Fall Prevention: Balance and Strength Exercises for Older Adults

4 Ways to Improve Fall Safety

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

Linkedin Pinterest Safety at Home Home Care Aging Well Avoiding Injuries as You Age

Every year, nearly one in three adults age 65 and older fall, according to the Centers for Disease Control. Your risk of falling increases as you age.

Although many falls don’t cause serious injury, falls remain the cause of nearly all hip fractures and the most common cause of traumatic brain injuries.

Still, almost half of the adults who fall don’t tell their doctor or family, fearing a loss of independence or a potential move to an assisted living facility.

While falls are a real danger for older adults, they aren’t an inevitable part of aging. Simple precautions can reduce your fall risk long before an injury happens. In fact, careful adaptation can allow you to stay in your home and in control of your life even after a fall.

  1. Staying active is the simplest way to reduce fall risk.

    “Anyone aging from midlife on should keep up regular activity to maintain core muscle and leg strength as they transition into early old age and beyond,” says Hopkins ElderPlus Medical Director Matthew McNabney, M.D.

     It’s important to stay mobile and avoid a sedentary lifestyle, according to McNabney. Instead of engaging in strenuous exercise, choose “activities that are pleasurable” such as walking or yoga.

  2. Falls rarely happen without warning. Often, people will start showing signs of instability, balance or frailty, says Dr. McNabney. However, your primary care provider may not focus on balance issues and fall risk. If you have questions or concerns, be sure to ask your doctor. Recognizing these warning signs can reduce the risk of falls and the hospitalizations that may accompany them:

    • Unsteadiness walking. Unsteadiness over uneven surfaces—even the difference between a rug and a hardwood floor—can present a fall risk. After a safety evaluation, your primary care provider may recommend  physical therapy  or a mobility aid such as a cane or walker.
    • Vision problems. Worsening eyesight makes it harder to see obstacles and maintain balance. An eye exam can help you identify any vision problems.
    • Medication side effects. The medications you take may have side effects that could compromise your stability and balance. For example, blood pressure medicine, diuretics and antihistamines may cause lightheadedness or dizziness. You should do a careful review of your medications—both prescription and nonprescription—with your primary care provider.
  3. The key to living at home is to “acknowledge and adapt to limitations instead of suppressing them,” says Dr. McNabney. Rather than improving their surroundings, many older adults “become fearful and decrease their personal space” even before a fall.

    This reduction in activity increases the risk of falling further and has psychological risks. A physical therapist can help identify any unique risks in your home to provide both peace of mind and greater physical safety.

    The following are the most common risk areas in the home:

    • The bathroom. The bathroom is uniquely risky since it requires moving between many varied positions. Toilets and bathtubs are often not arranged well for people with mobility issues. Shower or bath chairs and hand bars are common adaptations.
    • Uneven floors and stairs. Thresholds, rugs, thick carpets and floor clutter can be dangerous for adults with balance issues or reduced step height. Once you’re aware of these areas, the removal of rugs, floor clutter and other uneven surfaces will reduce your fall risk.
    • The kitchen. Working in the kitchen often requires many changes in position, including bending down, turning and pivoting. Rearranging kitchen items can help minimize risk.
    • Low light. The ability to see in low light decreases with age. Adding brighter light bulbs or more lights to the home can reduce fall risk.
    • Stairs. Stairs should be used as long as it remains safe to do so. Adding a hand rail increases security and confidence.
  4. Reporting a fall is essential. “Being as open as possible about your fall is vital to your long-term safety,” says Dr. McNabney. “Since many people think that falling is an indicator of decline, they may try to keep it quiet so they won’t have to leave their home.

    ” However, covering up your fall means that there’s no opportunity for your doctor to understand the circumstances surrounding the fall. This increases the chance of another, potentially more serious fall in the future.

    Your physician will help you take the steps necessary to continue to live your life as fully as possible.

Try It

Worn around the neck or on the wrist, medical alert devices can give you a sense of security when you’re home alone. In addition to the standard call function, some alerts have sensors that can detect and automatically report a fall. Combined with cell phones, alert devices help you live independently with confidence, knowing that you can communicate with others if you need assistance.

Assisted living: A place for adults to live who do not need full-time nursing care but do need help with everyday tasks, such as dressing, bathing, eating or using the bathroom.

Residents often need help due to memory disorders, incontinence or mobility issues.

Centers offer a home atmosphere, providing meals, housekeeping, laundry, recreational activities, transportation and assistance 24 hours a day.

Traumatic Brain Injury: A type of brain injury caused by external force, often due to impact. Symptoms can include headache, nausea, vomiting, slurred speech, unconsciousness, convulsions or cognitive/emotional changes.

Physical Therapy: Physical therapy uses specific exercises and therapies to improve strength, flexibility, range of motion and balance to improve or recover a patient’s ability to move and function in his or her daily life.

We provide high quality, individualized care for patients of all ages where you feel most comfortable – your home or community. Our services and equipment are designed to help you regain and retain a level of independence.

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/4-ways-to-improve-fall-safety

Fall Prevention: Balance and Strength Exercises for Older Adults

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

Linkedin Pinterest Aging Well Staying Active as You Age Safety at Home Exercise and the Aging Person

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Falls can have very serious consequences as we age. Each year, more than 25percent of adults 65 or older have a fall, and 3 million are treated inemergency departments for fall injuries, according to the Centers forDisease Control and Prevention.

Fall Risks

The risk of falling in older adults is usually related to combination offactors, including:

  • Balance and/or walking problems. Balance can be affected by vision changes, vestibular problems and altered sensation in the feet.
  • The use of multiple medications. Studies indicate that when individuals take five or more medicines, the risk of falls increases.
  • Home hazards (including dim lighting and trip hazards)
  • Positional low blood pressure (such as orthostatic hypotension, when blood pressure drops upon standing.
  • Feet and footwear issues

Falls often occur in the bathroom when sitting or standing from the toiletor shower, or at night in a dark bedroom when getting up quickly andtripping on the way to the bathroom.

While it’s not possible to completelyprevent a fall, exercises that focus on balance and strength training canreduce the risk of falling.

“We treat elderly adults for injuries sustained from falls, and otherpatients who feel unsteady while walking or standing and are fearful offalling,” says Lora Stutzman, a physical therapist with theJohns Hopkins Rehabilitation Network. “These exercises can help improve balance and build strength to helpprevent future falls.”

For older adults, activities such as squatting, standing up from a chairand walking may be difficult or cause them to feel unsteady, whichincreases their risk of falling.

The following exercises are intended forthose who have a low risk of fall and are able to stand on their ownwithout support from others.

Always talk to your doctor or physicaltherapist first before starting new exercises, especially if you have weakbalance.

Stutzman demonstrates two exercises below.

Sit-to-Stand Exercise

The sit-to-stand exercise builds leg strength and improves body mechanicsand balance, which are all important in reducing falls.

1. Start by sitting on a sturdy chair of standard height, and make surethat it won’t slide or roll. You should be able to sit comfortably withyour feet flat on the ground. Have a sturdy support surface in front ofyou, such as a countertop, so that you can reach to it for support if youstart to feel unsteady when standing. Scoot forward so your buttocks ispositioned at the front of the seat.

2. Lean your chest forward over your toes, shifting your body weightforward. Squeeze your gluteal muscles and slowly rise to a stable standingposition.

3. Slowly sit back down to the starting position and repeat 10 times.

4. If necessary, place your hands on the arms or seat of the chair and pushthrough your hands to help stand and sit. The goal is to not use your handsat all.

Perform 10 repetitions, twice a day. For an advanced version, hold handweights to add resistance.

If you have pain in your knees, back or hips, discontinue and talk to yourdoctor or physical therapist.

Balance Exercise

This series of exercises helps if your balance is unsteady. Make sure youhave someone with you in case you lose balance.

To begin, stand in a corner or have a kitchen counter in front of you toreach out to in case you start losing balance.

1. Feet apart: Stand with feet about shoulder-width apart,eyes open, and hold steady for 10 seconds, working your way up to 30seconds.

If you find yourself swaying or reaching for the wall or counterfrequently, just keep working on this exercise until you can do it withminimal swaying or support. Once you can hold this position firmly for 30seconds, move on to the next exercise.

2. Feet together: Stand with feet together, eyes open, andhold steady 10 seconds, working your way up to 30 seconds.

Once you can do this exercise for 30 seconds with minimal swaying orsupport, move on to the next one.

3. One foot: Stand on one foot, eyesopen, and hold steady 10 seconds, working up to 30 seconds. Switch to theother foot.

4. Eyes closed: If you can perform the first threeexercises safely and with little support, try to do each one with your eyesclosed. Hold for 10 seconds, working up to 30 seconds.

The goal for each exercise is to hold the position for 10 seconds andprogress to 30 seconds, five repetitions (including five per leg on theone-foot exercise), two times a day.

Additional Steps to Prevent Falls

Remember, it’s important to talk to your doctor or physical therapist aboutfall prevention.

  • Discuss medications and changes in your exercise routine.
  • Tell your doctor if you fall.
  • Ask a friend or family member to help check your home for trip hazards.

“Keep in mind,” adds Stutzman, “it is always best to have company at homewith you while exercising for safety and supervision and in case you needhelp.”

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/fall-prevention-exercises

Fall Prevention Tips for Seniors | Grand Oaks Assisted Living Blog

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

As you age, falls are a real threat to both your health and independence. Every year, millions of seniors ages 65 and older fall. According to the Centers for Disease Control and Prevention (CDC), more than 1 in 4 older people fall each year, but less than half tell their doctor. This only doubles your chance of falling again.

And, every 20 minutes, an older adult in the U.S. dies from a fall.

These stats are alarming, but falls are not just something that have to happen with age. They can be reduced by following a few fall prevention tips. If you or your loved one is 65 years or older, consider these fall prevention safety measures.

1. Talk to your doctor

Discuss openly with your healthcare provider about your personal risks and fall prevention ideas. Ask them to review your medicines and identify any that may make you sleepy or dizzy and more ly to fall. Ask if you need additional supplements vitamin D to improve your bone and muscle health, too.

Call your healthcare provider immediately if you feel unsteady, as if the room is spinning, as if you’re moving when you stand still, or lose your balance.

2. Do strength and balance exercises

Exercising can improve your balance and strength, lowering your chances of falling. At Grand Oaks, for example, our residents practice Tai Chi. This simple form of exercise helps them to feel better and more confident and reduces weakness and chances of falling. Our partners at Johns Hopkins Medicine also recommend simple sit-to-stand and balance exercises. Give them a try here.

3. Get your eyes checked yearly

When was the last time you or your loved one had an appointment with an eye doctor? If you’re tripping more often or have poor vision or low vision, you may need to update your eyeglasses prescription.

4. Safeguard your home

The majority of falls happen at home.

That’s why it’s important to keep the home and floors clear of clutter, use handrails on all staircases, repair or remove tripping hazards, and make sure the house has plenty of light.

Ask a friend or family member to help you, if you need it. Use nonslip mats on kitchens, bathrooms, and porches. Use this home fall prevention checklist for more ideas.

5. Consider your footwear

Just your eyesight, you need regular foot care with age, too. In addition to visiting a foot care specialist, always wear rubber-soled and low-heeled shoes that fit properly and support your feet. Do not wear loose-fitting slippers or other shoes that could cause you to trip easily. wise, avoid wearing loose clothing that can drag on the ground.

6. Watch out for nasty weather

Be careful on wet or icy sidewalks, especially walking up and down staircases. Always use handrails and ask a friend, family member, or neighbor to help remove any outdoor obstacles that could cause falls.

7. Limit the amount of alcohol you drink

According to the Alcohol Addiction Center, alcohol contributes to about 60% of falls. They’ve also seen a 65% increase in high-risk drinking in the elderly. Because seniors often lose dexterity and flexibility, they may already have balance problems made worse by drinking.

8. Live on one level

For some seniors, stairs are a significant falling hazard. If possible, try to live all on one level or limit the trips you have to take up and down the stairs. If your home is two stories, consider rearranging rooms so the majority of living can occur on the first floor.

9. Consider mobility aids

Is it time for a cane, walker, wheelchair, or motorized scooter? While some still see stigma and loss of freedom with walkers and other mobility aids, many seniors instead find that using these aids increases their independence and quality of life. Talk to your healthcare provider if you think you need a mobility aid, and make sure it’s properly fitted for the best and easiest use.

10. Take your time

Many falls can be prevented by moving more carefully. Do not move too quickly from sitting to standing positions, pause after going upstairs if needed, or take a break before using the railing on stairs. Give yourself extra time to do tasks or go places, especially if you know there will be fall hazards extra stairs.

Important Facts About Falls

  • Most falls do not cause injury, but 1 in 5 falls causes a serious injury broken bones or head injuries.
  • More than 95% of hip fractures are the result of falls.
  • In addition to injuries, falls can also reduce independence and lingering doubts about what seniors are capable of doing.
  • Many seniors who have fallen become afraid of falling again. This may cause them to become less active and weaker.
  • Many conditions contribute to falling, including lower body weakness, vitamin D deficiency, difficulties with walking and balance, vision problems, foot pain, use of medicines tranquilizers or sedatives, and home hazards uneven steps or clutter.
  • Balance disorders vertigo and Ménière’s disease can make you feel unsteady or you’re moving or spinning. They can also lead to falls.
  • Medicines that lower your blood pressure could make you feel dizzy and increase your chances of falling.
  • Not sure if your loved one is at risk for falls? If you notice they are holding onto walls, furniture, or others when walking, or they appear to have difficulty walking or standing up from a chair, it may be time to intervene with fall prevention measures.

Source: https://www.grandoaksdc.org/fall-prevention-tips-for-seniors/

How Yoga Improves Heart Health and Reduces Fall Risk

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

Yoga is for everybody. That means for every type of body at any age! At its core, it is the art and science of healthy living that brings the mind and body into alignment.

The word ‘Yoga’ means ‘to unite’ or ‘to join’. It is a physical practice that can simply improve basic flexibility and physical well-being and can awaken one to deep spiritual truths about the very nature of reality and consciousness.

The benefits for developing a yoga practice are numerous and have been proven throughout the ages to benefit anyone who engages in any form of this broad discipline.

We will cover tips for creating a yoga practice, give an overview of the benefits that yoga has to offer, and describe some of the poses for you to try.

A Little Background on Yoga

There are so many types of yoga being taught these days it is difficult to know where to begin. Let’s start with Hatha yoga, the hallmark of all yoga and the best starting place for any beginner.

  • Hatha is an umbrella term for all of the postures of yoga. Here in the West, hatha refers to all the styles of yoga that are based in a physical exercise practice. Physical yoga practices are the most popular and are best for beginners.
  • Hatha yoga classes are slower paced. They embody breathing and exercises making it the best choice for the beginner. Once one has some experience and has developed an interest, there are other schools of yoga that focus on various forms or methods of practice these include, but are not limited to:

o Ashtanga

o Iyengar

o Vinyasa

o Bikram

o Restorative yoga

How Yoga Improves Heart Health

Many studies have been done to determine whether or not yoga is beneficial to heart health. Good news, yoga is great for your heart. You don’t have to exert yourself with exercises that raise your heart rate. Yoga can also help prevent or manage heart disease.

According to the Director of Cardiac Arrhythmia Service at Johns Hopkins, Hugh Calkins, M.D., “There’s been a major shift in the last five years or so in the number of cardiologists and other professionals recognizing that these benefits are real.” Some of the most powerful benefits include:

  • Relaxing the mind and body. Practicing yoga regularly helps regulate hormones such as cortisol and adrenaline which are released when we are under emotional stress. As we get stressed these hormones narrow arteries and increase blood pressure. By practicing yoga, stress is reduced.
  • Promoting recovery. For patients who have experienced a cardiac event such as a heart attack, surgery, or a diagnosis of heart disease, doctors often encourage doing yoga as part of the overall treatment plan.

Also, according to one study, subjects who practiced yoga for three months were able to lower blood pressure, cholesterol, glucose levels, along with heart rate. Yoga reduces the impact of conditions such as metabolic syndrome.

5 Yoga Postures for Fall Prevention

One of the biggest risks as we age is falling. For a multitude of reasons, we move less, and lose our balance more easily. Falls are the leading cause of broken bones and hospitalizations for seniors, so taking the proper steps to prevent falls inside the home is essential.

Yoga improves balance and helps prevent falling. Here are five yoga postures that you can start practicing today for fall prevention or share with your loved one. If you are a caregiver, do the exercises along with your loved one and make it fun.

Great Yoga Poses for Seniors

Downward dog: This pose elongates the spine. It is achieved by folding the body at the hips and placing the hands and feet on the floor. If you can’t reach the floor you can place your hands on a chair instead.

Crescent Lunge: This pose is done in standing position, lunging forward on one foot,

bending at the knee and holding the arms in the air or at the sides. Crescent lunge is an excellent pose for balance because the base of support is long and narrow.

Chair pose: This pose strengthens the muscles in the thighs and simulates sitting in a chair without actually using one. It involves bending the knees and hips and lowering as though you were going to sit down into a chair. This pose helps to increase strength and stability through strong leg muscles.

Bridge pose: Bridge pose increases the strength of the core muscles as well as those in the hips and legs. It is done on the floor but can also be done on a firm bed or couch. It strengthens and challenges the stability of the muscles in the hips, core, and legs. It involves lying on your back and raising the pelvis to create one long line between the head and the knees.

Tree pose: This pose involves standing on one leg and stabilizing the body using leg and core muscles to achieve balance and prevent falls for seniors. There are beginner versions of this and more advanced versions so it is a good exercise to improve balance over time.

You may find that your parents are resistant to change. Offering a new activity such as yoga can seem daunting. Talking to your loved one about fall prevention can be a difficult task, but with some tips and knowledge, you can navigate the conversation successfully.

The Best Chair Yoga Poses for Seniors

Don’t worry, yoga isn’t just for those who can put their foot behind their head! Chair yoga is highly beneficial and can improve strength and balance. The best thing about yoga is that it can be practiced gradually and poses can become more challenging as you build strength, lengthen, and strengthen your muscles.

Here is one example of one great stretch that can be done in a chair. There are many sites online that show with photographs and video how to do many chair poses clearly and safely.

Seated Forward Bend:

  • Inhale while sitting firmly upright in a chair without arms. Focus on extending your spine. Fold your torso over your legs. Start with your hands resting on your thighs. You can slide them down your legs as you bend for extra support. As you get more flexible, you can keep them at your sides as your torso gets closer to your thighs.
  • While bent toward your thighs, take five breaths. This massages the intestines and helps to passively lengthen the spine and stretch the back muscles.
  • When ready, inhale as you slowly lift your torso to a fully seated position with your spine straight, yet relaxed.

Other Benefits of Yoga for Seniors

The ancient practice of yoga is enormously beneficial for the body and the mind.

No matter what your age or current physical state, there are yoga exercises that will be of benefit if given some attention and time. Within just a couple of weeks people begin to notice profound changes. Yoga is a practice everybody should consider.

Additional yoga benefits include:

  • Improves core strength
  • Loosens the joints and builds muscle
  • Prevents falls and improves balance
  • Reduces anxiety and depression
  • Improves the function of nearly every organ in the body
  • Reduces fatigue and improves sleep
  • Increases joint lubrication
  • Helps relieve arthritic pain
  • Provides a supportive and fun social environment for seniors
  • Increases physical and emotional confidence

Start slowly at home by watching videos, finding yoga teachers online or television. You can also start by going to a class in your area. The important thing is to try it because it is good for you and your loved one.

Creating a Yoga Practice

The very best way to create your own yoga practice is to find a local yoga class where the instructor can guide you as you learn the poses.

If you believe that your loved one would benefit from fall prevention exercises, research senior yoga classes in your area. Yoga centers offer them and some senior centers do as well.

Search for “senior yoga” and you will find the resources in your area.

Here are a few basic guidelines to keep in mind when beginning to practice yoga:

  • Yoga is a practice. It is not a competition. Don’t compare yourself to others. It is meant to bring one into alignment with their body, breath, and mind.
  • Always use a Yoga mat. This way you do not slip while practicing the poses.
  • Don’t force any movement. Listen to the limits of your body. The point is to do the best you can now and know that overtime your flexibility will improve. If you cannot get into the pose don’t force yourself. Do the ones you can achieve easily.
  • Keep it slow and steady. A slow, steady, rhythmic breathing will actually help you to balance in these poses.
  • Breathing is worth focusing on. Breathing with the various movements is important. It seems very obvious, but the truth is many of us hold our breath when engaged in moving. Breath in slowly through your nose and exhale through your mouth.


The Yoga-Heart Connection

7 Yoga Poses You Can Do in a Chair

Source: https://homecareassistance.com/blog/yoga-for-fall-prevention

7 Fall Prevention Exercises for People With Arthritis

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

Everyone’s fallen at one point or another and been able to get right back up. So it may come as a surprise that falls are a growing and significant public health problem because they can cause injuries with long-lasting consequences — anything from knee damage and hip fractures to traumatic brain injury — especially as we get older.

Sound alarmist? Consider this: According to the U.S. Centers for Disease Control and Prevention, “Every second of every day an older adult (65+) suffers a fall in the U.S., making falls the leading cause of death and injury in this age group.”

And people with osteoarthritis and rheumatoid arthritis are especially at risk because those conditions often lead to weakening of the muscles that assist with balance and stability, notes physical therapist and sports medicine consultant John Gallucci Jr.

Also, having joint pain from arthritis may cause you to alter your gait to compensate. “The way you change your gait may cause you to lose your balance and fall,” says rheumatologist Sharon Kolasinski, MD, a professor of clinical medicine at the University of Pennsylvania Perelman School of Medicine.

The fear of falling by itself can also increase your risk.

Strengthening Key Muscles Can Help Maintain Balance

The good news is that several studies, including one published in January 2019 in the Cochrane Database of Systematic Reviews, show that exercises that target balance, gait, and muscle strength help prevent falls in older people. While your personal fall prevention program should be tailored to your condition and your particular needs, one of the following exercises is bound to work for you.

Tai chi, an ancient Chinese martial art, involves slow, graceful, continuous movements designed to increase your balance and flexibility for all people with joint pain, including those with osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

A study published in October 2018 in JAMA Internal Medicine involving 670 adults ages 70 and older with a history of falls or impaired mobility found that tai chi reduced falls 58 percent compared with stretching, and by 31 percent compared with an exercise regimen that included various forms of aerobic, balance, flexibility, and strength training exercises.

Earlier research that looked at how a 12-week course of tai chi training impacted older women with osteoarthritis concluded it significantly improved the women’s balance and reduced the joint pain and stiffness linked to a higher risk of falls. “There is good evidence that tai chi can be good for fall prevention,” Dr. Kolasinski confirms. “It comes from the fact that it focuses on balance and strength.”

Related: Is Tai Chi Good for Rheumatoid Arthritis?

If you have access to a warm-water swimming pool, aquatic exercises are great for people with arthritis because they allow you to strengthen your muscles and improve endurance without stressing your joints and worsening joint pain.

As a bonus, there’s no risk of falling while exercising in a pool, note researchers writing in the February 2019 issue of BMC Geriatrics.

 Other benefits of water exercises, Kolasinski notes, are that the heated water feels good to aching joints and, other aerobic exercises, pool workouts can help you lose weight, which is a nondrug way to manage arthritis if you're packing extra pounds.

Related: Physical Activity Is Essential for Managing Rheumatoid Arthritis

Source: https://www.everydayhealth.com/arthritis-pictures/fall-prevention-exercises-for-people-with-arthritis.aspx

Falls Prevention Programs

Fall Prevention: Balance and Strength Exercises for Older Adults | Johns Hopkins Medicine

Explore the evidence-based programs on this page that are proven to help older adults reduce their risk of falling. Visit this webpage to find a program near you!

View the Falls Prevention Programs: Saving Lives, Saving Money infographic for information on the impact of falls among older adults and the benefits and return on investment of evidence-based falls prevention programs.

A Matter of Balance

A Matter of Balance is an 8-week structured group intervention that emphasizes practical strategies to reduce fear of falling and increase activity levels. Participants learn to view falls and fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance.

  • Program Summary
  • Program Website


Bingocize® is a 10-week program that combines a bingo- game with exercise and health education. The unique addition of bingo addresses many of the barriers to older adults’ participation because the game is fun, familiar, and done in a group setting.

The program has been shown to increase older adults’ functional fitness, health knowledge, and social engagement in a variety of settings.

The overall goals of the program are to help older adults improve and/or maintain mobility and independence, learn and use health information focused on falls reduction and other health-related behaviors, and socially engage with other older adults. A mobile app version is also available.

  • Program Summary
  • Program Website


CAPABLE (Community Aging in Place – Advancing Better Living for Elders) is a five-month structured program delivered at home to community dwelling older adults to decrease fall risk, improve safe mobility, and improve ability to safely accomplish daily functional tasks.  CAPABLE is delivered by an occupational therapist, who makes six visits to each participant; a nurse, who makes four visits; and a handyman, who contributes up to a full day’s work—providing home repairs, installing assistive devices, and making home modifications. Participants work with the therapist and nurse to identify three achievable goals per discipline, examine the barriers to achieving those goals, and make action plans, supported by changes to the home and medication environment, to achieve those goals.

  • Program Summary
  • Program Website

Enhance Fitness

EnhanceFitness is low-cost, evidence-based group falls prevention and physical activity program developed specifically for older adults.

The exercises have been packaged into a formal regimen focusing on four key areas important to the health and fitness of mature participants: low impact cardiovascular; dynamic/static balance work, strength training and stretching.

Classes meet three times a week, an hour each session, providing social stimulation as well as physical benefits.

  • Program Summary
  • Program Website


FallsTalk is an individual program for anyone who has experienced a fall or regular loss of balance; regardless of walking ability, medical condition, mobility or fitness level. The program begins with a personal FallsTalk Interview in-home or community space to discuss their unique situation.

The intervention consists of initial and follow-up interviews with a trained facilitator, daily personal reflection (2-3 min.), 3 brief weekly and then monthly check-in calls. Clinical trials and community results provide evidence that FallsTalk significantly reduces falls compared to untreated fallers.


FallScape is a customized program for anyone who has experienced a fall or regular loss of balance; regardless of walking ability, medical condition, mobility, cognitive or fitness level. FallScape consists of one or two training sessions with a set of brief (less than 1 min.

) multimedia vignettes that are selected specifically to help an individual prevent falls in their own unique situation. FallScape is offered in-home or community space in conjunction with FallsTalk.

Research shows that Participants achieve maximum benefit with the addition of this multimedia training.

Fit & Strong!

Fit & Strong! is an evidence-based physical activity/behavior change intervention that has been successfully implemented in multiple community-based settings. Participants are older adults who have lower extremity joint pain and stiffness related to osteoarthritis.

Fit & Strong! blends a multiple component exercise program with group problem solving/education using a curriculum designed to facilitate arthritis symptom management, confidence in ability to exercise safely with arthritis, and commitment to lifestyle change.

Before the end of the 8-week Fit & Strong! program, participants meet with the instructor to develop individualized exercise plans that foster ongoing maintenance of a balanced physical activity routine

  • Program Summary
  • Program Website

Healthy Steps for Older Adults

Healthy Steps for Older Adults (HSOA) is an evidence-based falls prevention program for adults ages 50 and over.

The program is designed to raise participants’ fall prevention knowledge and awareness, introduce steps they can take to reduce falls and improve their health and well-being, and provide referrals and resources.

Two 2-hour workshops are offered to interested individuals in the community at facilities such as senior community centers and health care organizations. HSOA was developed by the Fall Prevention Initiative of the Pennsylvania Department of Aging.

  • Program Summary
  • Program Website

Healthy Steps in Motion

Healthy Steps in Motion (HSIM)  is an exercise program designed for people of all fitness levels. The program is a one-hour session twice a week for eight weeks, and is taught by certified instructors; it starts with a warm-up, followed by strength & balance exercises and ends with a cool down-stretch.

 There are three levels so participants can continue HSIM as long as they . HSIM strives to reduce the risk of falling by building body strength, increasing flexibility, and improving balance. HSIM can be offered at senior centers, older adult living centers, recreation centers, hospitals, YMCAs/YWCAs, and more.

  • Program Summary
  • Program Website

The Otago Exercise Program

The Otago Exercise Program (OEP) is a series of 17 strength and balance exercises delivered by a Physical Therapist  or a Physical Therapy Assistant in the home, outpatient or community setting that reduces falls between 35 and 40% for frail older adults.

This evidence-based program calls for Physical Therapists to assess and progress older adults through an 8 week clinical phase and then the older adult is transitioned to a self-management phase for 4 – 10 months. During this time, the older adult is supported by monthly phone calls and check ins at months 6 and 12 if needed.

There are opportunities for Physical Therapists to collaborate with community providers to support dissemination and implementation of the OEP.

  • Program Website
  • Program Information and Guidance

Stay Active and Independent for Life (SAIL)

Stay Active and Independent for Life (SAIL) is a strength, balance and fitness program for adults 65 and older. Performing exercises that improve strength, balance and fitness are the single most important activity that adults can do to stay active and reduce their chance of falling.

The entire curriculum of activities in the SAIL program can help improve strength and balance, if done regularly. SAIL is offered 3 times a week in a one hour class. SAIL exercises can be done standing or sitting. The primary target audience is community-dwelling older adults (65+) and people with a history of falls.

The SAIL program is able to accommodate people with a mild level of mobility difficulty (e.g. people who are occasional cane users).

Stepping On

About 30% of older people who fall lose their self-confidence and start to go out less often. Inactivity leads to social isolation and loss of muscle strength and balance, increasing the risk of falling. Stepping On aims to break that cycle, engaging people in a range of relevant falls prevention strategies.

  • Program Summary
  • Program Website

Tai Chi for Arthritis

Many studies have shown Tai Chi to be one of the most effective exercises for preventing falls. Tai Chi for Arthritis helps people with arthritis to improve all muscular strength, flexibility, balance, stamina, and more.

  • Program Website
  • Program Information and Guidance

Tai Ji Quan: Moving for Better Balance

Tai Ji Quan: Moving for Better Balance™ is an evidence-based falls prevention program delivered in two one-hour sessions each week for 24 weeks. Each session consists of warm-up exercises; core practices, which include a mix of practice of forms, variations of forms, and mini-therapeutic movements; and brief cool-down exercises.

  • Program Summary
  • Program Website
  • Program Information and Guidance

YMCA Moving for Better Balance

Moving For Better Balance is a 12-week instructor-led group program designed to improve strength, mobility, flexibility, and balance for enhanced overall physical health and better functioning in daily activities. Participation in the program may also result in better mental health, reduced stress, improved memory and cognition, and increased self-esteem.

The program, the principles of Tai Chi, teaches eight movements modified especially for falls prevention. The program is targeted toward individuals 65 years or older who are physically mobile with impaired stability and/or mobility, or individuals 45 years or older with a condition that may impact stability and/or mobility.

 A YMCA membership is not required to participate in the program.

For more details on these programs, download the Select Evidence-Based Falls Prevention Programs.

Evidence-Based Community Falls Prevention Programs Review Council

NCOA’s National Falls Prevention Resource Center has established a review process for program developers and others to apply for possible inclusion on the approved list of programs for future falls prevention discretionary funding opportunities through the Administration for Community Living. Programs approved through the process will also satisfy the criteria for Older Americans Act Title III-D support. Please visit the Evidence-Based Falls Prevention Programs Review Council webpage for more information and instructions to apply.

Current Procedural Code (CPT) Code Flyer

A barrier to delivery of falls risk assessments in clinical settings is lack of a dedicated Current Procedural Terminology (CPT) code for this service.

However, providers are able to counsel their patients regarding falls risk and bill payers using existing Evaluation and Management (E/M) CPT codes. This CPT Code Flyer provides detail on which CPT codes to use for falls assessment and intervention.

Information about falls-related quality indicators as a means to incentivize providers to conduct falls prevention activities is also included on the resource.

Source: https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-programs-for-older-adults-2/