Older people who experience falls are frequently in contact with nurses in all sectors of health care. 

Falls are the number one reason older people are taken to the emergency department in a hospital.

Falls and fractures in older people are a costly and often preventable health issue. Reducing falls and fractures is important for maintaining health, wellbeing and independence among older people.

A fall is defined as an event that causes a person to, unintentionally, rest on the ground or lower level and is not a result of a major intrinsic event (such as a stroke) or overwhelming hazard. 

Risk factors of having a fall

Having a fall can happen to anyone; it can be as a result of an accident, but can also be an unfortunate but normal result of human anatomy. However, as people get older, they are more likely to fall over. Falls can become recurrent and result in injuries including head injuries and hip fractures.

Falls are events resulting from the presence of risk factors. The likelihood and severity of injury from an event is often related to bone health. People with low bone mineral density are more likely to experience a fracture following a fall. One of the main reasons why people have low bone mineral density is osteoporosis.

Over 3.5 million people in the UK have osteoporosis (3,775,000) (PDF). People with this condition are at much greater risk of fragility fractures. 

In its 2024 Annual Report, the National Hip Fracture Database (NHFD) reported that more than 70,000 individuals in England, Wales, and Northern Ireland experience hip fractures annually. Read the NHFD report in full.

Causes of falls

There are multiple causes and risk factors when it comes to having a fall. These include:

• having a history of falls
• muscle weakness
• poor balance
• visual impairment
• polypharmacy (taking multiple medicines)
• the use of certain medicines
• environmental hazards
• poor footwear and/or foot care
• medical conditions.

Please see Public Health England's Falls: applying All Our Health.

Integrating AI into older people’s care to prevent falls

Some health and social care settings are beginning to use artificial intelligence (AI) to help prevent falls and keep older people safe. This technology aims to allow residents to stay independent and live in their homes for longer. For example, in southwest London, a pilot scheme led by the local NHS is installing AI-powered monitors in residents' rooms, with their consent. These monitors analyse movement patterns to detect potential fall risks, enabling carers/nurses to respond quickly, and as a result, reducing hospital visits. 

Additionally, the NHS has introduced an AI tool capable of predicting a patient's risk of falling with 97% accuracy by monitoring vital signs during home care visits. This tool helps prevent up to 2,000 falls daily by detecting early warning signs such as changes in heart rate, blood pressure, and mobility. 

AI-powered virtual assistants are also being developed to remind people to take their medication, help with exercises, and warn carers if they show signs of confusion or unsteadiness  . However, these developments raise important privacy and ethical concerns. Some elderly residents may not fully understand or be able to consent to how their personal data is collected and used. 

Balancing safety with privacy

AI-powered monitoring systems, such as cameras and health-tracking devices, can improve safety but may also feel intrusive, especially if they monitor private moments. This highlights the need for informed consent and respect for the person’s dignity. 

Where it is not possible to gain the person’s consent, due diligence must be paid to following the legislative framework within the Mental Capacity Act process in terms of assessment, documentation and making a decision using the principles of best interests.

In addition to the Mental Capacity Act, care homes must follow data protection laws (GDPR). This means handling personal data responsibly, being transparent about how it is used, and ensuring residents and families are fully informed. While AI can help prevent falls and improve care, it is important to balance these benefits with strong privacy protections and ethical safeguards.