Why does my elderly mother keep falling?

Because something has changed, and a fall is the symptom rather than the cause. When an elderly mother or father keeps falling it is almost never bad luck. They are usually several small things stacking up— weakening legs, a medication added last winter, eyesight, a rug, a fear of falling that quietly shrinks how much she moves.

Most of those things can be changed.

What makes an elderly person fall?

• Leg strength and balance. The most common and the most fixable. If she pushes up with her arms to leave a chair, this is already happening.
• A previous fall. The single strongest predictor of the next one, partly because of what it does to confidence.
• Medications. Four or more regular medicines is a standard screening question for falls risk, and anything sedating raises it further. Worth a pharmacist or GP review.
• Dizziness on standing. A drop in blood pressure when she gets up. Common, treatable, often never mentioned.
• Doing less. After a scare, people cut back on walks and outings. That costs strength, which raises the risk again.
• The house. Loose mats, poor lighting, a step without a rail, the two-in-the-morning trip to the bathroom.

The one you can actually change

Of the six, leg strength moves fastest and is the one nobody organises. A medication review is a phone call. Glasses are an appointment. A night-light is a few dollars. Strength is the only one that needs a program, which is why it is the one that gets left.

It has to get harder to work. The same four exercises at the same difficulty for a year buys attendance rather than strength. It also has to happen where she falls — her chair, her hallway, her back step. Flat ground in a clinic does not test the surfaces that put her on the floor.

And it should be the same physiotherapist each visit, because progressing a program means knowing what was hard last month. Under Support at Home, physiotherapy is clinical care and she contributes nothing toward it. Most families find that out late.

Is winter the dangerous time?

Not really, though it is widely assumed. The AIHW reports little variation through the year in the largest causes of falls: slips, trips and stumbles, falls involving furniture, and falls on the same level. Winter is higher only for ice, snow and being knocked over by someone else. Summer is higher for ladders and outdoor activity (AIHW).

Winter changes which hazards turn up, not how many falls there are. There is no safer season to wait for.

How serious is this, honestly?

Falls were the leading cause of injury hospitalisation in Australia in 2024–25: 253,800 admissions, 43.4% of all injury hospitalisations. People aged 85 and over had the highest rate, at 10,065 per 100,000. Fall injuries cost the health system about $5.4 billion in 2023–24.

That is the case for acting now rather than after the next one. Waiting is not neutral — strength keeps fading while nothing is being done about it, and each fall makes the following one more likely.

What she will not tell you

Most older people under-report falls, and the reasons are entirely understandable: not wanting to worry anyone, and not wanting the conversation about giving up the house. So the count you have is usually low.

Ask differently. Not “have you fallen?” but “have you had a near miss?”, “do you hold the furniture?”, “have you stopped doing anything because of your balance?”

What to do this week

• Do the falls-risk check. Eight questions, two minutes. The same ones we ask at a first assessment.
• Book a medication review. Ask her pharmacist about a MedsCheck, or her GP about a Home Medicines Review. One of the highest-yield things on this list, and often free, though eligibility rules apply.
• Get her eyes checked if it has been more than a year, especially if she wears multifocals on stairs.
• Fix the obvious hazards. A plug-in sensor night-light between bed and bathroom is a cheap fix for the three-in-the-morning trip.
• Start strength and balance work. It is the best-evidenced way to prevent falls in older adults, and it has to be progressive to work.

If she has fallen twice this year, the next one is more likely than the last, and nothing on this list happens by itself. For the room-by-room side of it, the home-hazard checklist goes through the house.

Physiotherapy under Support at Home carries no participant contribution — here is where the government says so.