Falls Prevention

Falls Risk in Ageing Parents | A Guide for Families | Physio to Home

Michael Ghattas, Physiotherapist6 March 2026

Worried about your elderly parent falling at home? North Tasmania's home physiotherapist explains the warning signs families miss, what actually reduces falls risk, and how to have the conversation.

Micheal Ghattas

3/6/2026 · 7 min read

What Families Need to Know About Falls Risk in Ageing Parents

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

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

For many families, the moment they start worrying seriously about a parent's safety at home comes after a fall has already happened. A phone call from a neighbour. A bruise that is hard to explain. A quiet admission over the phone that Mum slipped in the bathroom last week but is fine, don't worry.

By that point, the fall risk was already elevated — often for months or years. The signs were there. They just were not always obvious to someone who does not visit regularly, and they are not always obvious to the older person themselves, who has often adapted their behaviour so gradually to increasing instability that they have stopped noticing.

This guide is written for adult children and family members who want to understand falls risk in their ageing parent — what causes it, how to recognise the warning signs, what actually reduces it, and how to navigate the conversation.

Who this guide is for

This article is for family members and carers of older Tasmanians — particularly those who live at a distance from their parent, or who have noticed changes in their parent's movement and confidence that concern them. It is also for anyone who has experienced a parent's fall and wants to understand what to do next.

Why Falls Are Not Simply Accidents

The word "accident" implies randomness — something that could not have been anticipated or prevented. The research on falls in older adults tells a fundamentally different story. Falls in people over 65 are almost always the predictable outcome of a combination of risk factors that accumulate over time: reduced muscle strength, declining balance, medication side effects, visual changes, and environmental hazards, compounding quietly until the system fails.

This matters because it means falls are largely preventable — with the right assessment and the right intervention. It also means that when an older person falls, it is a signal worth taking seriously, not a one-off event to be reassured away.

In Australia, falls are the leading cause of injury-related hospitalisation in people over 65. One in three people over 65 falls at least once a year. For people who have already fallen once, the risk of a subsequent fall is roughly doubled. And for those with osteoporosis — a common and often silent condition in older women — a single fall can result in a hip fracture with devastating consequences for independence and life expectancy.

Warning Signs Families Often Miss

Falls rarely come out of nowhere. The physical changes that elevate falls risk develop gradually, and older people often compensate so naturally that the signs become invisible — both to themselves and to the family members who see them regularly. When you visit less frequently, the change can be more striking. When you see someone every day, it tends to slip past unnoticed.

Here are the warning signs worth watching for:

Furniture-touching when moving through a room. If your parent is routinely touching walls, furniture, or countertops as they move — not reaching for things, but using surfaces for balance — their postural stability is reduced. This is often one of the earliest visible signs of balance decline.

A shuffle rather than a clear step. Watch how your parent lifts their feet when they walk. A shuffling gait — feet skimming the floor rather than lifting clearly — dramatically increases trip risk. It is also associated with Parkinson's disease and other neurological conditions.

Hesitation before movement transitions. Watch for pausing before standing up, sitting down, or turning around. These transitions are among the highest-risk moments for falls, and hesitation reflects awareness of instability that the person may not have articulated.

Significant slowness or stiffness in the morning. Morning stiffness and difficulty getting going is normal to a degree — but marked difficulty getting out of bed, dressing, or moving around in the first hour of the day can reflect muscle weakness and joint stiffness that carries over into falls risk throughout the day.

Changes to what they are and are not doing. One of the most telling signs is behavioural: has your parent stopped going to the shops alone? Stopped using the stairs? Stopped walking to the letterbox? Avoided going out at night? These reductions in activity often reflect a quiet, internal acknowledgement of instability that the person has not told anyone about.

Bruises that are not clearly explained. Small bruises on forearms, shins, or hips — attributed vaguely to "bumping into things" — can indicate minor falls or near-falls that were not reported. Older adults often minimise or conceal falls out of fear of losing independence.

Medication changes. A new blood pressure medication, a new sleeping tablet, a new antidepressant — any of these can affect blood pressure regulation, dizziness, and balance. Falls risk rises with polypharmacy (four or more medications), and medication reviews are a meaningful intervention.

Having the Conversation

For many families, the hardest part of addressing falls risk in an older parent is the conversation itself. The topic touches on independence, vulnerability, and the fear of being seen as declining — all of which can make older adults defensive or dismissive.

Some approaches that tend to work better than others:

Frame it around a specific observation, not a general concern. "I noticed you were holding the bench when you walked through the kitchen" is easier to hear than "I'm worried you're going to fall." Specific observations are harder to dismiss and easier to discuss.

Use curiosity rather than alarm. "Have you noticed your balance feeling different lately?" is less threatening than "I think you need help." Asking your parent what they have noticed opens a conversation rather than closing one.

Raise the physiotherapy option as information, not a directive. Many older adults are more receptive to "I read that a home physiotherapy assessment can identify fall risks before they become a problem — would it be worth a call to find out more?" than "You need to see a physiotherapist."

Acknowledge their autonomy. The goal is not to take over your parent's decision-making. It is to give them better information. Most older adults, once they understand that falls risk is both real and addressable, choose to act on it.

What Actually Reduces Falls Risk

There is a large body of research on falls prevention in older adults, and the evidence is clear about what works.

Physiotherapy-led balance and strength training is the most evidence-supported intervention for reducing falls in community-dwelling older adults. A Cochrane Review of over 100 trials found that exercise programmes targeting balance and lower limb strength significantly reduce both the rate of falls and the number of people who fall. The effects are clinically meaningful and cost-effective.

Home hazard assessment and modification — removing loose rugs, improving lighting, installing grab rails in the bathroom — reduces falls risk, particularly when combined with physiotherapy. The important nuance is that a home hazard assessment conducted by a physiotherapist goes considerably further than a checklist-based approach, because the trained eye identifies risks that a non-clinical observer would not notice.

Medication review — a GP review of all current medications, specifically looking for drugs that affect blood pressure, dizziness, and balance — is a high-yield intervention, particularly for older adults on multiple medications.

Vision check — annual eye testing reduces falls risk. Poor vision is a simple but powerful contributor to falls that is often neglected.

What does not work, despite its common use: generic exercise programmes without a balance-specific component, passive treatments without active exercise, and home modifications without the accompanying physiotherapy programme.

How Physio to Home Helps Families in North Tasmania

Physio to Home provides home physiotherapy falls risk assessments for older adults across North Tasmania — including Launceston, George Town, Longford, Deloraine, Scottsdale, Exeter, Beaconsfield, and surrounding rural areas. The assessment is conducted in the person's own home — the environment where the falls risk is actually present.

A home falls risk assessment from Physio to Home includes:

Standardised balance and gait assessment
Lower limb strength testing
A walk-through of the home identifying specific environmental hazards
Review of medications and medical conditions contributing to falls risk
A written report summarising findings and recommendations
A personalised falls prevention exercise programme to begin immediately

For families who live away from their parent — in Launceston, interstate, or overseas — arranging a home assessment is a practical and meaningful thing they can do remotely. Contact Physio to Home, provide your parent's address and contact details, and we will arrange the visit and send you a copy of the findings report.

After a Fall: What to Do

If your parent has already had a fall, the priority is twofold: medical assessment (to rule out injury, particularly if the fall involved a hard surface or resulted in pain that limits movement) and physiotherapy assessment (to identify what contributed to the fall and address it before the next one).

A previous fall is the single strongest predictor of a future fall. The period immediately after a fall — when fear is high and confidence is low — is both the time when people are most motivated to accept help and the time when intervention has the greatest potential to break the cycle.

If your parent has had a fall in North Tasmania and you are concerned, contact Physio to Home. We can typically arrange a home visit within 1–2 weeks and will prioritise post-fall assessments where possible.

Funding a Home Falls Assessment for Your Parent

My Aged Care — Home Care Package — If your parent receives a Home Care Package, a physiotherapy falls risk assessment and prevention programme can be funded through their package. Contact their care coordinator.

Medicare GP Management Plan — A GP Management Plan provides up to five subsidised physiotherapy visits per year. The falls assessment counts as a covered visit.

My Aged Care — CHSP — Entry-level support for older Australians not yet on a package.

Private health insurance — Most extras policies cover physiotherapy including home visits.

Private self-funding — A private falls risk assessment can be arranged directly without a referral or funding pathway.

Frequently Asked Questions

My parent says they are fine and does not want physiotherapy. What can I do?

You cannot force an assessment. What you can do is arrange a conversation — many older adults are more open to a physiotherapist calling them directly than they are to their child raising the topic. A phone call from Physio to Home, framed as a brief discussion rather than a commitment, often goes further than a family conversation. Contact us and we can discuss the best approach for your parent's specific situation.

My parent lives in rural North Tasmania and I live interstate. Can I arrange a home visit for them remotely?

Yes. Contact Physio to Home with your parent's details and we will manage the arrangements. We can also email you a copy of the assessment findings so you are kept informed, with your parent's consent.

How do I know if my parent needs a falls assessment or just a general check-up?

If you have noticed any of the warning signs described in this article — furniture-touching, shuffling gait, movement hesitation, unexplained bruises, or behavioural withdrawal from activities — a falls risk assessment is warranted. You do not need to wait for a fall to occur.

Concerned About Your Parent's Falls Risk in North Tasmania?

Contact Physio to Home today — we can discuss your parent's situation, advise on the most appropriate assessment, and arrange a home visit anywhere across North Tasmania.

📞 [Insert phone number]

🌐 physiotohome.com

Book a home falls risk assessment for your parent 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 falls prevention, aged care physiotherapy, and home-based rehabilitation for complex presentations.

References & Further Reading

Sherrington C, et al. Exercise for preventing falls in older people living in the community. *Cochrane Database of Systematic Reviews*, 2019.

Australian Institute of Health and Welfare (AIHW). Injury in Australia: Falls. Cat. no. INJCAT 199. Canberra: AIHW, 2022.

Gillespie LD, et al. Interventions for preventing falls in older people living in the community. *Cochrane Database of Systematic Reviews*, 2012.

Australian Commission on Safety and Quality in Health Care. Preventing Falls and Harm from Falls in Older People. ACSQHC, Sydney, 2021.

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