Now that Thailand has fully become an ageing society, one of the most common problems with the most serious impact on older people’s quality of life is the “fall”, or what many simply call “an elderly person falling”. This is no ordinary accident, because the consequences can be severe enough to cause death, or to become a long-term burden on both the older person and the family.
This article takes the reader through every dimension of falls among older adults — the causes, the risks, the consequences, and systematic ways to prevent them, covering the physical, psychological and environmental sides, as well as the modern technology that can help reduce the risk of a fall.
Why do older people fall so often?
1. Changes in the body
Older adults often live with muscle wasting (Sarcopenia), thinning bones (Osteoporosis), reduced balance, a slower nervous system and declining sight and hearing. All of these factors make a fall more likely, even during ordinary daily activities such as walking, going up and down stairs, or standing up and sitting down.
1.1 Muscle weakness (Sarcopenia)
Muscle degeneration becomes noticeable from around the age of 50 and continues to progress from 60 onwards. The muscles — especially in the legs and trunk — shrink and lose strength, so balance and general movement become less efficient. Standing up, sitting down, climbing stairs, or even a quick change of position such as turning around or reaching for something, can lead to a loss of balance and a fall.
1.2 Thin and brittle bones (Osteoporosis)
In post-menopausal women and older men, bone density steadily decreases, leaving bones fragile and easy to break. Even a minor fall can immediately fracture a hip or an arm, which in turn leads to repeat falls and a loss of confidence in moving around.
1.3 Reduced balance
The body’s balance depends on the brain, the eyes, the inner ear that senses body position (the vestibular system), and the sensory nerves in the skin and muscles. As we age, all of these systems work less well, so standing or walking on uneven ground carries a much higher risk.
1.4 A slower nervous system
The nervous system plays a key role in commanding movement and reacting to stimuli. Slower reactions in older adults — stepping on something slippery, or tripping over an object — can leave too little time to regain footing or protect themselves, making a fall far more likely.
1.5 Declining senses
- Eyesight Vision problems such as cataracts, glaucoma or age-related long-sightedness make it hard to see clearly, to spot a change in floor level, or to notice a frayed rug.
- Hearing Impaired hearing has a direct effect on balance, especially when the older person also suffers from dizziness.
- Sensation in the feet Reduced feeling in the soles of the feet, particularly in people with diabetes, makes it difficult to sense where the feet are while walking or standing.
1.6 Less flexible joints and tendons
Joints — especially the ankles, knees and hips — become less flexible with age, so stepping, shifting position or moving in different ways feels stiff or unsteady.
1.7 Blood pressure changes when changing position
Some people experience a drop in blood pressure when moving from sitting to standing (Orthostatic Hypotension), which causes light-headedness and dizziness and can bring on a sudden fall.
In short, the physical changes that come with age are a natural process, but combined with an unsuitable environment or a lack of proper care they make falls and injuries far more likely. Understanding your own body and keeping a close watch on these changes is therefore the key to preventing falls effectively.
2. Chronic conditions and medication
Chronic conditions such as high blood pressure, diabetes, heart disease or Parkinson’s disease all affect the balance system. On top of that, certain medicines — blood pressure drugs, sleeping pills, antidepressants — can cause dizziness, light-headedness or loss of balance. Among older adults, chronic illness and long-term medication are another major factor that significantly raises the risk of a fall. Understanding how these conditions work and what side effects the medicines have helps carers and older people plan better ways to reduce the risk.
2.1 Conditions affecting the nervous system and balance
- Parkinson’s Disease Patients experience tremors, slow movement and muscle rigidity, which severely disrupt balance — especially when starting to walk, stopping, or turning around.
- Stroke People with a history of an ischaemic or haemorrhagic stroke may have weakness in the arms and legs, poor muscle coordination (ataxia) or partial loss of sensation, all of which increase the risk of falling.
2.2 Heart and blood vessel disease
- Irregular heartbeat Reduces the blood supply to the brain, causing light-headedness or fainting and an immediate fall.
- Low blood pressure (Hypotension) Especially a drop when changing position (Orthostatic Hypotension), which is common in people taking certain blood pressure medicines such as diuretics or Beta-blockers.
2.3 Diabetes
Low blood sugar (Hypoglycemia) caused by diabetes medication or a missed meal can bring on dizziness, confusion or loss of consciousness, resulting in a fall. Diabetes also damages the nerves in the hands and feet (Peripheral Neuropathy), leaving numb feet and a loss of the sense of balance.
2.4 Mental health conditions
- Depression Affects concentration, judgement of a situation and the speed of movement, so the person may not react to a hazard in time.
- Dementia/Alzheimer’s Impaired memory and perception lead to poor decisions, such as walking in the dark or not using a walking stick.
2.5 Medication use in older adults
Older adults often take at least 3-5 different medicines at the same time (Polypharmacy), which raises the risk of drug interactions and of side effects that affect the nervous system, balance and alertness — for example:
- Sleeping pills and tranquillisers (Benzodiazepines) Cause drowsiness, confusion and light-headedness.
- Allergy medicines (older Antihistamines) Cause dry mouth, blurred vision, drowsiness and confusion.
- Opioid painkillers (Opioids) Affect perception and movement.
- Diuretics Cause dehydration, low blood pressure or the need to urinate at night, which raises the risk of falling on the way to the bathroom.
2.6 Problems with managing medication
Some people forget to take their medicine, take it at the wrong time, or accidentally take a double dose — particularly those without a carer close by. All of this increases the chance of complications from medication, which can lead to an unexpected fall.
3. An unsafe home environment
The home, which should be the safest place to enjoy retirement, can quietly turn into a hazardous space — especially when it has not been designed to suit an older person’s physical condition.
3.1 Slippery and uneven floors
Floors laid with slippery tiles, polished wooden floors, or rugs without a non-slip backing can easily send an older person sliding. Changes in floor level and high door thresholds are another major trip hazard.
3.2 Not enough light
A poorly lit home, especially at night or along corridors, in the bathroom and on the stairs, makes it hard for an older person to see clearly and easy to misjudge distances.
3.3 An unsafe bathroom
The bathroom is one of the highest-risk spots because the floor is almost always wet. Without grab rails, non-slip mats or a sturdy shower seat, the chance of slipping is much higher. Bending or twisting to reach something while showering adds even more risk.
3.4 Stairs
Many older adults have accidents going up and down the stairs because they lack strength and good balance. Stairs with no handrail on both sides, insufficient lighting, or steps that are too narrow or too steep are more dangerous still.
3.5 Furniture and household items
Cluttered furniture or sharp corners can trip an older person up or cause injury in a fall. Electrical cords running across walkways, unstable fans and wobbly TV stands are hazards that are easy to overlook.
3.6 How belongings are stored
If everyday items are kept too high or too low — in a high wall cabinet or a storage box under the bed — an older person may have to climb, strain their muscles or bend down a long way, all of which increase the chance of losing balance and falling.
3.7 A design that ignores how older people move
A home with narrow doors, tight corridors or several flights of stairs and no ramp does not suit older people who use a walking stick or wheelchair, or who have limited mobility.
How to prevent falls in older adults
1. Make the home safer to cut environmental risk
The home should be the safest place for an older person, yet it is often where they fall the most — particularly at high-risk points such as the bathroom, the stairs and the hallways. Sensible home improvements reduce that risk considerably. Here is what to do:
- Fit grab rails in the bathroom and on the stairs The number-one places for falls are the bathroom and the stairway. Install sturdy grab rails beside the toilet, the washbasin and the shower, and a handrail running the full length of the stairs.
- Use non-slip flooring Slippery floors in the bathroom or in areas that get wet easily should be replaced with non-slip materials, or covered with non-slip mats that have a rubber grip underneath.
- Secure rugs firmly, or avoid small rugs altogether Rugs that slide easily or curl up at the edges are another common trip hazard. Fix them down with double-sided tape, or switch to fitted carpet.
- Arrange furniture to keep walkways clear Walkways in the home should be wide enough to move through without bumping into objects or furniture, especially for anyone using a walking stick or a walker.
- Install enough lighting Bedrooms, bathrooms and night-time walkways should have sensor-activated pathway lights or a dim light left on, so everything is clearly visible when walking at night.
2. Build physical strength, the foundation of fall prevention
Older adults with low muscle mass, poor balance or stiff joints are far more likely to fall. Building physical strength is therefore the most effective long-term approach. Recommended activities include:
- Suitable exercise
- Yoga or tai chi to build flexibility and balance
- Brisk walking or arm-swing walking for at least 30 minutes a day to strengthen the leg muscles
- Balance training such as standing on one leg, or standing up and sitting down from a chair several times a day
- Good nutrition
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- Focus on calcium-rich foods such as small whole fish, milk and tofu
- Get vitamin D from morning sunlight or supplements (on a doctor’s advice)
- Protein from lean meat, eggs, beans and tofu to build and repair muscle
- Get enough rest Too little sleep leads to dizziness, grogginess and poor balance, and makes a fall more likely.
3. Use technology to help, combining safety with convenience
Using modern technology to support older people’s mobility and safety is another approach that suits today’s families. Examples of technology that helps prevent falls include:
3.1 Home Lift
Ideal for multi-storey homes. Installing an elderly lift reduces the risk that comes with using the stairs, and gives older people the freedom to move between floors without relying on anyone else. Choosing a Cibes Lift home lift is one way to look after an older family member and prevent a fall.
Recommended model: Cibes UNO
Cibes UNO is a screw-driven home lift from Sweden, meticulously designed with clean Scandinavian lines — minimal yet distinctive — and you can choose the material and colour of the platform, the shaft walls and the control panel to match your home perfectly.
Highlights of the Cibes UNO
- Easy to install Unlike a conventional passenger lift, the Cibes UNO needs no excavated lift pit (Pitless), no machine room (Machine Roomless), and very little disruption to the structure of the house. It suits homes that are already built, and even narrow townhouses, with installation completed in just a few days.
- Screw-driven Technology The screw drive is a technology unique to Cibes that delivers smooth, quiet travel with far less noise than a conventional lift system, and it is easy to look after with no complicated maintenance.
- The lift structure comes with a “ ready-made lift shaft ”, or Ready-Made Shaft, produced from high-quality materials and available in clear glass so the lift lets in natural light and shows off the design of your home. The Cibes UNO also offers as many as 41 lift sizes to choose from.
- Safe in everyday use Comprehensive safety systems, from the emergency stop and the backup battery for power cuts to the emergency telephone inside the car, automatic floor levelling and obstruction sensors, make daily use safe and worry-free — especially in a home with older people, small children or people with disabilities.
3.2 Walking-assistance technology
On the subject of walking-assistance technology, in March 2025 Assoc. Prof. Dr. Ronnapee Chaichaowarat of the Faculty of Engineering, Chulalongkorn University, unveiled the “Wheelchair Exoskeleton”
The Wheelchair Exoskeleton is a body-support robot developed by combining technology with human anatomy, applying the principle of “Kinematic Compatibility” together with current robotics technology.
The Wheelchair Exoskeleton has a structure resembling an “external skeleton” that adds strength to the muscles and joints, allowing the wearer to move, stand up and walk. It works using motors that control the hip and knee joints
Assoc. Prof. Dr. Ronnapee Chaichaowarat trying on the Wheelchiar Exoskeleton. Image courtesy of Assoc. Prof. Dr. Ronnapee Chaichaowarat trying on the Wheelchiar Exoskeleton. Image courtesy of https://www.chula.ac.th/highlight/210855/
3.3 Non-slip shoes
Non-slip shoes for older adults, made to prevent falls, are now designed specifically around the physiology and anatomy of older people, using materials such as:
- EVA rubber Light, highly flexible and resistant to wear even under heavy use, it also absorbs impact effectively and so reduces fatigue while walking or standing.
- Natural rubber Tacky and with excellent grip on the floor, hard-wearing over the long term and the best choice for walking on wet, slippery surfaces — the bathroom, the poolside or outdoors.
- PVC A material known for strength, water resistance and good grip. It is also easy to clean, does not absorb dirt and costs little, making it good value and suitable for many situations on both wet and dry floors.
3.4 Fall detection sensors
These are devices worn by the older person that send an alert to the family or care team the moment a fall occurs.
3.5 GPS trackers
For older people with memory problems, a tracker can pinpoint their location if they get lost.
4. Care from family and community, the emotional factor not to overlook
Older people who feel cared for, supported and accepted are more willing to move about and leave the house, which directly benefits both physical and mental health. Ways to support them include:
- Encourage and support them, and build their confidence in moving around Never let them feel that a fall is a failure.
- Organise group activities or a seniors’ club Taking part in activities with others in the community reduces isolation and encourages movement without them even realising it.
- Train carers and family members to understand how to support them How to walk with them and help them safely, and how to spot the warning signs before a fall, such as shuffling feet, difficulty balancing or dizziness.
