The top 5 moments falls can happen in your home

At the 2026 BCH Trauma Symposium in May, Barry Platnick, MD, FACS, a trauma surgeon with 30 years in the specialty, shared that falls are roughly 70% of what he treats in Colorado trauma centers, and falls account for a majority of lasting disabilities and death. Globally, ground-level falls and falls from height kill about 684,000 people a year. The situation becomes more serious for seniors, where more than one in four adults over 65 falls annually—and falling once roughly doubles the odds of falling again.

And yet, falls are among the most preventable serious injuries in medicine. Nearly four out of five fall injuries among older adults happen at home, which can sound alarming until considering that home is the one environment you have the most control over. Most of what puts people on the floor is findable, and most of it is fixable in an afternoon.

At BCH, our trauma surgeons provide care after a fall occurs. Our geriatricians work to make sure those falls are less impactful and less fatal. On Monday, Sept. 28, from 7 to 8 p.m. Koby Caplan, MD, a geriatrician with Geriatric Medicine of BCH is giving a free online lecture, Preventing Falls and Keeping Your Independence. This lecture is annual reminder of how we can prevent falls in the homes of our elders.

And while the lecture is geared towards the elderly population, there is no reason the discussion can’t provide everyone—of all ages—with tips and advice on what to do before, during and after a fall.

The most common moments when a fall happens in the home, and what to do in each instance

#1) The Bedroom – 25% of at-home falls

Walking from the bed to the bathroom in the early morning hours is the most reliable fall scenario there is. The bedroom and the bathroom are two of the three most common places older adults fall at home, and the trip between them combines nearly every risk factor at once.

Consider what is working against you at 2 a.m. You are thirsty after sleeping a few hours. The room is dark. Your body is not fully awake. And somewhere along that path is a throw rug, a low table or a sleeping pet.

Simple fixes: Light the entire path, not just the destination. Sit on the edge of the bed and count to 10 before standing up. Use the restroom before going to sleep. Ensure the path is clear of debris like clothes. And, if you are making that trip three or more times a night, mention it to your provider.

#2) The stairs — 23% of at-home falls

Stairs are the second most common place older adults fall at home, accounting for nearly 23% of at-home fall injuries. Nationally, stair-related injuries send an estimated 1.08 million people to emergency departments every year.

What makes stairs deceptive is that they feel routine. You may have climbed those same steps thousands of times, which is why you stop looking at them. Most stair falls will happen on the way down, and they usually involve some combination of carrying something in both arms, poor lighting at the landing, a loose or missing handrail, or footwear with no grip.

Simple fixes: Keep one hand free for the rail, always. Install a second handrail if there is only one and make sure both run the full length of the stairs. Light the top and bottom landings, where depth perception becomes crucial. Remove anything stored on the steps. If you regularly carry laundry or groceries up and down, use a basket you can manage with one arm—or make the dreaded two trips. Better to get extra steps in than risk an injury.

#3) The bathroom — 23% of at-home falls

The bathroom is full of hard surfaces, water, and fixtures people instinctively grab for support but that were never built to hold weight. Towel bars and sink edges come off walls. Porcelain toilets shift and crack. Mirrors can fall off and break. While many things can go wrong, the riskiest moments are specific. Stepping into and out of the tub or shower, standing up from the toilet, getting caught up in corded appliances and turning around in a space too small to recover your balance are all major risk factors of falling in the bathroom.

Simple fixes: Put a non-slip mat in the tub and another outside it. Make sure your hygiene items are properly stored and out of the way. Consider a shower chair and a handheld showerhead, which remove any need to balance on one foot. Keep a nightlight on permanently. For those with more mobility issues, install grab bars—properly anchored into studs—beside the toilet and inside the shower.

#4) The kitchen and dining room — 7% of at-home falls

Kitchen falls drop off sharply from the top three, but the falls that happen here share a cause worth naming: reaching for something above your head.

Think about how you use space in your kitchen; where do you hide the cookies so the children cannot reach them? Where are the least-used dishes? As high as possible. What else sits on that counter? Knife blocks, microwaves, paper towels, kettle and coffee pots. All things that can complicate a fall when reaching up for items.

Simple fixes: Move daily-use items: plates, glasses, coffee mugs—the things you reach for every morning—to between hip and shoulder height. Wipe spills immediately rather than after you finish cooking. Wear shoes or slippers with rubber soles in the kitchen instead of socks. And if something must live on the top shelf, use a sturdy step stool with a handrail, not a chair.

#5) The driveway and garage — 6% of at-home falls

Most falls in this category have to do with ladders, but the reason ladders are so dangerous may not be what you think. Roughly 500,000 Americans are treated for ladder-related injuries each year, and most of those falls occur from under 10 feet. When researchers reviewed hundreds of ladder falls at a trauma center, the factor that predicted injury severity was not the height of the fall—it was the age of the person who fell.

Dr. Platnick mentioned a rule at the symposium in May he asks everyone to memorize: If being on a ladder is not part of your business, you have no business being on a ladder. He is usually thinking about the holidays when he says this, and the Consumer Product Safety Commission (CPSC) estimates approximately 160 decorating-related injuries per day during November and December, with falls being the largest category.

Simple fixes: To avoid a fall, hire the holiday lights out or ask a younger family member to be the steady one. If you must use a ladder, never use one alone and never place a ladder on stairs. Keep the garage floor clear and well lit. Clear the area of any debris and place the ladder in a nice open space.

Two final points to consider if a fall happens

A person who has fallen may look stable, but that doesn’t mean they’re okay.

At the symposium, Dr. Platnick described a patient who arrived awake and talking, with perfectly normal vital signs. He had fallen from a ladder onto a broken wood post—which appeared to be stuck in his lower thigh, but in fact had traveled all the way into his abdomen. Serious injuries do not always announce themselves, which is why a fall that seems minor still deserves a call to a provider.

Additionally, any fall where you hit your head is worth getting checked, especially if you are on a blood thinner—as we age, the brain sits looser in the skull, and the small veins bridging that gap can tear and bleed slowly, with symptoms surfacing days later.

When receiving care, make sure you mention any and every fall.

Fewer than half of older adults who fall ever tell a doctor, usually because saying it out loud feels like the first step toward losing their independence. And while that is a reasonable fear for an older adult, the results of staying silent can risk even further loss of independence, or even life. An unreported fall is an unexamined cause, and the same conditions are still waiting next time.

For the younger population, the fall may seem insignificant to the injury or worth mentioning unless asked.

While insulating yourself to a padded home is not reasonable, being mindful with small changes is. The goal is to remind you of the multitude of places that make it easy to fall resulting in a trip to the trauma unit. One of the most important factors in preventing falls is staying active and using your muscles every day to keep your balance and engage your ability to catch yourself during a fall and make it less impactful.

At BCH, we would rather help you stay active safely than give up the things you enjoy out of fear of falling.

Is Dr. Koby Caplan’s lecture for you?

If you have fallen in the past year, feel unsteady standing or walking, worry about falling, or are helping an aging parent think through fall risks, our upcoming community lecture is for you.

Three questions are worth answering before you attend:

1. Have you fallen in the past year?
2. Do you feel unsteady when standing or walking?
3. Do you worry about falling?

How to register

Preventing Falls and Keeping Your Independence, presented by Koby Caplan, MD, of Geriatric Medicine of BCH, takes place Monday, Sept. 28, from 7 to 8 p.m. online. Registration is free at bch.org/falls.

The lecture runs approximately 45 minutes, with the remaining time reserved for questions submitted through the chat.