: If a physical therapist or occupational therapist recommends a device, use it. Then get it fitted to your height. This applies to canes, walkers, and crutches alike.
Why it matters: There’s a stigma here, and it does real damage. People refuse walkers because of what a walker seems to say about them — and then a fracture takes far more independence than a walker ever would.
Fit matters as much as use. A badly fitted cane or walker can create as much instability as going without one. Crutches are especially often mis-sized.
One of the surgeons offers a reframe worth keeping: think of a walker the way you think of a shopping cart. Something you lean on, put things in, and take with you.
What NOT to Do
Don’t respond to fear by doing less. This is the trap the surgeons describe directly. A fall produces fear, fear produces caution, caution produces inactivity, and inactivity produces the weakness that causes the next fall. Cutting back on walking, stairs, or outings feels like prudence. It works like risk.
Don’t assume your medication list is safe because each drug was prescribed correctly. Each one may be appropriate on its own. The problem is what happens when four or five of them are in your system together, which may be something nobody has ever assessed.
Don’t refuse a device because of how it looks.
Don’t stay quiet after a fall. Fewer than half of older adults who fall mention it to their doctor. A first fall is exactly the moment to get a medication review and a referral to a falls program — it’s the point where prevention is most useful.
Tips for Success
- Ask your doctor for a referral to a falls prevention program rather than searching alone. Referrals often move faster.
- Do the home assessment with someone else. Hazards in your own home become invisible through familiarity.
- Bring every bottle to the medication review, including anything over-the-counter.
- If a device has been sitting unused in a closet, get it fitted before deciding it doesn’t help. Poor fit is a common reason people abandon them.
When to Seek Medical Help
Get prompt medical attention after any fall involving a blow to the head, or if you can’t bear weight afterward. See your doctor about dizziness or lightheadedness on standing, which is often medication-related and often fixable.
And tell your doctor about any fall, even one that caused no injury and even if you got straight back up. That single conversation is what opens the door to everything on this list.
Senior Health News publishes educational information about fall prevention, home safety, and healthy aging. This article summarizes a video by Talking With Docs and is not medical advice. Talk to your doctor about your own situation.