12/23/2025
Here is my annual posting of HOW NOT TO FALL. from Amy Tan:
First, an update: In the last few months, three close friends fell and suffered significant injuries. One required stitches and had post-concussive syndrome. Two required surgery, very long hospitalizations, and ongoing therapy in a skilled nursing facility. One now has quadriplegia. They are all over 70.
Here are the reasons they fell: One tripped when not scanning ahead to see the tree roots that had broken up the path. Another had a cell phone tucked under her chin and books in her hands. She tripped on an old thin bath mat that had no anti-slip backing left. The other friend fell down steep winding stairs that were poorly lit.
There are alarming statistics concerning women over age 65 who suffer hip fractures from falls. According to one scientific study, the one year mortality rate was 27%, meaning 1 in 5 women will die in the first year, usually related to complications, such as blood clots, infection, additional falls, or pneumonia that can develop when a person is less mobile. And men don’t get a break, so to speak, with the statistics. They suffer more injuries and death from falling than women. Some of this may be due to the fact that men tend to place themselves in riskier fall situations, for example, cleaning gutters while standing on a tall ladder.
Since many of my followers are over 60, here is some advice to prevent falls. Most of them are my own “live and learn” lessons from falls I’ve had and the factors that put me at risk.
1. ALWAYS USE THE HANDRAIL WHEN TAKING THE STAIRS OR A STEEP INCLINE. Not counting spills in childhood, I estimate I’ve fallen down stairs a half-dozen times over my adult lifetime and for various reasons. I’ve tripped over things and fallen on stairs in the dark when what I thought was the last step was not the last. Most would not have happened if I had used a handrail. Consider installing handrails leading up to your front door. If you think you don’t need it, think about elderly friends or relatives who are not as fit as you.
2. CONSIDER AREAS WHERE HANDRAILS ARE NEEDED. Typically, these are places where a number of people have already fallen. Going down steps of the house. Going down pathways that are slippery in the rain or when covered with moss. Walking down uneven steps.
3. USE A FLASHLIGHT WHEN WALKING DOWN STEPS OUTDOORS. GIVE ONE TO GUESTS TO USE. If you have stairs leading to your front door and do not have a brightly lit path that illuminates steps ahead, use a flashlight. Although our stairs are lit, older guests may have impaired vision. I have about five rechargeable waterproof and extremely bright flashlights. Guests place the flashlights in our mailbox at the bottom of the stairs.
Consider adding reflective strips on stairs so that the edges of steps are apparent.
4. WHEN GETTING UP IN THE MIDDLE OF THE NIGHT, USE A PORTABLE LIGHT OR AUTO-ON NIGHTLIGHT. I’ve stumbled over dog toys, a slipper, a stool, etc. in the dark. I use one of those clip-on reading lights, which is always nearby for reading books. And before going to sleep, I check the path between the bed and the bathroom.
5. DON’T CARRY ITEMS IN BOTH HANDS WHILE DESCENDING STAIRS, INCLINES OR UNEVEN SURFACES. Those items may block you from seeing obstacles or uneven steps. A friend who used both hands to carry a car seat with her grandchild strapped into it missed the last step and managed to keep the baby from hitting the pavement but did some damage to herself. A friend insisted on carrying boxes of Christmas gifts in both hands while going down the front stairs and missed the last step and fell forward onto the gifts. If possible, use large bags with handles to hold bulky items, so you can see what is in front of you, while freeing one hand to take the rail.
6. CHECK SURFACES INSIDE AND OUT THAT MAY BE SLIPPERY. My husband recently slipped and nearly fell on a sloped walkway that had accumulated algae from the winter rains. Fortunately, he grabbed onto the rail and did not crash to the ground. I slipped turning a corner after an over-zealous new housekeeper used wax to polish our wood floors to a high sheen. For outside steps and pathways, I have used straight 2% hydrogen peroxide from a spray bottle to remove algae. H202 deteriorates to water within 24 hours and does not kill plants the way bleach does. In fact, hydrogen peroxide can be used to treat root rot and bacteria and to release more oxygen in soil.
7. NEVER LOOK AT YOUR CELL PHONE WHILE WALKING. That goes for inside the home and out. I know of two older friends who recently fell while looking at their cell phone. One tripped over a bag, and another did not take into account the greater height of her friend’s car as she stepped out while reading email. A firefighter in NYC told me that one of the leading causes of pedestrian deaths is inattention while looking at a cell phone, and the number of deaths is even higher for those also wearing headphones.
8. ROUTINELY SCAN AHEAD TO NOTE OBSTACLES AND CHANGING CONDITIONS. I once was engaged in talking to someone as we strolled on a level walkway. I did not notice that the flat walkway was becoming an elevated sidewalk with a 5” curb. My left foot rolled off the curb and I fractured my ankle. Fortunately, it was not my hip.
9. BE AWARE OF WHERE YOU PLACE THROW RUGS AND ESPECIALLY RUGS THAT DO NOT LIE FLAT. Falls can happen when your foot catches the edge or when rugs are slippery and lacking grippers. People walking fast or turning corners in the house can send a rug flying. This is a real danger for those with balance problems, such as those with Parkinson’s or MS.
10. CONSIDER INSTALLING GRAB BARS IN YOUR SHOWER OR TUB. Amost 80 percent of falls in the home occur in the bathroom, and according to the CDC, more than 200,000 seniors are treated in emergency rooms each year for bathroom-related injuries. I am actually surprised how many bathrooms of friends have deep tub-and-shower combos, and only a slippery tiled wall to lean against and faucet handle to grab onto. They cite that grab bars are ugly, yet their own bathroom is not on regular public display. You can slip when you step in and balance on one leg. You can slip on a bar of soap or when tub bottoms have an invisible layer or shampoo or conditioner. You can lose your balance when you close your eyes for more than a few seconds, as might happen when shampooing and rinsing hair. Your balance is simply not as good when you can’t see. Try standing on one foot with eyes open and then closed. I speak from experience. I have fallen in the shower of a former home that had very slippery tiles and nothing to grab onto. Another fall occurred when I already had a broken leg in a cast and had use of only one good leg in the shower. Another fall occurred in a hotel with a curved tub, which led to my shooting up and over the tub and landing onto a very hard floor. I have nearly fallen many times when using shower-tubs in hotels and the homes of friends. Oh, and those bath mats with grippy suction cups. Did not work for me. Soap on plastic is dangerous.
If you use a shower chair, be aware that it may not be stable to lean against if the shower floor is slippery.
11. CONSIDER INSTALLING A GRAB BAR NEAR THE TOILET. I have had more than one elderly guest rip off the towel bar or toilet paper holder when they leaned on them to stand up. Low toilet seats are a challenge for some. Mask the grab bar by hanging a small washcloth over it. There are many websites that sell attractive grab bars that don’t resemble those ugly aluminum ones you see in hospitals.
12. BE CAREFUL IN BATHROOMS WITH MARBLE, GRANITE or POLISHED TILE FLOORS and SHOWER BOTTOMS. I once fell three times during the course of my stay in a hotel that had beautiful marble floors that housekeeping polished to a shine. Actually, I am baffled why people install bathrooms with highly slippery flooring. Are the aesthetics really worth the risk? When choosing tile for a bathroom, consider small, unpolished tiles, like penny tile, connected by grout.
13. WEAR NON-SKID SHOWER SLIPPERS. Choose ones that have non-slip properties when walking on wet surfaces. Smooth-bottoms are not good. I bring shower slippers when I travel for hygienic and safety reasons. Many hotel showers are slippery.
14. BE AWARE OF DOGS AND CATS THAT TEND TO GET UNDERFOOT. Unless you have trained your pets to not rush ahead of you, you will need to check if your pet is following you. Dogs, for example, barrel head when the doorbell rings. A friend of mine tore her ACL when she tried to avoid falling on her little dog. Another friend broke her foot when her cat scooted under her as she was going down the stairs.
15. GET IN A BALANCED POSITION BEFORE STEPPING OUT OF THE CAR. I once hurriedly stepped out of the car on one foot when the door was not fully open. I was off balance sideways with one foot still in the car and when I lost my balance, I had nothing to grab onto and fell backward and hit my head on concrete. That’s one way to end your writing career. I recommend opening the door fully, and swinging your legs out together while seated so that both feet are on the ground before standing up. Be a triangle, not a T.
16. SLOW DOWN WHEN TURNING FAST OR CHANGING DIRECTIONS. When you turn, your required balance shifts. I fell when I stepped outside onto the patio, immediately turned, lost my balance, and fell onto a bunch of flower pots. Lots of bruises. I have slipped (without falling) a number of times turning corners in the house.
17. REMOVE OBSTACLES ON THE FLOOR, like magazines, clothes, dog toys, and charging cords. I know of one author who broke a leg when he got out of bed and immediately stepped onto a magazine. I fell when I stepped on loose clothes on the floor that I was about to pack for a trip.
18. IF YOU GO BAREFOOT OR WEAR SOCKS ONLY INDOORS, USE GRIPPY SOCKS. They are also sold as yoga socks. They often look like ballet slippers and can fit over socks easily.
19. USE A STEPSTOOL AND HAVE SOMETHING ANCHORED THAT YOU CAN GRAB ONTO WHEN TALKING DOWN ITEMS FROM A HIGH SHELF. I know of people who fell when they stood on collapsing tables, chairs, ottomans, and boxes. Keep in mind that once you take something off from a high shelf, your balance shifts. You don’t want to have to decide between a box of Christmas decorations and a concussion. Consider installing grab bars in your closet or garage that you can hold onto when taking down items on high shelves.
20. THINK TWICE BEFORE USING A LADDER, INDOORS OR OUT. My husband had a ladder slide out from under him when he was changing a light bulb on a 14’ high ceiling. He was lucky he was not killed. A high percentage of men who die of falls at home were on tall ladders or on the roof, cleaning gutters. We installed LED lights in our home so that we will not have to change lightbulbs as frequently. And when they need to be changed, we will hire a handyperson with a ladder to handle that task and other safety needs that may come up throughout the year.
21. BE AWARE OF TRIPPING IF WEARING LONG SKIRTS, PANTS, HIGH HEELS or LOOSE SLIPPERS. While going down stairs, I’ve tripped on skirt and pant hems. I also slipped wearing loose slippers and sandals. Sharply-pointed high heels can get caught on rugs.
22. GIVE UP TRYING TO LOOK THREE INCHES TALLER. Switch to stable shoes without heels or wedges. Avoid wearing shoes that are too big. And be aware that cushy tall foam slides are comfortable but not that the best for stability on stairs and such.
23. DO CORE BODY EXERCISES TO STRENGTHEN BALANCE and FLEXIBILITY. Core body exercises are not necessarily the same as muscle strengthening exercises. It is not the same as running on a treadmill. So look up the types of exercises that improve balance AND flexibility. Older people who are less flexible tend to move their upper and lower body as one unit. Practice turning your head to the side one way and the other. Turning your head to see something is better than turning your whole body. You can find exercise and stretching suggestions on YouTube, from a personal trainer, or from a physical therapist. Do the exercises at least three times a week.
24. BE PROACTIVE IF YOU LIVE WITH SOMEONE WHO IS OLDER OR WHO HAS MOBILITY IMPAIRMENTS. It could be someone who has weakness from a stroke, cancer, Parkinson’s, MS, arthritis, osteoporosis—any disease that impairs coordination or is high risk because of fragility. You may not have problems, but consider the safety needs of your family or friends who visit or stay overnight.
25. DO AN ANNUAL ASSESSMENT FOR FALLING HAZARDS IN YOUR HOME, INSIDE AND OUT. Hazards change. If you have kids or grandkids or dogs over, obstacles increase. If you have snow or ice, accumulated leaves, or a lot of rain, your walkways will be slippery. If you are moving into a new home, do a run-through on safety issues, especially in the bathroom. There are some YouTube and Tik-Tok videos that show all the “hilarious ways” that people fall. I always wonder what happened to those people after the video ends. I imagine the outcome did not remain hilarious to the person who suffered the fall.
26. LEARN HOW TO FALL SAFELY. If you are falling, be like a child—squat to get lower and roll into the fall. Watch videos on YouTube, and practice quickly lowering yourself, although not simulating a complete fall. If you have fallen, you’ll no doubt be shocked. Try to determine if you are injured and where. If you hit your head, it may not be wise to move until you assess your injury. When people help you stand, do not have them pull you up by grabbing onto one hand. That was how I sprained my wrist. Have them support you under the armpits. I prefer to have people wait and see if I can get up on my own.
Have a healthy 2026!
