In short

Falls are the leading cause of hospitalised injury and injury death in Australians over 65, but they are not an inevitable part of ageing. Most stem from fixable causes: weak balance, risky medications, poor vision, and home hazards. Strength and balance exercise is the single most effective protection, and a GP Chronic Condition Management Plan can subsidise physiotherapy to help build it.

Of all the things that can happen in later life, one quietly does more damage than almost any other, and it's the one people take least seriously: a fall. It's easy to wave off — a trip on a rug, a wobble getting out of the bath — right up until the one that breaks a hip. And here is the reason it deserves your full attention: a fall is the most common single event that ends a person's independent life. But — and this is the whole point of this article — falls are not an inevitable part of getting old. Most of them are preventable. This article is general information only, not personal or medical advice — for exercise, medications, or anything about your health, talk to your GP, physiotherapist or pharmacist.

Is a fall just a fall?

Start with why this matters so much, because the numbers are genuinely startling. Falls are the leading cause of both hospitalised injury and injury death among older Australians: in 2019–20 they made up 77 per cent of all injury hospitalisations and 71 per cent of injury deaths in people aged 65 and over — around 133,000 hospital admissions and 5,000 deaths in a single year (Australian Institute of Health and Welfare, https://www.aihw.gov.au/reports/injury/falls-in-older-australians-2019-20-hospitalisation/contents/summary). Half of those hospitalised falls involved a fracture, and one in two happened at home rather than out in the world. A serious fall — a hip fracture, a head injury — can take someone from managing at home to permanent care in a single afternoon.

Even a fall that does little physical harm can do lasting damage of another kind: a fear of falling that makes someone move less, go out less, and shrink their world — which, cruelly, makes the next fall more likely. None of that is meant to frighten you. It's meant to make the case that this is the highest-leverage risk in later life to get on top of, because so much of it is within your control.

Is it inevitable?

This is the sentence to hold onto: falls are not simply part of getting old. Age raises the risk, yes, but a fall is almost always the result of specific, identifiable causes — and most of those causes are things you can change. Healthdirect, the national health information service, frames falls not as an unavoidable feature of ageing but as something you can act on, stating plainly that "there are many things you can do to reduce your chance of being injured by a fall" (Healthdirect, https://www.healthdirect.gov.au/falls). People who treat falling as an unavoidable fate do the one thing that makes it more likely; people who treat it as a manageable risk usually manage it.

What raises the risk, and how much of it is fixable?

The main contributors are well understood, and the reassuring thing about the list is how much of it you can do something about. The single biggest factor is also the most fixable: weakness and poor balance, the loss of leg strength and steadiness that creeps up so gradually most people never notice it until they stumble. After that come medications — some cause dizziness or drowsiness, and taking many at once, which doctors call polypharmacy, compounds the effect. Vision matters too: out-of-date glasses, or multifocals that blur the ground on stairs. So do home hazards — loose rugs, trailing cords, poor lighting, missing rails, slippery bathroom floors — which is unsurprising given that half of all serious falls happen at home.

Then there are the quieter contributors that rarely get named. Footwear and feet: loose slippers, worn soles, going barefoot, or foot pain that changes the way you walk. Blood pressure that drops when you stand up. Rushing to the toilet, especially at night. Poor nutrition thinning the muscle, and alcohol loosening the balance. And, above all of them, a previous fall — the strongest single predictor of the next one, which is exactly why no fall is ever "just a trip."

What actually works, starting with the big one?

Here's the good news buried in that list: the most powerful protection against falls is also one of the most available. Strength and balance exercise is the number one intervention — not gentle pottering, but specific exercise that builds leg strength and challenges your balance. Healthdirect puts it simply: "there is evidence that doing exercises that improve your balance and ability to move can prevent harm from falls," and it points older adults toward two to three hours of physical activity a week, whether through a home routine, a community class, or a program from a physiotherapist (Healthdirect, https://www.healthdirect.gov.au/physical-activity-guidelines-for-older-adults). This is, quite literally, the opposite of the instinct most people have after a scare, which is to rest and move less. Resting causes the weakness that causes falls; getting stronger prevents them.

And you can often get help paying for it. A GP Chronic Condition Management Plan — the Medicare plan that replaced the old GP Management Plan and Team Care Arrangements on 1 July 2025 — can give eligible patients access to up to five subsidised allied health visits a calendar year, and a physiotherapist or exercise physiologist is exactly the sort of professional those visits are for (Services Australia, https://www.servicesaustralia.gov.au/gp-chronic-condition-management-plan). Such a professional can build a safe, targeted balance-and-strength program suited to you; our article on the chronic condition management plan explains how the pathway works, including the gap fees that can still apply. Many communities also run subsidised balance and strength classes for older people. If you do one thing after reading this, make it this one.

What else belongs in the toolkit?

Around that centrepiece, several other moves each chip away at the risk, and none of them is expensive. Start by getting your medications reviewed. Ask your GP or pharmacist to look over everything you take — prescription and over-the-counter alike — for anything that affects balance; as Healthdirect notes, because those side effects can raise your falls risk, "your doctor or pharmacist can review your medicines" and check whether anything needs adjusting (Healthdirect, https://www.healthdirect.gov.au/falls). There is a formal pathway built for exactly this: a Home Medicines Review, in which a credentialed pharmacist visits you at home and writes a report for your doctor. It needs a GP referral, it's free of charge, and you can generally have one every two years (Healthdirect, https://www.healthdirect.gov.au/home-medicines-review). Whatever you do, don't stop anything on your own — ask first.

Get your eyes checked, too, because poor vision is a real falls risk and a cheaply fixed one; take particular care with multifocals on steps and stairs, and our article on eye care in retirement covers the help available. Fix the home while you're at it: clear the trip hazards, brighten the lighting, and add grab rails and non-slip surfaces in the bathroom — an occupational therapist can assess your home for precisely this, and our articles on home modifications and the Commonwealth Home Support Programme explain how the work can be funded. Sort out your feet and footwear, since supportive, well-fitting shoes make a genuine difference and a podiatrist can help with foot pain. And mind the basics that hold it all together: eat well enough to keep your muscle, which our article on eating well in later life goes into, stay hydrated, go easy on alcohol, and manage blood pressure and continence with your GP.

What do the worked examples show?

These show how differently the same advice lands depending on where someone is starting from. They are illustrative only, not personal or medical advice.

Consider Norma, 78, a widow who lives alone and stumbled in the kitchen last month. She wasn't hurt, so she didn't mention it to anyone — but she has quietly started holding the furniture, and she has stopped walking to the shops because she's frightened of falling again. On these facts Norma is doing the one thing the evidence says makes another fall more likely: retreating into stillness, which strips away the very leg strength that keeps her upright, while her unreported near-miss is the strongest warning sign there is that a serious fall may be coming (Australian Institute of Health and Welfare, https://www.aihw.gov.au/reports/injury/falls-in-older-australians-2019-20-hospitalisation/contents/summary). On these facts it is generally rational for someone in Norma's position to treat that stumble as worth a GP appointment rather than a secret, and to ask specifically about a Chronic Condition Management Plan so a physiotherapist can build her a balance-and-strength program — up to five subsidised visits a year (Services Australia, https://www.servicesaustralia.gov.au/gp-chronic-condition-management-plan) — because getting stronger, not sitting still, is what will keep her in her own home.

Now consider Frank, 82, and his wife Margaret, 79, who are comfortable and self-funded and take, between them, eleven regular medications for blood pressure, cholesterol, sleep and arthritis. Frank has been feeling lightheaded when he stands, and put it down to age. On these facts the leading suspect isn't weakness at all — it's the combination of medicines, the polypharmacy that so often produces dizziness and unsteady mornings, and the fix costs them nothing. It is generally rational for someone in Frank's position to ask his GP for a Home Medicines Review, the free, referral-based service in which a pharmacist comes to the house, checks all eleven medicines together, and reports back to the doctor on anything worth adjusting (Healthdirect, https://www.healthdirect.gov.au/home-medicines-review) — a single, cost-free step that can remove a falls risk hiding in plain sight on the kitchen bench.

What if you do fall?

Preparing for a fall isn't defeatism — it's sensible. Make sure you can call for help: a phone kept within reach, or a personal alarm pendant for those who live alone. It's also worth knowing how to get up from the floor safely, and how to stay warm and call for help if you can't. Above all, don't let the fear of falling talk you into a smaller life — staying active is the protection, not the risk. And if you're watching a parent, the early signs are quiet: someone starts trailing a hand along the wall, or steadying themselves on the furniture, or mentions a "near miss" in passing, or stops going to things they used to. Take it seriously and raise it gently — and if you push for one thing, push for the exercise referral. It's the highest-value move there is, and the one most likely to keep them on their feet and at home.

What should you do in short?

A fall can undo a retirement in a moment, which is exactly why it's worth taking seriously — but the story that falls are just an unavoidable part of ageing is wrong, and it's a dangerous thing to believe. The risks are known and mostly fixable, and the best defence is to get stronger and steadier rather than to slow down and sit still. Treat any fall as a warning worth acting on, get the balance-and-strength help that Medicare can subsidise, and tidy up the hazards around it. Staying on your feet is, in the end, how you stay in your home.

Sources

Key takeaways

  • Falls are the leading cause of hospitalised injury and injury death among Australians aged 65 and over, but they are not an inevitable part of ageing.
  • The biggest fixable risk factors are weak leg strength and poor balance, followed by medications that cause dizziness, poor vision, and home hazards like loose rugs and poor lighting.
  • Strength and balance exercise is the single most effective protection against falls — resting after a scare increases risk, while getting stronger reduces it.
  • A GP Chronic Condition Management Plan can unlock up to five Medicare-subsidised allied health visits a year, including a physiotherapist or exercise physiologist to build a balance program.
  • A free, GP-referred Home Medicines Review lets a pharmacist check all your medications for falls risk, and can generally be done every two years.

Frequently asked questions

Are falls a normal part of getting older?

No. While age raises the risk, a fall is almost always the result of specific, identifiable and often fixable causes — weak balance, medications, poor vision, or home hazards. Healthdirect frames falls as something you can act on, not an unavoidable feature of ageing.

What is the most effective way to prevent falls?

Strength and balance exercise is the single most powerful protection — specific exercise that builds leg strength and challenges balance, not gentle activity alone. Resting after a fall or a scare typically makes the next fall more likely, because it causes further weakness.

Can I get subsidised help to prevent falls?

Yes. A GP Chronic Condition Management Plan can give you access to up to five Medicare-subsidised allied health visits a year, including a physiotherapist or exercise physiologist who can build a targeted balance-and-strength program. Many communities also run subsidised balance and strength classes.

What is a Home Medicines Review?

It's a free, GP-referred service where a credentialed pharmacist visits you at home, reviews all your medications for anything that might affect your balance or increase your falls risk, and reports back to your doctor. You can generally have one every two years.

A note on advice. This article is general information only and doesn't account for your personal circumstances. Everyone's situation is different — before acting, it's worth talking it through with a licensed adviser who knows your full picture.