In this guide:

1. Identifying new or underlying illnesses
2. Checking blood pressure while sitting and standing
3. Assessing balance, gait and leg strength
4. Evaluating osteoporosis and fracture risk
5. Reviewing medications
6. Frequently asked questions

Fall prevention is a critical aspect of caring for an elderly loved one in Singapore. Falls are the leading cause of injury-related hospitalisation among seniors in Singapore, with bathroom falls — particularly on wet marble and tiled floors — being among the most common incidents.

Mobility aids such as walking canes, walkers, rollators, as well as home safety fixtures like grab bars and bedrails can significantly reduce fall risk at home. However, even with a carefully fall-proofed home and the right equipment, it is impossible to eliminate fall risk entirely. When a fall does occur, the immediate medical visit often focuses on diagnosing visible injuries such as fractures. However, a thorough post-fall assessment must go further — identifying the underlying causes that contributed to the fall.

This guide explains the six key areas doctors should assess, and what caregivers should prepare and communicate before the appointment.

1. Identifying new or underlying illnesses

A new or worsening health condition is one of the most common and overlooked causes of falls in seniors. The following acute illnesses can directly cause weakness or loss of balance:

2. Checking blood pressure while sitting and standing

Definition — Orthostatic Hypotension
Orthostatic hypotension is a drop in systolic blood pressure of 20 mmHg or more within 3 minutes of standing. It causes dizziness or fainting and is a leading cause of falls, especially when getting up from a chair, bed, or toilet. Request that the doctor measures blood pressure in both sitting and standing positions.

This condition is particularly important to assess if the fall occurred when your loved one stood up from a chair, bed, or toilet — the classic trigger for orthostatic hypotension. Blood pressure medications, diuretics, and some antidepressants are common contributors. Request that the doctor measures blood pressure in both sitting and standing positions at the post-fall visit.

3. Assessing balance, gait and leg strength

These are the three most directly modifiable factors in fall prevention and can be improved with targeted physiotherapy:

• Chair stand test — doctor asks the senior to stand from a chair without using their arms; difficulty indicates reduced quadriceps strength
• Gait assessment — Doctor observes walking pattern for shuffling, asymmetry, or hesitation.
• Timed Up and Go (TUG) test — measures time to stand, walk 3 metres, turn, and return; over 12 seconds indicates elevated fall risk
• Physical therapy referral — if balance or gait is impaired, a physiotherapist can design targeted exercises to improve stability
• Mobility aid review — If the current aid is no longer appropriate, an upgrade may be warranted.

4. Evaluating osteoporosis and fracture risk

Osteoporosis does not increase the likelihood of falling, but it dramatically increases the severity of injuries when a fall does occur — particularly hip fractures, which carry a 20–30% one-year mortality rate in elderly patients. Osteoporosis is significantly underdiagnosed in Singapore, particularly in men.

• DEXA scan — Gold standard test for bone density; recommended for women over 65 and men over 70.
• Calcium and vitamin D — deficiency is common in Singapore's elderly population; supplementation may be recommended after blood tests
• Bisphosphonate therapy — medication to slow bone loss, often prescribed after a fragility fracture; discuss with the treating doctor.
• Hip protector pads — wearable padding that reduces impact force on the hip in the event of a fall

5. Reviewing medications

Summary — 5 things to do after an elderly person falls

1. Seek medical evaluation promptly — even if no obvious injury is visible.
2. Check blood pressure sitting AND standing (orthostatic hypotension test).
3. Request a balance and gait assessment.
4. Bring a complete medication list — including supplements.
5. Ask about osteoporosis screening — especially if this is not the first fall.

6. Frequently asked questions

What is the most common cause of falls in elderly people?

The most common causes of falls in elderly people include muscle weakness and balance impairment, medication side effects (particularly blood pressure medications, sedatives, and anticholinergics), orthostatic hypotension (dizziness on standing), environmental hazards (wet floors, poor lighting, loose rugs), and underlying conditions such as Parkinson's disease or inner ear disorders. In Singapore, bathroom falls on wet tiled or marble floors are among the most frequently reported incidents.

Should an elderly person always see a doctor after a fall?

Yes. Even if the fall appears minor and no injury is immediately obvious, an elderly person should be seen by a doctor after a fall. Fractures, particularly hip fractures may not always cause immediate severe pain in older adults. More importantly, a post-fall assessment can identify the underlying cause of the fall, reducing the risk of future incidents.

What is orthostatic hypotension and how does it cause falls?

Orthostatic hypotension is a drop of 20 mmHg or more in systolic blood pressure when a person stands up from a sitting or lying position. This sudden blood pressure drop reduces blood flow to the brain, causing dizziness, light-headedness, or momentary loss of balance — frequently resulting in falls. It is particularly common in elderly people taking blood pressure medications, diuretics, or antidepressants.

What bathroom safety equipment helps prevent falls in Singapore?

The most effective bathroom safety products for fall prevention in Singapore include grab bars (installed near the toilet, shower, and bath), non-slip shower chairs, raised toilet seats, anti-slip floor stickers, and handheld shower heads. The Golden Concepts offers a site evaluation service and carries a full range of bathroom safety equipment at our showroom at 3 Ubi Ave 3, Crocodile House, Singapore 408857.

What bedroom safety equipment helps prevent falls in elderly people?

The bedroom is the second most common location for elderly falls in the home, with most incidents occurring during the night when getting up to use the toilet. The key risk moments are getting in and out of bed — particularly from a bed that is too low, too high, or too soft to push up from safely.

Bed rails are the most effective single intervention. They provide a fixed handhold for the user to grip while transitioning from lying to sitting and from sitting to standing. Bed rails are available in two types: support rails that assist with repositioning and getting up, and fall-prevention rails that run along the length of the mattress to prevent rolling out of bed during sleep. For users who are frequently confused at night or have conditions such as dementia, fall-prevention side rails are particularly important.

For users requiring more support, or whose current bed is too low or too high, a homecare bed or nursing bed with adjustable height allows the bed to be raised to the correct transfer height during the day and lowered for sleep if preferred. Adjustable homecare beds — such as those in the Paramount Bed Japan range are available at The Golden Concepts.

Additional bedroom fall prevention measures include a night light or sensor light between the bedroom and bathroom (the most commonly travelled route at night) or even a bed sensor alarm. The full range of equipment can be found at our showroom at 3 Ubi Ave 3, Crocodile House, Singapore 408857.