Explained Simply · A Free Family Guide
Falls, Explained Simply
Written and reviewed by Halston Juracka, RN-BSN, Certified Brain Injury Specialist and Kayla Juracka, RN-BSN · Updated August 2026
Someone you love fell. Maybe they laughed it off. Maybe they were embarrassed, or annoyed that you brought it up. Maybe they told you they just tripped on the rug and it will not happen again. We are nurses, and here is what we know: a fall is almost never just a fall. It is the body telling you something changed. This guide explains what falls actually mean, what to do this week, and how to tell the difference between an accident and a warning.
A free two-page version of this guide. Page two is a home safety checklist built to be taped inside a closet door and worked through.
Written by Two Registered Nurses · Plain Words, Real Sources · Free to Print & Share
Why do older adults fall?
Falls happen when something that keeps a person upright stops working properly. Usually more than one thing at the same time. The most common causes are muscle weakness, balance problems, blood pressure that drops when standing, vision changes, medication side effects, pain, poor footwear, and hazards in the home.
Notice that almost every one of those is treatable. That is the whole point of this guide.
Picture It This Way
Staying upright is like a three-legged stool. One leg is strength, the muscles that hold you up and catch you when you stumble. One leg is balance, the inner ear, the vision, the sense of where your body is in space. One leg is blood pressure, getting enough blood to the brain when you stand up. When one leg gets shaky, most people manage. When two get shaky, the stool tips. Almost every fall is two or three legs going wrong at once, which is why the answer is rarely just being more careful.
One shaky leg and most people manage. Two shaky legs and the stool tips.
Is the first fall really a big deal?
Yes. About one in four adults over 65 falls each year, and roughly one in five falls causes a serious injury such as a broken bone or a head injury. Falls are the leading cause of injury death in older adults.
But here is the part families miss. The first fall is information. It means something in the body changed, and if nobody finds out what, the same thing is still there tomorrow. The people who do well after a first fall are the ones who treated it as a medical event rather than a clumsy moment.
What is the fall after the fall?
This is the pattern we watch for, and it is more dangerous than the original fall.
Someone falls and is not badly hurt. They get scared. So they move less, sit more, and stop going out. Sitting more makes the muscles weaker, and weaker muscles make balance worse. A few months later they fall again, and this time they break something.
Fear of falling causes falling.
It sounds backwards and it is one of the most consistent things we see. The right response to a fall is not to move less. It is to find out why it happened and then keep moving, safely.
What should you fix this week? Most of it is free.
Walk through the home at night, with the lights off first, the way they actually do it. Then fix what you find.
The Walkthrough
None of this requires a doctor's permission, and most of it costs less than dinner out.
Lighting and pathways
Remove throw rugs entirely, or tape them down
Clear the path from the bed to the bathroom and leave a nightlight burning along it
Put a lamp or lighted switch within reach of the bed
Get rid of extension cords running across walkways
Get rid of extension cords running across walkways
Move everyday items off high shelves and out of low cabinets, so there is no reaching or crouching
Bathroom
Add grab bars in the shower and next to the toilet, real ones bolted into studs, never a towel rack
Put a non-slip mat in the tub
Footwear and stairs
Real shoes with backs and grip, not socks and not loose slippers, even inside the house
Check that stair rails are solid on both sides
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Walk the route they actually walk at 2am, then fix what you find.
What should you ask the doctor?
Bring these to the next appointment, and do not wait for a scheduled visit if there has already been a fall.
Questions to Bring to the Appointment
Print this, or write it on the back of an envelope. Either works.
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Can we do a medication review? Specifically, which of these cause dizziness, drowsiness, or low blood pressure? Sleep aids, blood pressure medicines, water pills, and anything for anxiety or pain are the usual suspects, and older adults are often on several at once.
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Can you check blood pressure lying down and then standing? The drop that happens on standing does not show up in a normal reading.
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When were the last vision and hearing checks? Both affect balance more than people expect.
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What about vitamin D and bone density? The fall is one problem and the fracture risk is another.
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Can we get a referral to physical therapy for balance and strength training? It is one of the few interventions with real evidence behind it.
Most families never think to ask, and most doctors are glad to order it.
When should you call the doctor?
Call the doctor's office today, not 911, but today, for any of the following.
Call the Doctor Today
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Any fall, even without injury, because the cause needs to be found
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Near-falls, catching themselves on furniture, or new unsteadiness
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Dizziness or lightheadedness when standing
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New difficulty walking, shuffling, or a change in how they move
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Pain anywhere after a fall, even mild pain a day or two later, because fractures in older adults are not always obvious
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New fear of walking, or a sudden drop in activity
When is it 911?
Call 911 immediately for any of the following. Do not wait to see how it looks in the morning.
Call 911 Now
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Any fall with a head strike, especially if the person takes blood thinners, because bleeding in the brain can be slow and silent
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Loss of consciousness, even briefly
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Confusion, slurred speech, weakness on one side, or vomiting after a fall
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Severe pain, obvious deformity, or inability to bear weight, which usually means a fracture
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A person who cannot get up
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Anyone who has been on the floor for an extended time, because long lies cause muscle breakdown, dehydration, and kidney problems that need treatment
Never drag someone up yourself if you suspect a hip or spine injury. If a stroke could be part of the picture, the signs to know are in our guide to stroke, explained simply.
What if they refuse help?
Most older adults resist because a fall feels like the beginning of losing independence, and being told to be careful sounds like being told they are finished. Arguing rarely works.
What tends to work is trading one small thing at a time: a nightlight instead of a whole safety overhaul, a shower chair instead of a conversation about moving, a physical therapy appointment framed as getting stronger rather than being fixed. Let the doctor be the messenger when you can, because parents accept from clinicians what they refuse from their children. And when you do offer help, offer a choice rather than an instruction. Nobody accepts being managed.
Our guide to talking with someone who does not want help goes deeper on this, and it is free in our resource library. If memory is part of the picture, dementia, explained simply covers why the usual reasoning does not land.
Where can Las Vegas families turn?
Physical therapy for balance and strength is the single highest-value thing to pursue, and any physician can order it. Many local senior centers and community programs run evidence-based balance classes.
And when a family needs eyes in the home, someone catching the near-falls, watching the medications, doing the safety walkthrough, and noticing the change before the next fall, that is the work of our practice, and falls are one of the most common reasons families call us.
The goal is not to prevent every fall. It is to find the reason before the next one.
Free to print, copy, and share with patients, clients, families, and caregivers.
More in This Series
ALS, Explained Simply · Dementia, Explained Simply · Heart Failure, Explained Simply · Stroke, Explained Simply · Every "Explained Simply" guide is free, written by the same two nurses, and built to be shared.
HJ
About the owners
Halston Juracka, RN-BSN, CBIS and Kayla Juracka, RN-BSN are the registered-nurse owners of Apex Home Nursing Services, a premium private-pay home care agency serving Summerlin, Henderson, and the greater Las Vegas valley. Halston is a Certified Brain Injury Specialist and nurse educator. They founded Apex to give referral partners a clinically serious, reliable resource and to give families nurse-led care that actually keeps people safe at home.
Sources
Centers for Disease Control and Prevention. Older Adult Fall Prevention, Facts About Falls. 2024.
Centers for Disease Control and Prevention. STEADI Initiative for Health Care Providers.
American Geriatrics Society and British Geriatrics Society. Clinical Practice Guideline for Prevention of Falls in Older Persons.
Sherrington C, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews.
References
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U.S. Centers for Disease Control and Prevention. Facts About Falls, Older Adult Fall Prevention, 2026. cdc.gov/falls
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Reducing Hospital Readmissions, StatPearls, NCBI, 2024; and 30-day readmission analyses among older adults. ncbi.nlm.nih.gov
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Genworth and CareScout 2024 Cost of Care Survey; Nevada cost data. payingforseniorcare.com/nevada
This guide is general educational information, not medical, legal, or financial advice. Apex Home Nursing Services is an RN-owned, private-pay personal care agency in Las Vegas, Nevada. Registered nursing services, where applicable, are provided by the RN owners under their own Nevada licenses, coordinated by, not provided by, the agency.