How to Stay Steady on Your Feet

"I tell my patients that walking may be the single best thing they can do to help improve their balance and reduce risk of falls," Brangman says. For instance, women ages 65 to 70 who do at least 150 minutes a week of moderate intensity activity like brisk walking cut their risk of an injurious fall by about 30 percent, according to a 2024 study published in JAMA Network Open.

The 2023 National Survey on Drug Use and Health found that about a third of people older than 65 took prescription pain drugs, and 17 percent had taken prescription tranquilizers or sedatives like benzodiazepines in the prior year.

Those drugs all raise fall risks, says Stephen Persell, MD, a professor of internal medicine at the Feinberg School of Medicine at Northwestern University in Chicago. Medications like gabapentin (for chronic pain) and antidepressants also increase the chance of a tumble, and prescription sleep meds are particularly problematic, Persell says.

He recommends a yearly medication review, where a healthcare professional like a pharmacist or primary care provider looks at all your prescription and over-the-counter drugs, and supplements. Your doctor may change a medication that could increase your fall risk.

Better lighting on stairs and in hallways, and grab bars in these places and the bathroom, can make a big difference. Have light switches at the top and bottom of stairs, and at each end of long halls, says Samuels. Ted Johnson, MD, a geriatrician at Emory University School of Medicine in Atlanta, recommends motion-activated lights—they’ll automatically turn on when you walk by.

Padding around barefoot or in socks can raise fall risks, so wear sturdy shoes with good traction, like sneakers, at home, Crenshaw says. One study of adults ages 70 and older found that about half were barefoot or wearing socks or slippers when they fell at home. Those people were also more than twice as likely to be seriously injured in a fall than those who wore shoes when they slipped. Outdoors, wear boots with a nonslip sole on wet, icy surfaces, says Crenshaw, and use a cane or walking sticks if you’re concerned about balance.

As for home maintenance, consider hiring someone even for tasks as seemingly simple as changing a lightbulb in a ceiling fixture. "I tell all my patients not to get on a ladder after the age of 40," Brangman says.

The American Academy of Ophthalmology recommends having your vision checked at least once every two years if you’re age 65 or older. That helps you and your eye doctor keep tabs on conditions that can affect vision, like cataracts, age-related macular degeneration, and type 2 diabetes, Johnson says. He also advises skipping progressive lenses in eyeglasses, if possible. A 2025 study in the journal Optometry and Vision Science found that they hiked the risk of falls, compared with bifocals.

If you notice that you have trouble hearing—or loved ones complain about it—have a hearing test. Older adults with hearing loss are more than twice as likely to fall as those with normal hearing, but wearing hearing aids if needed can reduce that risk by about 50 percent. Ask your doctor how often you should have your hearing checked.

If you take a spill, it’s important to take the right steps afterward so that you don’t make matters worse—and that you get assistance if you need it.

1. Stay still for a few moments. Instead of trying to get up right away, stay where you are and take several deep breaths. This will help calm your nervous system and get you over the shock of the fall.

2. Check yourself for injuries. If you are in pain or bleeding, yell or phone for help, without moving. And if you have difficulty moving at all—which could indicate a fracture—or you’ve hit your head, seek emergency care. (Loss of consciousness, confusion, lightheadedness, headaches, and dizziness are potential signs of head trauma.) Those who are at higher risk of falls might consider wearing a medical alert bracelet or pendant or a smartwatch or having a cell phone handy. Those devices can monitor you for falls and call for help for you if you need assistance.

3. Take care when you do move. Change position slowly. First, roll over onto your side, get up onto your hands and knees, and crawl to a chair, if you can do so without hurting yourself or increasing your discomfort significantly. Then put your hands on the chair seat and slide one foot forward so that it’s flat on the floor. Keep the other leg bent so that the knee is on the floor. From this half-kneeling position, slowly rise and turn your body to sit in the chair.

4. Dial your doctor. Even if you don’t think you’ve been injured (some fall-related injuries may not be apparent right away), call your doctor’s office and let your healthcare provider know that you have fallen, Johnson says. They can help assess whether they need to see you, or whether you should go to the emergency room.

Managing both high blood pressure and fall risks can be challenging. "Older adults are more likely to have orthostatic hypotension, a sudden drop in blood pressure when they stand up—which leads to dizziness and falls," says Brangman.

Blood pressure drugs often exacerbate the dizziness of orthostatic hypotension, she says. For example, nursing home residents were more than twice as likely to break a bone in the first 30 days after starting a new blood pressure drug, according to a 2024 study in JAMA Internal Medicine.

If you use blood pressure meds and get dizzy or lightheaded when you stand up, tell your doctor, who may want to adjust your medication. All older adults on such meds should also periodically check their blood pressure while sitting and then while standing, Brangman says. If you see a drop of more than 10 to 20 points in your systolic (top) number, see your doctor. You may have orthostatic hypotension.