Falls Prevention in Aged Care: What Families and Facilities Should Know

Falls are one of the most common and preventable risks in aged care, and preventing them relies on a combination of individual risk assessment, environmental safety, appropriate mobility support, medication review, and consistent staff awareness. No approach eliminates all risk entirely, but a genuinely proactive falls prevention program significantly reduces both the frequency and severity of falls, and families play an important role in that process too.

Risk Assessment

Environmental Safety

Medication Review

Ongoing Monitoring

A fall can be one of the most frightening things to happen to an older loved one, and one of the most common reasons families end up reconsidering whether someone can safely stay at home, or worrying about safety once they’ve moved into residential care. Falls are also, genuinely, one of the most preventable risks in aged care, when they’re taken seriously and addressed systematically rather than treated as inevitable.

This guide explains why falls happen more often in older age, what a proper falls prevention approach actually involves, what families should look for in a facility’s approach to safety, and what to do if a fall does happen despite best efforts.

It’s worth acknowledging upfront that fear of falling is often just as significant as the physical risk itself. Many older adults become anxious about moving around after a fall, or even after hearing about someone else’s fall, and that fear can lead to reduced activity, which paradoxically increases falls risk further by weakening muscles and balance over time. A genuinely good falls prevention approach addresses this psychological side too, not just the physical hazards.

Why Are Older Adults More at Risk of Falls?

Falls risk increases with age for a combination of reasons, and understanding them helps explain why prevention needs to be proactive rather than reactive.

• Reduced muscle strength and balance, making recovery from a stumble harder
• Vision and hearing changes, affecting depth perception and awareness of surroundings
• Chronic health conditions, such as arthritis, Parkinson’s disease, or past stroke, affecting mobility
• Cognitive decline, including dementia, which can affect judgement around safe movement
• Medication side effects, particularly drowsiness, dizziness, or blood pressure changes
• Environmental hazards, poor lighting, loose rugs, or unfamiliar surroundings

Most falls result from more than one of these factors overlapping, which is exactly why a genuinely effective falls prevention approach looks at the whole picture, not just one risk in isolation. A resident with mild vision changes and a new blood pressure medication, for example, carries meaningfully more risk than either factor alone would suggest, and a good assessment accounts for that overlap rather than treating each risk factor as separate.

How Is Falls Risk Assessed in Aged Care?

A proper falls prevention program starts with an individual risk assessment, not a generic checklist applied the same way to every resident.

1

Mobility and Balance Review

Assessing gait, strength, and use of mobility aids

2

Medication Review

Checking for medications linked to dizziness or drowsiness

3

Health History Review

Considering chronic conditions, past falls, and cognitive status

4

Individual Care Plan

Tailored strategies based on the resident’s specific risk factors

This assessment isn’t a one-off exercise either, it should be revisited regularly, and especially after any change in a resident’s health, medication, or mobility, or after a fall has already occurred. Facilities that treat this as a living document, rather than paperwork completed once at admission, tend to catch emerging risks before they lead to an actual fall.

What Environmental Changes Help Prevent Falls?

Physical surroundings play a major role in falls risk, and many of the most effective prevention measures are environmental rather than clinical.

Common Environmental Safety Measures

Good lighting throughout hallways and bathrooms, non-slip flooring, clutter-free walkways, secured rugs and cords, grab rails in bathrooms and along corridors, appropriate furniture height, and clearly marked steps or level changes.

Bathrooms and bedrooms are particularly high-risk areas, since they involve transfers, standing from a seated position, and often occur during the night when a resident may be less alert. Well-designed facilities pay close attention to these specific spaces, not just general common areas.

Outdoor spaces deserve the same attention. Garden paths, courtyards, and outdoor seating areas should have even, non-slip surfaces and adequate shade and seating, so residents aren’t discouraged from enjoying fresh air and outdoor activity out of fear of uneven ground. Good design balances genuine safety with keeping outdoor spaces inviting rather than clinical.

What Role Does Mobility Support Play?

Appropriate mobility aids, walking frames, canes, wheelchairs, correctly fitted and regularly reviewed, are one of the most effective and underrated tools in falls prevention. A mobility aid that’s the wrong height, worn out, or simply not being used consistently can do more harm than good. Physiotherapy and occupational therapy input matters here too, helping residents build strength and confidence, and ensuring mobility aids are genuinely suited to how a person actually moves, not just prescribed once and forgotten.

Footwear is another often-overlooked factor. Well-fitted, supportive, non-slip footwear makes a genuine difference, while loose slippers or unsupportive shoes, however comfortable they feel, can quietly undermine even a well-designed mobility plan. It’s a small, practical detail that families can easily check and influence during visits, and one of the easiest wins in the entire falls prevention picture.

How Does Medication Affect Falls Risk?

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Worth Knowing

Certain medications, including some sedatives, blood pressure medications, and drugs affecting the central nervous system, are well recognised contributors to falls risk, particularly when a resident is taking several medications together. Regular medication reviews with a GP or pharmacist, ideally as part of routine care rather than only after a fall occurs, are one of the most effective, and most overlooked, falls prevention strategies available.

What Should Families Look For in a Facility’s Falls Prevention Approach?

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Things to Ask

• How and how often are residents formally assessed for falls risk?
• What happens immediately after a resident has a fall, is it documented, reviewed, and used to update their care plan?
• Are mobility aids reviewed regularly, not just supplied once?
• How are medications reviewed for falls-related side effects?
• What environmental safety measures are in place, particularly in bathrooms and at night?

A facility that talks openly and specifically about its falls prevention approach, rather than offering a vague reassurance, is generally a good sign. Falls happen even in excellent facilities, what matters most is how proactively risk is managed and how seriously each incident is taken afterwards.

What Happens After a Fall Occurs?

Even with strong prevention measures in place, falls can still happen, and how a facility responds afterwards matters just as much as the prevention itself. A proper response includes an immediate clinical check for injury, documentation of the incident, notification to family, and a review of what contributed to the fall, so the resident’s care plan can be updated to reduce the risk of it happening again. Under Australia’s Serious Incident Response Scheme (SIRS), certain falls resulting in injury must be formally reported and reviewed, which adds a further layer of accountability across the sector.

Families should expect to be informed promptly if their loved one has a fall, along with a clear explanation of what happened and what’s being done differently as a result. A pattern of falls without any visible change in approach is a genuine red flag worth raising directly with the facility. It’s also reasonable to ask specifically what changed after a previous fall, a good facility should be able to point to a concrete adjustment, whether that’s a mobility aid review, an environmental change, or additional supervision, rather than a vague assurance that “we’re keeping an eye on it.”

What Can Families Do to Help Reduce Falls Risk?

Families play a real role in falls prevention, even once a loved one is in residential care. Sharing information about a resident’s history, past falls, near misses, or specific fears, helps staff build a more accurate risk picture. Bringing appropriate, well-fitted footwear rather than loose slippers, checking that mobility aids are being used consistently during visits, and raising concerns early rather than waiting all genuinely contribute to a safer environment. For residents still at home, similar principles apply, removing loose rugs and trip hazards, improving lighting, and arranging a professional falls risk assessment through a GP or physiotherapist are practical first steps.

It also helps to be realistic with yourself as a family member. Wanting to eliminate all risk is a natural instinct, but a falls prevention approach that becomes overly restrictive, discouraging a resident from walking independently at all, for instance, can do more harm than good by reducing mobility, independence, and quality of life. The goal is genuinely reducing risk while still supporting a resident’s dignity and autonomy, not removing risk entirely at any cost.

Falls Prevention for Residents Living with Dementia

Residents living with dementia face a higher falls risk for reasons beyond physical frailty alone, impaired judgement about safe movement, disorientation, particularly at night or in unfamiliar surroundings, and difficulty communicating pain or discomfort that might otherwise prompt caution. Effective falls prevention for these residents tends to rely more heavily on environmental design and routine than verbal reminders alone, consistent room layouts, clear visual cues, good lighting that reduces confusion after dark, and predictable daily routines that reduce disorientation and agitation.

Sensor technology, such as bed and chair alarms that alert staff when a resident at high risk attempts to stand unassisted, is also increasingly used in dementia-specific care, though it works best as one part of a broader approach rather than a substitute for regular staff presence and engagement.

Safety Built on Awareness, Not Assumption

Falls prevention in aged care isn’t about eliminating every possible risk, that’s simply not realistic. It’s about taking a genuinely proactive, individualised approach, one that treats safety as an ongoing responsibility rather than a box ticked once at admission. Facilities that do this well combine careful assessment, thoughtful environmental design, appropriate mobility support, and honest communication with families when something does go wrong.

At Superior Care Group, safety is something we build into daily life at Wellington Park and Merrimac Park, not something we bolt on separately. Our teams work closely with residents, families, and allied health professionals to keep falls risk front of mind without making residents feel restricted or watched. If you’d like to know more about our approach to resident safety, we’d be glad to talk it through. You can learn more at superiorcare.com.au.

Have Questions About Resident Safety?

Wellington Park 16 Balmoral Street, Wellington Point, Brisbane (07) 3822 1876

Merrimac Park 50 Macadie Way, Merrimac, Gold Coast (07) 5618 1111

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