Falls are common, costly, predictable, and preventable.

According to the National Council on Aging, every 11 seconds, an older adult is treated in the emergency room for a fall, and every 19 minutes, an older adult dies from a fall. In 2013, the total cost of fall injuries was $34 billion and is expected to rise to $67.7 billion by 2020.

Falls are a big deal. They are also largely preventable. Here are three strategies that can significantly reduce the risk of falling for older adults, especially when they work together within a comprehensive fall prevention program.

1. Reduce the fear of falling.

Falls are serious and fall prevention should be taken seriously. But, this is a bit of a slippery slope because fear of falling can increase the risk of falling. This is especially true after a fall, even if the fall didn’t cause injury.

Fear of falling can cause seniors to limit their physical activity. This leads to a loss of muscle strength, endurance for normal everyday activities, and flexibility – all of which increase the risk of falling. Further perpetuating the cycle, the physical decline can cause depression and social isolation, increasing the risk even more.

Fear of falling also has a direct impact on balance when people are in a situation causing them to feel off balance. When walking up uneven stairs or on a gravelly path, for example, the body’s natural reaction is to stiffen. This natural reflex tightens the muscles of the legs and causes people to take stiffer, smaller, slower steps. While this constricted movement might feel safer, it has the opposite effect and can lead to a fall.

So, fear prevention strategies are an important and necessary part of fall prevention programs.

One way to reduce the fear of falling in seniors is to teach them balance exercises that they can do throughout the day, during normal activities. Simple activities that can be incorporated into daily life, like standing on one foot while holding onto the kitchen counter, can have a significant effect on both physical and mental wellbeing by helping seniors feel more in control. After all, feeling empowered is a great antidote to fear.

It’s also important to understand why someone is afraid of falling. Often a person’s fear of falling stems from an internal sense that their balance isn’t quite what it used to be. Fear is, after all, one of the ways our bodies and minds alert us to a problem. Understanding the root causes of their fear can uncover both internal and external factors that are in fact putting them at a greater risk for falling.

2. Strength training, especially for the lower body and core.

Decreased strength in the lower body and core, which is an inevitable part of aging, dramatically increases the risk of falling. Thankfully, muscle strength can be restored with strength training – if training is both consistent and challenging.

For strength training to decrease the risk of falling in any meaningful way, moderate to high-intensity training should occur at least 3 times per week. We know this. Seniors know this. Study after study has demonstrated that strength-training exercises reduce weakness and frailty and their debilitating consequences.

For senior living facilities, the biggest challenge is often not convincing residents that strength training is good for them – it’s getting residents to commit to consistently challenging training sessions.

Accurate risk assessment can offer a significant amount of motivation to get serious about building strength. This is especially true if regular assessment is part of their training program and they can see their progress.

Focusing on manageable goals is another way to maintain motivation for regular training.

Setting goals is an effective way to maintain a sense of purpose and accomplishment unless they are too many or too far-reaching. To support an effective strength training routine, it’s best to focus on a small number of challenging yet attainable goals.

As much as possible, it’s also important to offer enough variety and options for seniors to choose the exercises they find the most enjoyable. Granted, sometimes options are unavoidably limited. Still, chances are that options can be found in most situations. Offering seniors some control over the exercises they choose to perform can instill a greater sense of autonomy and fuel motivation.

3. Gait training exercises

Simply walking on a treadmill can improve gait and have a positive impact on balance. So, can exercises like stepping over or between objects. These types of activities might be effective, but they can also be boring. That’s why offering classes such as yoga and tai chi can be an especially effective component in a fall prevention program.

Tai Chi can significantly reduce falls by improving balance, physical endurance, and even decreasing the fear of falling. One six-month trial study on the effects of tai chi demonstrated a 55% reduction of falls compared to those in a stretching control group.

Another review of over 100 different trials singled out tai chi as being particularly effective in reducing the risk of falls for older adults. With regular practice, tai chi strengthens muscles and improves coordination - two things required for good balance. Perhaps equally important is the fact that for many people, tai chi can increase feelings of calm and improve confidence, counteracting the fear of falling.

Likewise, Yoga is also an effective strategy for fall prevention. Yoga strengthens muscles, improves balance and flexibility, and can also support a confident mindset that reduces the fear of falling. An added benefit of yoga is that many poses can be done while seated, making it a great choice for seniors who are at a particularly high risk of falling.

How HUR can support your fall prevention program.

The HUR SmartBalance is technology-driven testing, training, and reporting system that makes it easier than ever for next-generation rehabilitation and senior living providers to respond to healthcare's increasingly results-driven demands. Find out more.