From Hospital to Home: The Fall Risk Factor Too Few Talk About

2 minutes read • October 20, 2025

A Critical Window for Safety

Each year, millions of older adults leave hospitals for homes that aren’t equipped for recovery. While hospitals emphasize fall prevention during inpatient care, the real danger often begins after discharge, in environments filled with stairs, clutter, or uneven flooring, and without professional supervision.

Post-discharge falls are a leading cause of emergency visits, readmissions, and long-term loss of independence. Older adults recovering from fractures, joint replacements, or other orthopedic surgeries face challenges: new mobility restrictions, complex medication regimens, and overwhelming instructions.

Why the Transition Is So Risky

The days and weeks following discharge represent a critical window for safety.

Common risk factors include:

• Unfamiliar Home Environments: Patients return to settings that may not support safe recovery: loose rugs, poor lighting, or narrow pathways.
• Overwhelming Instructions: Lengthy, jargon-heavy discharge paperwork causes confusion, especially among older adults with cognitive or sensory impairments.
• Limited Oversight: Once home, many patients manage recovery alone. The first 7–14 days post-discharge carry the highest risk for falls and medication errors.

The Language Gap That Compounds Risk

Beyond physical hazards, communication barriers quietly magnify fall risk. Many older adults with limited English proficiency do not fully understand discharge instructions, medication changes, or home safety precautions.

When instructions are delivered only in English, or explained solely to caregivers, critical safety steps are lost in translation. Misunderstanding how to use mobility aids, mismanaging pain medication, or skipping follow-up appointments can all lead to preventable harm.

What Providers Can Do

Preventing post-discharge falls requires a team-based, culturally responsive approach.

Evidence-based strategies include:

1. Pre-Discharge Safety Walkthroughs: Review common home hazards and demonstrate safe mobility techniques before discharge.
2. Certified Medical Interpreters: Ensure that every instruction, consent, and safety tip is clearly understood in the patient’s preferred language.
3. Early Follow-Up (Within 48–72 Hours): Check in with patients soon after discharge to clarify instructions, assess pain or dizziness, and identify early red flags.
4. Clear, Visual Instructions: Supplement verbal education with diagrams and step-by-step visuals to reinforce safe movement and medication routines.
5. Caregiver Engagement: Involve family or caregivers in every education moment, using the teach-back method to confirm understanding.

Five Practical Steps to Prevent a Fall at Home
(Patient Education Guide)

1. Remove Hazards: Clear walkways of clutter, throw rugs, and electrical cords. Ensure lighting is bright and consistent.
2. Keep Essentials Close: Place frequently used items (phone, glasses, medications) within easy reach to avoid unnecessary movement.
3. Use Mobility Aids Correctly: Follow therapist instructions on how to use walkers, canes, or braces. Never “guess” or improvise.
4. Wear Proper Footwear: Choose shoes with non-slip soles; avoid socks or slippers without traction.
5. Stay Connected: Ask a family member or nurse to check in daily during your first week home to ensure you feel steady and supported.

Closing the Safety Gap

The transition from hospital to home is short—but its impact can last a lifetime. With proactive communication, language access, and early follow-up, providers can prevent avoidable injuries and help older adults recover safely where they most want to be – at home.