How do you stop an older parent falling at home in Nigeria? Home changes and checks

How common are falls among older people in Nigeria?

Falls are common among older Nigerians: community and clinic studies have found that a fifth to two fifths of older adults fell within a year.

Worldwide, the WHO estimated about 842,000 deaths from falls in 2023, making falls the second-leading cause of unintentional injury death after road injuries. About 71% of those deaths were among people aged 60 and over.

Nigerian studies measure falls in different ways and over different periods, so the figures below are not directly comparable, but all of them are high.

• Igboora, Oyo State (published 2009): 21.4% of 210 people aged 65 and over had fallen in the previous year, and 11.1% of those who fell had a fracture.
• Ado-Ekiti, Ekiti State (published 2021): 41.3% of urban and 25.3% of rural adults aged 65 and over had fallen in the previous six months, among 624 people.
• Benue State (published 2023): 33.2% of 494 mostly rural adults aged 60 and over had fallen two or more times in the past year.
• Kano (data collected 2016, published 2024): 41.4% of 295 hospital outpatients aged 60 and over had fallen in the past 12 months, and 25.4% of those who fell were injured.

Why do older people fall at home?

Most falls among older Nigerians in these studies happened while walking, through tripping or slipping, rather than from a height.

In Igboora, 86.7% of those who fell were walking at the time, 44.4% tripped and 35.6% slipped. In Kano, 80.2% were walking, 49.2% tripped and 41.8% slipped.

The Kano study found slippery mats, wires or cords exposed on walkways, and shoes with uneven or slippery soles were among the predictors of falls. Its authors linked the exposed cords to erratic power supply and the wide use of generators.

In Ekiti, low visual acuity, arthritis, hearing impairment, high fasting blood sugar and higher body weight were linked with falls in the urban group, while more physical activity was protective.

The NHS lists other common causes: muscles weakening with age, conditions such as arthritis, stroke or Parkinson's disease, low blood pressure, side effects of some medicines, problems with eyesight or hearing, and dementia. The WHO adds unsafe stairs, lighting and walking surfaces, poverty and substandard housing.

Which hazards matter in a Nigerian home, and how can you fix them cheaply?

The hazards that matter most are the ones on the routes your parent walks every day, especially between the bed, the toilet and their usual seat.

What should you check room by room?

Walk the home at the times your parent moves around, including after dark, and check each room against the list; WHO and NHS guidance supports each of these changes.

• Bedroom: put a light within reach of the bed that works in a power cut.
• Bedroom to toilet: clear the route and light it at night.
• Bathroom: fit a non-slip mat in the shower or bathing area.
• Bathroom: fit a grab bar or firm handhold by the toilet and shower.
• Bathroom: wipe up water straight away and keep buckets off the walkway.
• Living room: move furniture to leave a wide, clear path.
• Living room: remove or fix loose rugs and mats.
• Stairs: fit a handrail and keep the steps clear.
• Stairs and outside steps: mark the edges with bright tape or paint.
• Outside: light the path to the gate and to any outside toilet.
• Everywhere: run generator and extension cables along walls, not across floors.
• Footwear: check shoes are enclosed, fit well, stay on and grip.
• Eyes: book an eye test; Age UK suggests at least every two years.
• Phone: keep a charged phone within reach, so they can call if they fall.

What else lowers the risk besides changing the home?

Exercise that challenges balance is one of the most effective measures: the WHO cites a Cochrane review in which it reduced the overall rate of falls by about 23%.

Home hazard changes work best for people already at higher risk. The WHO cites a 2023 Cochrane review that found a 38% reduction in fall rates in higher-risk groups, but no demonstrated effect in older people in general.

The NHS recommends being active every day and doing activities that improve strength and balance at least twice a week, eating well and drinking enough, and having regular eye tests and hearing checks. Age UK suggests 6 to 8 glasses of fluid a day, since not drinking enough can cause dizziness.

NICE's 2025 falls guideline (NG249) says people who have fallen in the past year should be offered a comprehensive falls assessment if they are frail, were injured and needed medical treatment, lost consciousness, could not get up on their own, or have fallen two or more times. It recommends that home hazard assessments use a validated tool and suggests an occupational therapist carry them out.

The WHO says routine vitamin D supplements should not be presented as a general way to prevent falls in all older adults. This is general information; the person's doctor decides on any change to medicines or supplements.

What should happen after a fall?

Call an ambulance if someone may have hurt their head, back, neck or hip in a fall, or cannot get up, the NHS says; in Nigeria call 112, or 767 in Lagos.

Any fall, even without injury, is worth telling the person's doctor about, because NHS guidance says to see a GP after a fall and NICE asks clinicians to ask older people whether they have fallen in the last year.

• Stay calm and check for pain or injury before trying to get up.
• Get up slowly: roll onto the side, then onto hands and knees.
• Hold something stable, such as heavy furniture, and stand up slowly.
• Sit and rest before doing anything else.
• If they cannot get up, call or shout for help and keep warm.
• Change position about every 30 minutes while waiting.
• Do not try to lift someone who has fallen by yourself.
• Call 112 for a possible head, back, neck or hip injury, or if they cannot get up.
• Tell their doctor about the fall, and fix whatever caused it.

Questions people ask

Related

• What a home visit to an older parent should check
• An emergency plan for a parent in Nigeria
• Recovering at home after a stroke in Nigeria
• A health check-up for an older parent in Lagos