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Public Health - Seattle & King County

One Step Ahead: Fall Prevention and Resources for Seniors

Falls are a major cause of injury and result in substantial morbidity and even mortality. Two of the strongest risk factors for falls are older age and prior history of falls. As part of the One Step Ahead Fall Prevention Program, King County EMS in conjunction with local Fire Departments have collaborated to identify and intervene with those at highest risk in the community. The EMS Division screens 9-1-1 calls to identify older adults who have required EMS care for a fall. Healthcare professionals can also refer patients to the program if they meet the program criteria: 50 years old and older; independent living – not in subsidized housing facilities, nursing homes or retirement facilities; at risk for a fall or has fallen in the past 6 months.

About one out of ten falls among older adults result in a serious injury, such as a hip fracture or head injury that requires hospitalization. In addition to the physical and emotional pain, many people need to spend at least a year recovering in a long-term care facility. Some never return to their homes. Falls are the leading cause of injury deaths among older adults.

Two thirds of seniors who experience a fall will fall again within six months.

Reducing your risk

There are four important strategies to reduce your risk for falls (click on each strategy to expand information):


Keeping in good physical condition with moderate daily exercise will reduce your risk of falls. A combination of flexibility, weight bearing exercises and aerobic exercise can markedly improve your level of fitness-at any age. Even if you should fall, being in good physical condition will lower your chances of serious injury and raise your ability to heal quickly and completely. You should always talk to your health care provider about what kinds of exercise are best for you and about specific exercise instructions.

Regular exercise can:

  • Improve your muscle tone, strength and endurance
  • Keep joints, tendons and ligaments more flexible for unrestricted movement
  • Increase your sense of balance, agility and confidence
  • Strengthen your bones to fight osteoporosis and resist injury
  • Increase your stamina and energy.

Fear of falling is a common anxiety among seniors and it can actually increase to risk for a fall.

Different types of exercises:

  • Physical therapists can teach people how to compensate for balance problems and determine if your walking could be steadied with either an exercise program to strengthen muscles, or an assistive device such as a cane or walker.
  • Community programs such as: Tai Chi, Enhanced Fitness, Matter of Balance, group exercise programs, individual exercise sessions can provide strength, balance and flexibility.
  • Personal trainers can provide one on one exercise programs in your home or at a fitness center.

60% of fatal falls occur in the home.


Eye disease or normal aging can make it difficult for seniors to read fine print, judge distance or identify objects clearly. These factors can lead them top develop a poor sense of balance or misread medicinal instructions. Have your vision checked annually and prescriptions updated as needed.

One in three people aged 65 years and older fall at least once every year. One in forty of those will be hospitalized and only half of those hospitalized will survive the year.

Medication management

Four out of five older adults take at least one prescription medication per day and most take at least 2 prescriptions a day. Drug interactions and the physical changes that come with age can lead to an increased risk of falling. The more medications taken, the greater risk of risk of drug interactions and side effects. Symptoms can range from dizziness to drowsiness, vision impairment and loss of balance.

Tips to manage your medication safely:

  • Keep a complete and updated medication list, including prescriptions, over the counter medications, herbs, and vitamins, and always carry it with you. Bring your medication list every time you visit the doctor or hospital.
  • Have all your medications filled at one pharmacy. Ask your pharmacist or your doctor about drug interactions ("Will this medication interfere with my other medications?").
  • Take your medications regularly, don't skip or decrease the dose to cut cost. If you take more then one prescription, create a system and regular routine for taking your medications.
  • Always ask your doctor before you start an herbal supplement or over-the counter remedy and don't forget to ask your pharmacist to check for herb-drug interactions.
  • Report adverse drug reactions to your doctor.
  • Ask your pharmacist if your medications look different in any way (color, size, shape) than the ones you're currently taking.
  • Limit use of alcohol.
  • Never use someone else's medications and discard old unused medications.
Home modification

Approximately 50%-70% of falls are due to home hazards, so it's crucial to recognize risks before they lead to an accident. The following checklist will help you identify and correct common hazards that lead to falls.


  • Keep stairways, halls & walkways well lit
  • Light bulbs should be 60-75 watts in all rooms


  • Arrange furniture so that you have plenty of room to walk without obstacles.
  • Keep walkways free of cords, clutter, and other obstacles.
  • Don't let newspapers/magazines collect on the floor.
  • Remove throw rugs or secure them with double stick tape or tacks.
  • Take care of spills and dropped objects promptly.

Steps and stairways

  • All stairs and steps should have secure handrails on both sides.
  • Secure loose carpet or loose steps.
  • Stairs should be well lit with light switches at the top and bottom.
  • Keep stairways free of clutter.
  • Don't wear socks on stairs.

Living Room/Bedroom/Kitchen

  • Make sure that your furniture is easy for you to get in and out of (knee height or higher is easiest).
  • Keep regularly used items within comfortable reach.
  • Keep a phone on a low table within reach of the floor.
  • Keep a light/flashlight and phone within reach of your bed.
  • Install night-lights in your bedroom and bathroom.


  • Place a non-skid rug on the bathroom floor.
  • Install and use wall grab bars by the toilet and inside the shower/tub area.
  • Line the tub or shower with non-skid mats or non-slip adhesive strips.
  • Use a shower chair and handheld shower head.


  • Firmly fastened (Velcro or cotton laces)
  • Non-skid
  • Low-heeled
  • Lightweight and supportive

STILL CONCERNED about preventing falls in your home?

King County Emergency Medical Services (EMS) will provide free home assessments and make recommendations for you. To qualify, you must be 50 years or older, live in King County outside of the City of Seattle and be at high risk for falls; low income individuals may be eligible for installation of fall safety devices. Contact King County EMS at 206-263-8544 for more information on eligibility or to schedule an appointment.

Educational web resources: