Managing Medications to Prevent Falls
Most older adults aged 65 or older take multiple prescription medications to manage their health, and about two-thirds take five or more different drugs each year. In long-term care settings, the numbers are even higher, since many residents live with several chronic conditions that require ongoing treatment. While medications play a vital role in maintaining health and controlling symptoms, the way they interact with the body and with each other can sometimes create new health risks. One of the most concerning is their potential to increase the likelihood of a fall.
Falls are the leading cause of injury-related hospitalizations among older Canadians, with an estimated 20 to 30 percent of seniors experiencing a fall each year. Although aging, chronic conditions, mobility issues and vision changes can all contribute to falls, medications are one of the few modifiable risk factors. Understanding how medications, both prescription and over-the-counter products, may impact your health and interact with each other is one key step older adults and their caregivers can take to reduce fall risk.
How Medications Contribute to Falls
As the body ages, its ability to process medications changes. Kidney and liver function may decline, and shifts in muscle and fat composition can alter how drugs are absorbed, distributed and eliminated. A medication that was prescribed in midlife and taken consistently over the years may become riskier with age if the dose is not adjusted as your body changes.
Certain medications are known to increase fall risk, particularly those that act on the brain or circulatory system, which can cause drowsiness and dizziness. These include:
- Drugs for high blood pressure and heart conditions
- Prescription and non-prescription sleep aids
- Anti-anxiety, antipsychotic and antidepressant medications
- Some pain relievers such as opioids and muscle relaxants
- Anti-seizure medications
- Bladder control medications
- Allergy, nighttime cold and antihistamine medications
- Some medications that lower blood sugar like insulin
The risk is higher when multiple medications are taken at the same time, a situation called polypharmacy. For example, a medication that blurs vision, such as certain eye or allergy medications, combined with a sleep aid that causes drowsiness, can make nighttime missteps or trips much more likely. Other factors that increase risk include taking medications longer than needed, not following prescribed instructions or combining drugs with alcohol.
Practical Strategies to Reduce Risk
Taking steps to manage health and medications safely can help reduce the risk of falling. Here are some strategies for older adults and their caregivers:
Review Your Medications Regularly. Check in with your doctor, nurse practitioner or pharmacist at least once a year—or sooner if your health changes or you have new or changed medications—to make sure your medications are safe and effective. Bring a list of all medications to your appointment, including all prescriptions (pills, eye drops, creams), over-the-counter products, vitamins and supplements. Ask your healthcare provider what each medication does, whether it is still necessary and if safer alternatives, lower doses or different timing could reduce side effects. Report any new symptoms, such as unsteadiness, blurred vision or excessive sleepiness, to your healthcare provider immediately.
Never Make Changes on Your Own. If you notice that medications or side effects are making you feel unsteady or more prone to falls, never make adjustments without speaking to your doctor, nurse practitioner or pharmacist. Changing or stopping a medicine without medical guidance can cause withdrawal, return of disease symptoms or harmful interactions. If you have concerns, your doctor, nurse practitioner or pharmacist can work with you to find the safest plan.
Use Tools to Stay Organized. Pillboxes or pharmacist-prepared blister packs, which organize medications by day and time, can help ensure you take the right pills at the right time. Medication reminder apps or calendars can also help you stay on schedule and prevent missed doses or harmful interactions. If you accidentally miss a dose, speak with your doctor, nurse practitioner or pharmacist before taking another one, as taking doses too close together can increase the risk of side effects, interactions and falls.
Combine With Other Falls-Prevention Strategies. In addition to managing medications, older adults can reduce their risk of falls by building strength and balance through exercise, keeping up with regular eye exams, wearing proper footwear and using assistive devices when recommended. Caregivers can further support safety at home by keeping walking areas clear, removing tripping hazards, improving lighting, installing grab bars in the bathroom and ensuring commonly used items are stored within easy reach.
Taking Action
Falls are not an inevitable part of aging. By paying closer attention to how medications affect the body, asking the right questions and creating safer routines, older adults and their caregivers can take meaningful steps to prevent unnecessary falls.
Conversations with a doctor, nurse practitioner or pharmacist are the best place to start and the right medication plan can make all the difference in staying safe, confident and independent. When combined with regular exercise, routine health checkups and a safe home environment, careful medication management provides a strong foundation for reducing fall risk and supporting long-term quality of life and independence at home.
Reviewed By: David Yam, Lead Pharmacist, VHA Home HealthCare