Feeling unsteady? Exercise can help prevent falls in long-term care

The Bottom Line

  • Older adults are more likely to experience falls as they age, and this can lead to serious injury.
  • Older adults living in long-term care have a higher risk of injury if they fall, although their risk of falling is lower than those living at home. 
  • Combining different types of exercise with other fall prevention strategies is a promising way to prevent falls in older adults living in long-term care. Tailored programs are most effective. 
  • Programs that combine multiple forms of exercise such as balance, muscle strength, endurance, stretching, and mobility exercises are most successful when they occur at least 2-3 times per week, either in the short or long-term. 

When you were young it was simple: if you fell, you got back up. But as you age, falls become more likely, and more dangerous.

It’s not the fall that’s the problem – it’s the landing that hurts. In Canada, falls are the most common reason for hospitalization in older adults (1). Between 2017–2018, falls led to a staggering 112,008 hospitalizations (1) and this number is on the rise (2).

Falling can be a life-changing event, especially for older adults. One in five falls results in either a broken bone or a head injury (3). The wrist, arm, ankle or hip are the most likely places for a break to occur (3) and falls can even lead to death (2). The recovery from a fall can also be lengthy. Older adults spend an average of 6 to 9 days longer in the hospital for a fall than for all other reasons. Falling can also lead to a shattered sense of self-confidence linked to a fear of falling again (2).

Older adults in long-term care are in a unique situation – although their risk of falling is lower than those living at home (1), they are at higher risk of breaking a hip if they do find themselves on the floor (2).

The good news is that falls are not inevitable. One way for residents in long-term care to stand up to falls is exercise (4;5).

So, how can residents living in long-term care prevent a fall?

What the research tells us

Exercise programs that focus on balance appear to be helpful in preventing falls, especially when they are combined with exercises designed to improve strength, mobility, endurance, and gait (how you walk) (4;5). The most benefit is achieved when fall prevention strategies are customized to an individual’s needs, and exercise is combined with other strategies such as adjusting medications, removing tripping hazards, education about fall prevention, and using mobility aids like walkers or canes (4).

Research also shows that more frequent exercise is better. Programs that combine different types of exercise are most beneficial when they are offered 2-3 times a week. Both short and long-term programs have demonstrated beneficial effects. Although these programs have been shown to prevent falls, they do not help to prevent broken bones when a fall occurs (5).

Life is a continual balancing act. If you are an older adult living in long-term care and worry about falling, exercise combined with other fall prevention strategies can help keep you steady on your feet.

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  1. Canadian Institute for Health Information. Falls and vehicle collisions top causes of injury hospitalizations for seniors. [Internet] 2019. [cited June 2020]. Available from https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors  
  2. Public Health Agency of Canada. Seniors’ falls in Canada, second report. Ottawa (ON): PHAC; 2014. 62 p. Available from http://www.phac-aspc.gc.ca/seniors-aines/publications/public/injury-blessure/seniors_falls-chutes_aines/assets/pdf/seniors_falls-chutes_aines-eng.pdf 
  3. Centers for Disease Control and Prevention. Important facts about falls. [Internet] 2017. [Cited December 2017]. Available from https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html 
  4. Lee SH, & Kim HS. Exercise interventions for preventing falls among older people in care facilities: A meta-analysis. Worldviews Evid Based Nurs. 2017; 14(1): 74-80. doi: 10.1111/wvn.12193.  
  5. Silva R, Eslick G, Duque G. Exercise for falls and fracture prevention in long term care facilities: A systematic review and meta-analysis. J Am Med Dir Assoc. 2013; 14(9):685-9.e2. doi: 10.1016/j.jamda.2013.05.015. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.