Fall Risk

What is a fall?

A fall is an unplanned or accidental change in position where you come to rest on the ground, floor, or a lower level. A fall can happen anywhere but often occurs in your home, outside, or in a healthcare setting like a hospital or care facility.

A fall can happen because of external (outside of your body) things, like:

• Tripping over an object or a person/pet.
• Slipping on a rug or wet floor.
• Someone pushing or shoving you.
• An object hitting you.

A fall can also happen because of internal (inside your body) things, like:

• Dizziness, low blood pressure, fainting.
• A stroke or other emergency.
• Confusion.
• Having a hard time seeing.
• Numbness, pain, or tingling in your feet or legs.
• Medications or alcohol.

Am I at risk of falling?

Most falls happen in people over the age of 65. More than one out of four older people fall each year. Falling once doubles your chances of falling again. This is not to say that younger people do not fall, but as you age your risk of falling increases. The chance of serious injury from the fall also increases with age. If you are over the age of 65, talk with your care team about what you and your caregivers can do to decrease your chances of falling.

Certain medications can increase your risk of falling. Talk with your care team and pharmacists about any medications you are on and how they might affect your risk of falling.

Other things that increase your risk of falling are:

• Lower body weakness/pain/tingling.
• Problems with confusion, vision, or balance.
• Ill-fitting shoes.
• Low levels of Vitamin D in your blood.
• Dehydration (not drinking enough fluids).

How does having cancer affect my risk of falling?

Being diagnosed with cancer (especially within the first 6 months of diagnosis) and chemotherapy are linked with a higher risk of falls. In one study, 50% of patients had a fall associated with a high risk of injury, regardless of age. In fact, about 37% of people who fell were under the age of 65. Some causes of falls in cancer patients can be:

• Diagnosis of a primary brain tumor or brain metastasis (cancer that has spread from another part of the body to the brain).
• A previous fall in the past 3 months.
• Depression.
• Medications, such as benzodiazepines.
• Cancer-related pain.
• Cancer-related bone fractures (breaks).

Another study has shown that your risk of falling increases with each round, or cycle, of chemotherapy. Certain aspects of cancer and its treatment can raise your risk of serious injury from a fall, such as thrombocytopenia (low platelet count).

Make sure to talk openly with your care team about any fear you might have of falling. Your care team may test your balance, gait (how you walk), and will ask you about your history of falls. If you do fall, be honest with your provider. They can help you lower your risk of falling again.

What could happen if I fall?

Most falls don’t cause an injury, but once you fall, your risk of falling again is higher. About one out of five falls causes a serious injury, such as a broken bone or head injury. Falls can cause:

• Broken bones, sprains, strains, and bruises.
• Head injuries. If you fall and think you might have hit your head, you should call your healthcare provider right away. If you are taking medications that thin your blood, call 911 or go to the emergency room.
• Fear of walking or doing things on your own. This can lead to a change in daily life and activities, lowering your quality of life.

How do I keep myself from falling?

Things you can do inside of your home to keep you safe from falls are:

• Removing throw rugs, which can slide out from under your feet.
• Wearing non-slip socks or shoes that fit well.
• Clearing a path for you to walk, free of cords and objects.
• Be aware of wet floors after spills or cleaning.
• Add grab bars where you might need them, like in the shower or bath, or next to the toilet.
• Use railings when going up and down steps.
• Add lighting where needed.
• Only bathe or shower when someone else is home to help you.
• If you use an assistive device, like a cane, walker, or scooter, make sure you know how to use it properly and safely.

Things you can do for your health to keep you safe from falls are:

• Schedule and keep routine visits with your care team to have your blood pressure, heart rate, and bloodwork checked.
• Tell your provider of any changes you feel.
• Have your eyes checked at least once a year. Wear your glasses or corrective lenses as needed.
• Do exercises, as given by your care team, to make your legs stronger and to help with your balance.

Things you can do while you are in the hospital to keep safe from falls are:

• Talk with your care team about any fall precautions they may be taking. You may need to wear nonslip socks. You may need to call anytime you want to sit or stand up. There may be an alarm on your bed to alert staff that you are getting out of bed so that if you forget to call for help, they can help you.
• Keep a light on in your room or bathroom at night.
• Always use your call bell to call for help before sitting or standing up.
• Ask about your blood levels and vital signs during your stay.
• If you have had surgery, follow any instructions your care team gives you.

If you are over the age of 65, talk with your care team and caregivers about your risk of falling. Be sure to talk about any fears you might have. Work together to make your home as safe as it can be. No matter your age, you may want to speak with a pharmacist about the medications you are taking and how they might affect your balance, vision, or if they cause any numbness or tingling in your legs or feet.

Ask your care team for ideas on how to get stronger and how to improve your balance. A physical or occupational therapist may be able to help. If you are in the hospital or a care setting, always ask for help.