How to Reduce the Risk of Falls at Home: Practical Advice for Older Adults
Falls are one of the most common reasons older adults lose confidence, independence, and mobility. The reassuring part is that many falls are preventable.
As a physiotherapist working with older adults, I often see how small, practical changes — both in the home and in the body — can significantly reduce falls risk. This guide outlines simple, evidence-based steps to help prevent falls at home and stay steady on your feet.
Why Falls Prevention Matters
In the UK, falls are a leading cause of injury-related hospital admissions in older adults. Evidence suggests many falls happen in and around the home and have many different causes including environmental hazards, reduced strength, balance problems and certain medications.
The good news? Addressing even one or two risk factors can make a meaningful difference.
1. Make Your Home Safer
Improving home safety is one of the most effective ways to reduce the risk of falls.
Clear walkways
Remove clutter, trailing wires, and loose items from areas you walk through regularly. Ensure furniture layout allows easy movement.
Secure rugs and flooring
Loose rugs and uneven flooring are common trip hazards. Either remove them or use non-slip backing to secure them in place.
Improve lighting
Good lighting is essential, particularly in hallways, on stairs, and in bathrooms. Consider nightlights for trips to the bathroom during the night.
The Age UK provides helpful home safety guidance for older adults.
Install grab rails and handrails
Handrails on both sides of stairs and grab rails in bathrooms can significantly reduce falls risk, particularly when standing up or stepping in and out of a shower.
Keep frequently used items within reach
Avoid climbing on chairs or overstretching to reach cupboards. Store everyday items at waist to shoulder height where possible.
Research supports these changes. A systematic review published in the PubMed Central found that home hazard modification programmes can reduce falls, particularly when tailored to the individual.
2. Improve Strength and Balance
Environmental changes are important, but physical strength and balance are just as crucial.
Loss of muscle strength — particularly in the legs — and reduced balance reactions are strong predictors of falls.
High-quality evidence published in the Cochrane shows that structured exercise programmes focusing on balance and strength significantly reduce falls in older adults.
Effective exercises include:
Sit-to-stand practice
Heel raises
Standing balance exercises
Walking practice
Tai chi-based movements
The key is consistency and progression. Exercises should feel challenging but safe. If you’re unsure where to begin, working with a physiotherapist can ensure exercises are appropriate for your level and any existing conditions.
3. Check Footwear and Clothing
Footwear plays a bigger role in falls prevention than many people realise.
Choose:
Well-fitting shoes
Low heels
Firm, non-slip soles
Secure fastenings (laces or Velcro)
Avoid walking around in socks or loose slippers, particularly on smooth flooring.
4. Review Vision, Hearing and Medication
Falls are rarely caused by just one factor.
Vision and hearing
Regular eye tests help identify changes that may affect depth perception or contrast sensitivity — both important for spotting trip hazards.
Medication review
Certain medications, especially when combined, can increase dizziness or affect blood pressure. The NICE recommends reviewing medications as part of falls prevention in older adults.
If you’ve noticed new dizziness, light-headedness, or changes in balance, it’s worth discussing this with your GP or pharmacist.
5. Build Confidence After a Fall
Many people tell me the biggest impact of a fall isn’t the injury — it’s the loss of confidence afterwards.
Fear of falling can lead to doing less, which in turn reduces strength and balance, increasing future risk. It becomes a cycle.
The right rehabilitation approach can rebuild strength, confidence, and independence. Falls prevention isn’t about wrapping people in cotton wool — it’s about building resilience.
Evidence and Further Reading
If you’d like to explore the research behind falls prevention:
Home hazard modification and falls reduction – systematic review
Exercise interventions for preventing falls in older adults – Cochrane review
Final Thoughts
Preventing falls in older adults isn’t about one big intervention. It’s about consistent, practical steps:
Make the home environment safer
Maintain strength and balance
Wear appropriate footwear
Review health factors
If you or a family member are concerned about falls risk at home, seeking personalised advice can make a real difference. Small changes today can help maintain independence for years to come. Home-based physiotherapy provides assessment and treatment in a calm, familiar setting. For older adults experiencing reduced balance or falls, being assessed at home allows for a far more practical and personalised approach. It also supports confidence and independence in the place where daily life actually happens.
Falls Prevention Physiotherapy in Bristol
If you live in Bristol and are worried about falling — or you’ve already had a fall — you’re not alone. Many of the people I work with want to feel steadier, safer, and more confident moving around their home.
A personalised falls assessment can help identify:
Strength or balance deficits
Walking pattern changes
Environmental hazards in the home
Contributing medical or medication factors
From there, we build a tailored plan focused on practical strength work, balance retraining, and simple home adjustments.
I provide specialist physiotherapy for older adults in Bristol, including balance assessment and falls prevention support. You can read more about my approach on my physiotherapy services page or get in touch using the information on my contact page.
