With the first frost already showing up on car windshields in much of the country, it is a good moment to talk about something that sends more older Canadians to hospital than any other kind of injury: falls.
According to the Public Health Agency of Canada (PHAC), falls are the leading cause of injury-related hospitalizations and injury deaths among people 65 and older. They are also, in large part, preventable. The federal government’s own guidance on how to lower the risk is practical, inexpensive and worth sharing with parents, grandparents and neighbours before the sidewalks turn to ice.
How big is the problem? PHAC researchers reported in November 2024 that 7,189 Canadians aged 65 and older died from a fall in 2022. Fall-related hospitalizations among older adults reached 81,599 in the 2023-24 fiscal year (a count that excludes Quebec), up 53 per cent from 53,347 in 2010-11. The age-adjusted rate stayed relatively stable over that period, a pattern consistent with a larger and older population rather than people suddenly becoming more likely to fall.
An earlier PHAC surveillance report found that in 2017-18, 5.8 per cent of Canadians 65 and older living at home, or roughly 350,000 people, said they had been injured in a fall in the previous 12 months. About one in three fall-related hospitalizations in 2019-20 involved a hip fracture, an injury that can mean a long recovery and, for some, a move into long-term care. PHAC estimated the direct cost of injurious falls among older adults at $5.6 billion in 2018.
Who is most at risk? The same report found the share reporting a fall injury was higher among women (6.5 per cent) than men (5.0 per cent), among people 85 and older (9.6 per cent), among those living alone (6.5 per cent) and among those with household incomes under $20,000 (8.0 per cent). PHAC says prevention efforts should focus on these groups.
PHAC lists the main contributors to falls as poor balance, muscle weakness, vision problems, footwear that doesn’t fit the job, tripping hazards, and slippery or uneven walking surfaces. Most of those are things a person, or their family, can actually do something about.
Where falls happen. Many people picture a dramatic tumble down the stairs, but the data point somewhere more ordinary. Among older adults injured in a fall, 61 per cent were walking at the time: 18 per cent slipped on ice or snow and 43 per cent fell on other surfaces. Stairs and steps accounted for 12 per cent. In other words, the everyday walk from the kitchen to the bathroom, or from the car to the front door, is where a lot of the risk lives.
What the official guidance recommends. Health Canada and PHAC offer a consistent set of steps:
- Slow down. Health Canada calls rushing a major cause of falls. Take your time getting out of bed or a chair, and never hurry on stairs.
- Keep moving. Health Canada suggests building up to a total of 30 to 60 minutes of moderate physical activity on most days, starting slowly. Shorter sessions spread through the day count too. Balance and strength are what keep a stumble from becoming a fall.
- Review medications. Ask a doctor or pharmacist whether any prescription, over-the-counter product or natural health product could cause dizziness or drowsiness, including in combination, and whether it is safe to drink alcohol with them.
- Check eyes and ears. Get vision and hearing checked regularly, and wear glasses and hearing aids. Health Canada also advises taking reading glasses off before going up or down stairs.
- Wear the right shoes. PHAC recommends well-fitting, sturdy shoes with good support, rather than loose slippers or socks on smooth floors.
- Light the way. Keep hallways, stairs and entrances well lit and add night lights for trips to the bathroom after dark.
- Fix the bathroom. Use a rubber mat in the tub and shower, install grab bars by the toilet and bath, and wipe up spills right away. Bath seats and raised toilet seats can help too.
- Clear the path. Remove clutter and tripping hazards, and make sure stairs have solid handrails on both sides.
- Get sleep. PHAC lists getting enough sleep among its basic prevention tips.
Getting ready for winter. Since nearly one in five injurious falls among older adults happens on ice or snow, the coming months deserve extra attention. Health Canada advises keeping front steps and walkways in good repair and clear of snow, ice and leaves. For icy days, it suggests grippers on boots and a special ice tip with cleats for a cane so it doesn’t slide. Arranging now for someone to help with shovelling and salting, whether a family member, neighbour or local service, can remove one of the riskiest winter chores entirely.
If a fall does happen. Health Canada’s guidance says that if you feel yourself falling, try to land on your buttocks to reduce the chance of a more serious injury, and check yourself for injuries before trying to get up. It also cautions against a common reaction after a fall: becoming less active out of fear of falling again. Cutting back on movement weakens the muscles and balance that protect against the next fall. PHAC data show about 70 per cent of older adults injured in a fall sought medical attention, and anyone who has fallen, even without an obvious injury, can raise it with their health-care provider.
For families, a simple walk-through of a parent’s or grandparent’s home with this list in hand, looking at lighting, loose rugs, the bathroom and the front steps, can be one of the more useful visits of the fall season.
This article is based on official guidance from the Public Health Agency of Canada and Health Canada and is provided for general public information. It’s not a substitute for medical advice, if you have questions about how this applies to you, talk to your doctor or pharmacist.
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Sources: Public Health Agency of Canada, Preventing falls and injuries for older adults; Public Health Agency of Canada, Health Promotion and Chronic Disease Prevention in Canada (November 2024); Public Health Agency of Canada, Surveillance report on falls among older adults in Canada; Public Health Agency of Canada, How to Lower Your Fall Risk; Health Canada, Preventing Falls in and around Your Home.
