Falling: What are the most common circumstances?

Anything and everything. Weakness, dizziness, confusion, fainting, tripping, eyesight failing, knee gave out for no reason, trying to climb a ladder. Dementia. A mole hole. Fall over the dog. You name it, fall happens.

I used to wonder why my parents weren’t falling in the shower too. It’s because they didn’t use the shower. They would sponge bathe at the bathroom sink and wash their hair in the kitchen sink . Very common among the elderly because they fear falling in wet shower .

Balance, weakness, shuffling. Poor judgment, like getting up on ladders. Forgetting that they can't walk unassisted: this is what happened to my 100-yr old Aunt...escaped out of her bed in the middle of the night for who knows what reason and fell on her carpeted floor and broke her hip. Before this incident she fell twice before, once while on a stepstool to decorate her Christmas tree and another time tripped and fell while walking even though she was being assisted/supported by her niece. Each time she broke a bone.

Omg- the ladders and step stools!
Why, oh WHY do they start climbing on stuff? I’m convinced they ALL do it.

With my late husband, his falls were either from him having seizures or from his unsteady gait from his vascular dementia, as that is one of the many symptoms.
Thankfully with all of his falls(and there were many)he only once broke a bone and that was the ball of his hip, though there were a couple times when he did hit his head and had a brain bleed.
Often it is a fall that will kill someone, so they should not be taken lightly.
Maybe it's time that your mother shouldn't be living alone anymore.

As an old retired RN, and as now a senior, I can tell you there are two causes for falls pretty much running neck and neck from the presenting in ER stories.

1. Over medication with blood pressure and/or heart meds, along with dehydration and orthostatic hypotension. Often blood pressure measure higher in MD office that it would in relaxed circumstances at home. BP in anyone who has labile/unstable BP should be measure twice a day. Seniors lose their drive to know when they need to take in fluids, so fluids are important.
2. BALANCE issues. These are usually lower brain moderated, and they are a part of aging. I always knew this as an RN, but now as an 81 year old I not only KNOW but I FEEL it. I weight 143 and stand 5'7". I weighed, younger, about 120 steadily thoughout my life, so I now weigh the most I have ever weighed. Yet, standing on the bus I feel like a feather in the wind. I better hold on. The balance is not there. I consistently walk a mile or more daily and I do balance exercises, but balance changes with age.

The one certainty with age is that WE WILL FALL.
No matter WHAT, we will fall.
Best out to you Xena.

Well let's see. Mom fell 95x for a variety of reasons.

Not using her walker
Using her walker but refusing to pay attention to where she was going
Having no core strength for refusing PT repeatedly
Refusing to push the button to ask for help, admitting her "weakness"
Trying to help others to show her non existent strength and abilities
Insisting on sitting on the very EDGE of her wheelchair
Insisting she could walk when she could not
Refusing to ask for help on the toilet
Not believing she had neuropathy in her feet which made them numb while chronically complaining about neuropathy in her feet

Those are a few reasons I can think of.

Orthostatic hypotension is why my mom falls

My mother’s falls were due to her Parkinson’s disease which caused her to have strength and balance issues.

Rehab and home health were good. PT and OT helped her gain some strength and improve her ability to balance.

The OT went through our home and gave us tips on how to make our home as safe as possible to deter falls. I don’t think it is possible to avoid all falls. She fell in spite of our best efforts.

Falls are hard for them and also hard for us to see them getting bruised and hurting. My mom was fortunate that she never broke any bones. Stitches yes, but no broken bones.

My Husband originally was diagnosed with Alzheimer's but I think he had Vascular Dementia as well.
His first fall..the one that sort of got the dominos falling was an actual slip and fall on black ice.
Each fall after that was the start of a noticeable decline.
He had 9 falls over a 3 year time period and I kept a note of them on the side of the refrigerator. He was on Hospice and I wanted to make sure the Nurse and the CNA were aware of any falls. So in my Husbands case I think the fall was the result of a mini stroke.
He also had 2 occasions where he "slipped" out of a chair and I had to call for a Lift Assist. He would just slide down as he stretched his legs out and eventually his butt would be on the edge of the chair and I could not get him back up. But I would not categorize these as "falls"

The most common circumstance is advanced age. Falls by themselves are not inherently bad; it's who is falling. A 40 year person slipping on ice might have simple bruise to the hip. To an 80 year old it can mean a fractured hip and then the beginning of the end.

If you want to live a long, healthy life. don't fall!

People who are at a fall risk should not live alone.

Falls do so much damage,so quick ,all over the body.
My Mother fell over her 4 prong cane when she was going to the kitchen to answer the phone.
She hit the wall and broke her neck in C-1.
Just a half inch ,she would have died or been paralyzed.
That fall started the decline in Mother .After she fell,she had one health problem after the other til I lost her.
Anyway,that's what a fall cost my Mom~

My mom had low blood pressure and would get dizzy if she got up from the bed of chair too quickly. She fell multiple times because of that. Also, certain medications can cause dizziness which is a recipe for disaster for the elderly.

Uneven ground is a "thing" yes, however, the brain is the organ that compensates for the anticipated steps to catch yourself. There's a few factors that can cause a fall. Dehydration is a big one. The type of shoes are also a factor. For example, sandal flip/flops aren't ideal for a person who isn't steady on their feet. Spinal issues and inflammation cause falls. Bad knees and diabetic neuropathy can cause a fall. But again, one of the biggest causes is dehydration/dizziness.
If your mom is refusing a cane or rollator, it may be time to remind her that if she's alone and she falls, a trip to a hospital and then a facility rehab may well be in store the future if she can't come to terms with some preventative tactics to maintain the independence she desperately hangs onto. And you're right to be concerned with bathroom falls, that's very possible.

Literally anything and everything can cause a fall. It's impossible to prevent every one of them.

My mother has fallen many times both before and since she moved in with me 6 years ago.

She fell walking to her next-door neighbor's house and split her lip on a concrete planter which led to stitches and a Z-pack which led to C-Diff and an 8 day hospital stay. And that was 16 years ago when she was 80 years old.

The worst one was January 2020 when she tripped while standing up from a chair and broke her hip upon hitting the floor.

She has sat down on the side of the tub thinking it was the toilet and fallen backward into it. That resulted in yet an other compression fracture the x-rays couldn't determine specifically because she has had so many from her osteoporosis.

She fell sideways while holding on to her walker - with a death grip - and it ripped the skin off of her finger and she split her forehead open. So then it was stitches again and several visits to a hand doctor to monitor the healing of her finger.

She literally fell from standing when she had Covid in December 2021.

She has most recently fallen off of the bed before while reaching for her walker that I put out of her reach. A couple of bruises from that one.

And that's just a sampling of her fall history.

The main issues surrounding falls, IMO are poor eyesight and loss of balance. Once they are down, the inability to get themselves up from the floor is also a big liability.

I've noticed that my Mom falls generally from 2 reasons: 1) her legs can no longer support her, so she just crumples....a vertical soft fall. 2) because her muscles aren't strong enough to maintain her balance.

My Mom shuffles. Yet, when she falls, she never falls forward, indicating to me that she hasn't fallen while in a forward momentum from shuffling. Most of the falls were at night when she wasn't awake enough to be walking. She could take the turn from her bed to the bathroom. However it was the straightaway to the bathroom where she would just crumple...usually because she couldn't maintain balance when she was shuffling.

We worked on sit-to-stand, "stair stepping" (it was only a 4 inch rise) which works the abs, and that prevented nearly all the falls.

My Mom rarely, if any, fell during the day while she was awake.

XenaJada: Once while attending a family reunion on my DH's side I advocated for elderly family members by speaking up to the host to remove scatter rugs. A scatter rug is an elder's enemy!

My mother did not let me know times that she took a slip and fall, saying in a childlike voice "I don't have to tell you everything." "I need to know these times that you have fallen, mother."
Another time she uttered "A walker makes me look old. "HELLO - you're 94" was my response."

In answer to your question about the most common cause of falls, I would say 'balance/equilibrium.' Or in my mother's case, VERY low vision. She had a terrible time stepping off a curb, doing so very tentatively.

Most of my mother's falls are related to low sodium, and she has broken many bones as a result. Just within the last 8 months, she has fallen about 12 times with 10 of them related to low sodium. The other two were related to infections, in particularly, UTIs. She often falls in bathrooms. Up until about two or three months ago, she lived in assisted living. She now lives in skilled nursing. So, the bathrooms that she has fallen in over the past year were designed with elderly individuals in mind. Besides that, she's also not very good at putting on the brakes of her rollator or wheelchair. While that hasn't led to falls, they were some close calls.

Stubborness

Her problems might be a combination of balance issues, loss of muscular strength, and vision issues. Your best answer for why your mom is falling is - get a referral from her doctor for physical therapy. A few weeks of physical therapy can identify her problems, get suggestions of mobility aids that will help her the most, and work on developing strength and balance. Of course, those throw rugs need to go. Find out why she likes them (maybe floors are cold underfoot) and come up with alternatives (like warmer shoes or good slippers).