One fall can change everything for older Long Islanders. Here's how to lower the risk.

On a recent Thursday morning, 14 participants ages 60 and older practiced heel-to-toe walking and other controlled movements in a Tai Chi for Health and Balance class. Among them were Loreen Meserole, 69, of Coram, and Ray and Linda Schmitt of Commack.

Meserole said that in addition to managing hip pain, she takes the class at the Osher Lifelong Learning Institute at Stony Brook University because she had a scare while working as a nursing administrator a few years ago.

“I almost face planted at work because my foot kind of got stuck on the tile,” she said. “I’m worried because you hear people that fall and break their hip and then they're never the same. So it's always in the back of my mind now to be very careful.”

Ray Schmitt, 78, said he fell in his garden four years ago while wearing “bad shoes,” carrying a bag of fertilizer in one hand and a shovel in the other, and not paying attention.

“I stepped in a hole and was lucky that all I got were a few bruises,” said Schmitt, who retired in 2017 from the HVAC industry.

When his wife Linda, 76, suggested they take the Tai Chi class to address balance issues, they both signed up, he said. Linda said the class has taken on more significance because they know four people around their age who have suffered “vicious falls,” in the past few months, including one who broke a wrist.

“In our age group, that’s downright scary, so anything that you can do to give yourself a better sense of balance and stability when you're walking is extremely beneficial,” said Ray.

Leading cause of injury

The Centers for Disease Control and Prevention says falls are the leading cause of injury among adults 65 and older nationwide. That is reflected in the injuries being treated at area trauma centers, said Kristi Ladowski, associate director of injury prevention and program integration at Stony Brook Trauma Center. According to New York State Department of Health data for 2022-2024, Suffolk County had 278.5 fall-related hospitalizations per 10,000 residents ages 65 and older, compared with 240.2 per 10,000 in Nassau County.

Francene Stauber, the trauma injury prevention outreach coordinator for Mount Sinai South Nassau in Oceanside, said these falls “can result in fractures, head injuries, prolonged hospitalization, loss of mobility, independence, functional decline and increased mortality.”

Not only do falls impact an older adult's physical, emotional and financial well-being, said Ladowski, “they’re a leading cause of nursing home placement, often that turning point of somebody who was living independently or semi-independently.”

'I wasn’t paying attention'

While older adults are a diverse group, from very active to those who have mobility issues from chronic conditions or health issues, there’s a trend when it comes to falling, Ladowski said.

“Younger older adults, those under 75, tend to have more injurious falls when they're out and about,” she said. “They're walking the dog, rushing around somewhere and trip on the uneven piece of sidewalk or a tree root.”

Among those 75 and older, falls tend to happen at home, Ladowski said. “It's in our everyday navigation going from the bedroom to the bathroom to the kitchen. But most fall stories for all ages usually start with 'I was rushing' or 'I wasn't paying attention.' "

Medications are another factor. According to the National Institutes of Health, taking four or more medications can increase an older adult's risk of falling, particularly if the drugs cause dizziness, sedation or confusion.

A fear of falling

Chronic conditions such as type 2 diabetes, depression and cardiovascular disease can also contribute to fall risk. Sarah Cohen, a physical therapist and administrator for the Center for Parkinson's Disease at Stony Brook Southampton Hospital, said this is particularly true for those with Parkinson's disease, a progressive neurodegenerative disorder.

“They’re twice as likely to fall compared to their same age peers and nine times more likely to have a recurrent fall,” Cohen said.

Cohen said people with Parkinson's disease face additional fall risks.

“They may experience all of the same fall risk factors as the general older population, but there are specific factors that increase their risk, such as stiffness, rigidity and balance impairments,” she said.

For people who do fall — whether they’re injured or not — a fear of falling also puts them at risk, said Josephine Peterson, injury prevention specialist in the Division of Trauma & Acute Care Surgery at NYU Langone Hospital-Long Island in Mineola. “People might be afraid to go out, which of course affects their physical and mental health, and there’s a correlation between social isolation and falls as well,” she said.

Hip fractures can have serious consequences. 

A July study published in the medical journal JAMA said 22% of people who suffer a hip fracture die within a year.

They’re not inevitable

Fortunately, falls aren’t an inevitable part of aging, said Stauber. “There’s a lot older adults can do to prevent them and many of the risk factors for falls are modifiable.”

But don’t wait to think about the issue, said Peterson, “because it happens fast.”

Start by fall-proofing your home, she said. “The reason falls happen more often at home is so many of us have been in them for so long and are used to our space being a certain way. We don’t realize that the clutter, the way our furniture is laid out, or the fact that we don't have handrails on our stairs is all going to be dangerous as we get older.”

Additionally, our homes were designed for healthy adults in their 20 through 50s, said Ladowski. “They weren’t originally designed for young children, for older adults and for people with different types of mobility needs. There would be no hesitation if you’re going to babysit your grandchild that you’re going to take steps to make sure that they're safe and remove any hazards. But we don't do that same thing for ourselves.”

Near-falls are warnings

If you’ve been feeling unsteady or had a near-fall — or more than one — talk to your healthcare provider, said Stauber, who is also the fragility hip fracture liaison for Mount Sinai South Nassau’s Orthopedic Department. “A fall may be a simple accident you can bounce back from, but it also may be the first sign of a deeper health problem.”

Stauber said medical professionals should also regularly review your medications. “Make sure the side effects or the interactions between your medications aren't setting you up for a fall. They could be making you dizzy, disoriented, confused, lethargic.”

There’s also help available through fall prevention programs at most Long Island trauma centers, Ladowski said. They focus on strength and balance, home safety, medication review, and chronic disease management, along with vision and other health screenings. (See sidebar.)

For people living with Parkinson's disease, Cohen said, “we’re fairly certain that we're able to delay the disability of the disease with regular exercise.”

Roland Kravats, 83, of Westhampton Beach, who was diagnosed with Parkinson's disease in 2017, said he’s been participating in a Rock Steady Boxing class in Hampton Bays three times a week for several years.

“It definitely helps with my balance and other aspects like using my hands so I can tie my shoes and stuff like that,” he said. “You’ve got to just keep that body moving. As long as you're physical, you have a chance of being able to do things that eventually you're going to lose capability.”

Share with your family

Stauber also advised older adults not to hide falls from their families.

“People want to stay as independent as long as possible, and if they feel they're losing a grip on some of that independence, they're not eager to share it. But being aware and proactive, taking those steps to prevent a fall, will make you feel healthier,” she said. “Many risk factors are modifiable as long as we do something before we have that first fall.”