Falls Prevention | Dizziness | Physio to Home

Dizziness is one of the strongest predictors of falls in older adults — and it's often treatable. North Tasmania's home physiotherapist explains the causes, red flags, and what to do.

Dizziness is one of the strongest predictors of falls in older adults — and it's often treatable. North Tasmania's home physiotherapist explains the causes, red flags, and what to do.

Micheal Ghattas

2/27/2026 · 10 min read

When Is Dizziness a Fall Risk? What Older Tasmanians and Their Families Need to Know

By Michael Ghattas, DPT | AHPRA Registered Physiotherapist | 18 Years Experience

Physio to Home, North Tasmania | Last reviewed: February 2026

Part of the Physio to Home Falls Prevention Series

This article is a companion to our complete guide: How to Prevent Falls at Home — A Guide for Older Tasmanians. If you have not read the pillar guide yet, we recommend starting there for a full overview of fall risk and prevention strategies.

Dizziness is one of the most common complaints among older adults — and one of the most underreported. Many people dismiss it as a normal part of ageing, push through it, or simply avoid the activities that trigger it. But dizziness is not something to normalise. It is one of the strongest independent predictors of falls in older adults, and in many cases it is highly treatable.

The challenge is that dizziness means different things to different people — and the cause determines the treatment completely. This guide explains the most common types of dizziness in older adults, which ones are serious fall risks, what you can do at home, and when a physiotherapy assessment is the right next step.

Who this guide is for

This article is for older Tasmanians — and their families and carers — who are experiencing dizziness and want to understand whether it is increasing their fall risk. It is particularly relevant for people in rural North Tasmania who want to know whether a home physiotherapy assessment is appropriate before travelling to a clinic.

Dizziness vs Vertigo vs Lightheadedness: Why the Difference Matters

The word 'dizziness' is used to describe several very different sensations, and the distinction matters clinically because each type has a different cause, a different fall risk profile, and a different treatment pathway.

True Vertigo

Vertigo is the false sensation that you or the room is spinning or moving when neither is. It is caused by a problem in the vestibular system — the balance organs in the inner ear or their connections to the brain. It can come on suddenly and be extremely distressing, even when lying still. Vertigo is a significant fall risk, particularly during acute episodes.

Lightheadedness or Pre-Syncope

This is the feeling of nearly fainting — a sudden sense that you might black out, often accompanied by visual dimming, nausea, or weakness. It is most commonly caused by a drop in blood pressure when you stand up (orthostatic hypotension) and is strongly associated with falls in older adults, particularly in the morning or after meals.

Disequilibrium

Disequilibrium is a sense of unsteadiness or imbalance without a spinning sensation — the feeling that you might topple, particularly when walking or standing. It is often caused by problems with proprioception, muscle weakness, or central nervous system changes associated with ageing or neurological conditions. It is a chronic, persistent fall risk rather than an episodic one.

Non-Specific Dizziness

Some patients describe a vague, floating, or foggy feeling that does not fit neatly into any of the above categories. This is often multifactorial — involving combinations of medication effects, anxiety, dehydration, and sensory changes — and requires careful assessment to untangle.

Why the type of dizziness matters for fall risk

Vertigo causes brief but intense episodes during which fall risk is extremely high. Lightheadedness causes predictable falls at specific moments — when standing, after meals, in hot environments. Disequilibrium causes a persistent background fall risk during all weight-bearing activity. Each requires a different management approach. Treating the wrong type can be ineffective at best and harmful at worst.

The Most Common Causes of Dizziness in Older Adults

Benign Paroxysmal Positional Vertigo (BPPV)

The most common and most treatable cause of vertigo

How it feels

Brief but intense spinning episodes lasting 20–60 seconds, triggered by specific head movements — rolling over in bed, looking up, bending forward, or tilting the head. Episodes stop when movement stops. May be accompanied by nausea.

What causes it

Calcium carbonate crystals (otoliths) that normally sit in one part of the inner ear become dislodged and migrate into the semicircular canals, where they create false movement signals with head position changes.

How physiotherapy helps

BPPV is one of the most satisfying conditions physiotherapists treat — because it responds dramatically to a specific repositioning manoeuvre called the Epley manoeuvre, which can resolve symptoms in one to three sessions. A home physiotherapy visit is ideal for BPPV because the assessment and treatment can be performed safely on your own bed.

Orthostatic Hypotension

Dizziness when standing — a common and underrecognised fall risk

How it feels

Lightheadedness, visual dimming, or near-fainting within 30–60 seconds of standing up from sitting or lying. Most common in the morning, after meals, in hot weather, or after prolonged sitting. May cause actual loss of consciousness in severe cases.

What causes it

A sudden drop in blood pressure upon standing that is not compensated quickly enough by the cardiovascular system. Common causes include dehydration, antihypertensive medications, diuretics, Parkinson's disease, and diabetes. Prevalence increases significantly with age.

How physiotherapy helps

Physiotherapy addresses orthostatic hypotension through physical countermanoeuvres (leg exercises before standing, graduated position changes), education on triggers and prevention strategies, and coordination with the patient's GP to review contributing medications. A home visit allows observation of the patient's actual morning routine — the highest-risk period.

Vestibular Hypofunction

Reduced inner ear function causing persistent unsteadiness

How it feels

Persistent unsteadiness and visual disturbance (difficulty focusing on moving objects or when moving the head quickly), worsening in low light or on uneven surfaces. Not episodic — present most of the time at a low level. Often worsens significantly with fatigue.

What causes it

Reduced function of one or both vestibular organs, often following a viral illness (vestibular neuritis), inner ear damage, or as part of normal ageing. The brain has not fully compensated for the reduced vestibular input.

How physiotherapy helps

Vestibular rehabilitation — a specialised form of physiotherapy using specific gaze stabilisation and habituation exercises — is the evidence-based treatment for vestibular hypofunction. It works by promoting central nervous system compensation for the reduced vestibular input. Results take weeks to months but can be highly significant for quality of life and fall risk reduction.

Medication-Related Dizziness

Often overlooked — and often fixable

How it feels

Variable presentation — can mimic any of the above types. Particularly common after starting a new medication, increasing a dose, or in the context of taking four or more medications simultaneously (polypharmacy). May be accompanied by cognitive slowing or unusual fatigue.

What causes it

Many commonly prescribed medications cause dizziness as a side effect or interaction effect. Blood pressure medications, diuretics, sedatives, antidepressants, antihistamines, and some pain medications are frequent contributors. Polypharmacy — taking multiple medications — significantly amplifies dizziness and fall risk.

How physiotherapy helps

Physiotherapy includes medication-related dizziness in the falls risk assessment and communicates findings to the patient's GP. While physiotherapists do not prescribe or deprescribe medications, identifying medication timing patterns, postural triggers, and functional impacts provides the GP with valuable clinical information to guide a medication review.

When Dizziness Is a Medical Emergency: Red Flags

Call 000 or go to emergency immediately if dizziness is accompanied by any of the following

Sudden, severe headache unlike any previous headache. Difficulty speaking, understanding speech, or finding words. Weakness or numbness on one side of the face, arm, or leg. Sudden vision loss or double vision. Difficulty walking or sudden loss of coordination. Chest pain or palpitations with dizziness. Loss of consciousness. These symptoms may indicate a stroke, transient ischaemic attack (TIA), or cardiac event — all of which are medical emergencies. Do not drive yourself to hospital.

When to See a Doctor or Physiotherapist Promptly

The following situations are not emergencies but warrant professional assessment within days rather than weeks:

• New onset dizziness in someone over 65 with no previous history of balance problems

• Dizziness that has caused a fall or near-fall, even once

• Dizziness that is getting progressively worse over days or weeks

• Dizziness accompanied by hearing loss or a new ringing in the ears (tinnitus)

• Dizziness that is significantly limiting your daily activities — avoiding going out, stopping driving, or restricting movement

• Dizziness in someone already assessed as high falls risk

• Dizziness that started or worsened shortly after a new medication was prescribed

For many of these presentations, a home physiotherapy assessment is the ideal first step. Michael can assess your specific type of dizziness, screen for red flags requiring GP or specialist referral, and begin treatment in the same visit where appropriate.

What You Can Do at Home While Waiting for Assessment

If your dizziness does not include any red flags and you are waiting for a physiotherapy or GP appointment, the following strategies reduce your fall risk in the interim:

Pause Before Standing

Sit on the edge of your bed or chair for 30–60 seconds before standing fully upright. Pump your ankles and feet several times while seated to push blood back up toward your heart before you rise. This is particularly important in the morning, after meals, and after prolonged sitting.

Move Your Head Slowly

If your dizziness is triggered by head movements, slow down every movement deliberately. Avoid sudden turns of the head, and when looking up or down, move through the position slowly and pause if dizziness starts.

Improve Your Home Lighting

Vestibular and balance problems worsen significantly in low light because the visual system compensates for balance deficits. Night-lights in hallways and bathrooms dramatically reduce fall risk for people with dizziness-related balance impairment.

Stay Hydrated

Dehydration is a significant and underappreciated contributor to dizziness and orthostatic hypotension in older adults. Aim for at least 6–8 glasses of water per day. Reduce or time your caffeine and alcohol intake, as both contribute to dehydration.

Use a Walking Aid If Needed

There is no benefit in avoiding a walking aid if dizziness is affecting your balance. A walking stick or frame provides an additional sensory anchor point for your balance system and dramatically reduces fall risk during dizzy episodes. Using one when needed is a sign of good judgement, not weakness.

Do not drive if you are experiencing active dizziness

Dizziness — particularly vertigo — significantly impairs driving ability. If you have been experiencing episodic dizziness, speak with your GP before driving. In some cases, a formal fitness-to-drive assessment may be required. In rural Tasmania, where driving is often essential for independence, this conversation is worth having early rather than after an incident.

What a Home Physiotherapy Assessment for Dizziness Involves

A physiotherapy assessment for dizziness is quite different from a general health check. Michael uses a structured clinical assessment that includes:

• A detailed history of your dizziness — when it started, what triggers it, how long episodes last, what makes it better or worse, and how it affects your daily life

• Positional testing — gently moving your head into specific positions to identify BPPV and determine which canal is affected

• Orthostatic blood pressure testing — measuring your blood pressure lying, sitting, and standing to identify orthostatic hypotension

• Gaze stability and eye movement assessment — testing how well your visual and vestibular systems work together

• Balance and gait assessment — standardised tests including the Timed Up and Go (TUG) and Berg Balance Scale to quantify your fall risk

• Medication and medical history review — identifying contributing medications and conditions

Following the assessment, Michael will either begin treatment in the same session (for conditions like BPPV, where immediate treatment is appropriate), provide a home exercise programme, refer to your GP with a clinical summary, or coordinate with your existing care team.

Accessing Funded Home Physiotherapy for Dizziness in North Tasmania

A physiotherapy assessment for dizziness and falls risk is accessible and often subsidised for older Tasmanians through several pathways:

• Commonwealth Home Support Programme (CHSP): For older Australians who need entry-level support to remain living independently at home. Allied health services including physiotherapy are a covered service category. Contact My Aged Care on 1800 200 422 to determine your eligibility.

• My Aged Care Home Care Package: If you already receive a Home Care Package, physiotherapy for dizziness and falls prevention is a covered allied health service. Speak with your care coordinator.

• Medicare GP Management Plan: If your GP determines that dizziness is related to a chronic condition, a Team Care Arrangement can provide up to five Medicare-rebated physiotherapy sessions per year.

• NDIS: For eligible participants, physiotherapy for balance and dizziness management may be funded under Improved Daily Living or Improved Health and Wellbeing categories.

• Private Health Insurance: Most extras policies cover physiotherapy, including home visits.

Not sure which pathway applies to you?

Call us before you book. We help patients across North Tasmania — including in Launceston, George Town, Scottsdale, Ringarooma, and the Tamar Valley — identify their funding entitlements at no cost. Many families are surprised to discover that a home physiotherapy assessment for dizziness is more affordable than they expected.

Frequently Asked Questions

Is dizziness just a normal part of getting older?

Dizziness is common in older adults, but it is not simply something to accept as a normal part of ageing. In many cases — particularly BPPV and orthostatic hypotension — dizziness has a specific, treatable cause. Even when dizziness cannot be fully eliminated, its impact on fall risk can be significantly reduced through physiotherapy, lifestyle adjustments, and medication review. Normalising dizziness and doing nothing about it is one of the most common and avoidable contributors to falls in older Australians.

Can BPPV go away on its own?

BPPV can resolve spontaneously, but this may take weeks to months — during which fall risk remains elevated. The Epley manoeuvre, performed by a trained physiotherapist, resolves BPPV in 80–90% of cases within one to three sessions. There is no benefit in waiting for BPPV to resolve on its own when a highly effective, non-invasive treatment is available.

My parent keeps saying their dizziness is nothing to worry about. How do I convince them to get assessed?

This is one of the most common conversations families have with us. A helpful approach is to frame the assessment around function rather than fear — not 'you might fall and hurt yourself' but 'there may be something simple causing this that can be fixed, and it would be worth finding out.' For many older adults, the prospect of losing independence is more motivating than fall prevention messaging. A home visit also removes the barrier of transport and the unfamiliarity of a clinic, which can make acceptance easier.

How quickly can BPPV be treated in a home visit?

In many cases, the Epley manoeuvre can be performed and the dizziness significantly reduced in the first visit. The manoeuvre itself takes less than five minutes once the assessment has confirmed the diagnosis and identified the affected canal. Most patients notice improvement immediately or within 24 hours. A follow-up visit is usually recommended to confirm resolution and introduce balance exercises.

Can dizziness come back after treatment?

BPPV recurs in approximately 30–50% of patients within five years. Vestibular rehabilitation exercises can reduce recurrence risk and improve your ability to manage mild episodes independently. For other causes of dizziness, ongoing management — including regular physiotherapy, medication review, and lifestyle strategies — reduces both the frequency and severity of episodes over time.

Experiencing Dizziness in North Tasmania? Don't Wait for a Fall.

Dizziness is not something to push through or accept as inevitable. Whether it is BPPV that can be resolved in a single visit, orthostatic hypotension that can be managed with simple strategies, or vestibular dysfunction that responds to rehabilitation — a home physiotherapy assessment is the clearest first step.

Physio to Home provides AHPRA-registered physiotherapy assessment and treatment for dizziness and falls prevention across North Tasmania — in your own home, funded through Medicare, My Aged Care, NDIS, and private health insurance.

Book a home dizziness and falls risk assessment today →

About the Author

Michael Ghattas, DPT

AHPRA Registered Physiotherapist | Doctor of Physical Therapy | 18 Years Clinical Experience

Michael is the founder of Physio to Home, a mobile physiotherapy practice serving older adults and rural residents across North Tasmania. He specialises in vestibular physiotherapy, falls prevention, and aged care — all delivered in the home setting.

References & Further Reading

Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo. *Otolaryngology–Head and Neck Surgery*, 2017.

Agrawal Y, et al. Disorders of balance and vestibular function in US adults. *Archives of Internal Medicine*, 2009.

McDonnell MN & Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. *Cochrane Database of Systematic Reviews*, 2015.

Australian Institute of Health and Welfare. Falls in older Australians 2019–20. AIHW, Canberra, 2022.

My Aged Care. Commonwealth Home Support Programme. Commonwealth of Australia, 2025. www.myagedcare.gov.au