What is an example of an external fall? A Comprehensive Guide to Environmental Fall Hazards

According to the Centers for Disease Control and Prevention (CDC), environmental hazards are involved in 30% to 50% of falls among community-dwelling older adults. For anyone seeking to improve home safety, understanding what is an example of an external fall is the critical first step toward effective prevention.

Quick Summary

An external fall is caused by a hazard in the environment, such as tripping over a loose rug, slipping on a wet kitchen floor, or navigating poorly lit stairs. These are extrinsic risk factors, stemming from a person's surroundings, rather than their intrinsic health conditions.

Key Points

• External vs. Intrinsic: External falls are caused by environmental hazards, while intrinsic falls relate to a person's internal health and physical condition.

• Common Hazards: Examples of external falls include tripping on loose rugs or electrical cords and slipping on wet or icy surfaces.

• Home Safety: Simple home modifications like improving lighting, securing loose carpets, and clearing clutter can dramatically reduce the risk of external falls.

• Proactive Audits: Regularly inspecting your home and surrounding environment for potential hazards is a critical and preventative step for older adults and their caregivers.

• Environmental Control: Unlike intrinsic factors, external fall risks are often easily identifiable and can be modified or eliminated to create a safer and more secure living space.

Understanding External (Extrinsic) vs. Internal (Intrinsic) Falls

To effectively prevent falls, it is essential to distinguish between external (extrinsic) and internal (intrinsic) risk factors. While intrinsic factors relate to a person’s own body and health—like poor vision, balance problems, or medication side effects—extrinsic factors are external to the individual, caused by hazards in their immediate environment. Often, a fall results from a combination of both types of risks. For example, an older adult with a balance issue (intrinsic) who encounters an uneven surface (extrinsic) may be more likely to fall than a younger person in the same situation. By focusing on mitigating the external risks, we can remove a significant number of potential dangers and create a safer living space.

The Critical Difference: Intrinsic vs. Extrinsic Risk Factors

Feature	Intrinsic Risk Factors	Extrinsic Risk Factors
Origin	Inside the individual (physical and mental state).	Outside the individual (environmental hazards).
Examples	Muscle weakness, poor vision, balance issues, chronic conditions (e.g., arthritis), medication side effects.	Poor lighting, loose rugs, clutter, uneven surfaces, wet floors, lack of handrails.
Modifiability	Often managed through medical care, exercise, and lifestyle adjustments.	Often easily preventable through home modifications and careful awareness.
Intervention	Physical therapy, medication review, vision checks, balance training.	Environmental assessment, home safety upgrades, decluttering, better lighting.

Common Examples of External Falls

External falls are preventable accidents caused by hazards that exist both inside and outside the home. Recognizing these common dangers is key to eliminating them.

Household Hazards

The home environment is where the majority of senior falls occur. A proactive home safety assessment can identify and address these issues before they cause harm.

• Loose Throw Rugs: The edges of area rugs that are not secured to the floor are a leading cause of trips. Replacing them with non-slip alternatives or securing them with double-sided tape is a simple fix.
• Electrical Cords: Cords running across walkways or under rugs are significant tripping hazards. Use cord covers or secure them along walls to keep pathways clear.
• Clutter: Piles of books, magazines, or personal items on the floor can be difficult to see, especially for those with vision impairment. Maintaining clear pathways is essential.
• Inadequate Lighting: Dimly lit areas, such as stairwells, hallways, and bathrooms, can make it difficult to spot obstacles. Installing brighter bulbs, motion-sensor lights, or nightlights can significantly improve visibility.

Bathroom and Kitchen Risks

These rooms are particularly hazardous due to the presence of water and slick surfaces.

• Slippery Floors: Water spills from sinks, showers, or baths can create a slippery surface. Using non-slip mats inside and outside the shower and cleaning spills immediately can prevent slips.
• Lack of Grab Bars: Without proper support, getting in and out of the shower or using the toilet can be risky. Installing grab bars provides a stable handhold.
• Improper Storage: Reaching for high-up items on shelves or bending down to retrieve items from low cabinets can cause a loss of balance. Storing frequently used items within easy reach can minimize this risk.

Outdoor Dangers

Moving outside the home introduces a new set of environmental risks that require attention.

• Uneven Pavement or Sidewalks: Cracks, bumps, and tree roots can create uneven surfaces that are easy to trip on. Reporting public hazards or repairing private walkways can prevent falls.
• Slippery Surfaces: Wet leaves, snow, and ice on walkways or driveways pose a major slipping risk. Regular sweeping, salting, or shoveling can make these surfaces safer.
• Unstable Steps: Unmaintained or uneven outdoor steps can be dangerous. Ensuring all steps are in good repair and have a secure handrail can help prevent falls.

A Step-by-Step Guide to Preventing External Falls

Taking a systematic approach to fall prevention can make a significant impact on safety.

1. Conduct a Home Safety Audit: Walk through every room of the home, both indoors and out, with a checklist. Look for loose rugs, obstructed pathways, poor lighting, and other potential hazards. Don't forget to check stairs, the basement, and outdoor areas.
2. Improve Lighting: Add brighter bulbs, install motion-activated lights in key areas, and use nightlights in bedrooms and bathrooms. Ensure a light switch is accessible at both the top and bottom of stairs.
3. Secure Carpets and Address Uneven Surfaces: Remove loose area rugs completely or secure them firmly to the floor with non-slip pads or double-sided tape. Repair any uneven flooring or pathways immediately.
4. Install Safety Equipment: Install grab bars in bathrooms near the toilet and in the shower/tub. Add sturdy handrails to both sides of all staircases.
5. Wear Appropriate Footwear: Encourage the use of sturdy, non-slip footwear, even while indoors. Avoid walking in socks on smooth floors, which can be extremely slippery.

Making Environmental Modifications for Fall Prevention

Beyond simple fixes, more permanent modifications can create a safer environment for aging in place. Many of these changes can be implemented with the help of a professional or through local community programs.

• Stairlift or Elevator: For homes with multiple stories, a stairlift can eliminate the risk of staircase falls entirely.
• Ramps: Installing ramps instead of steps at entryways can provide a smooth transition for those using walkers or wheelchairs.
• Leveling Surfaces: Hiring a contractor to repair severely cracked or uneven sidewalks and driveways can be a worthwhile investment.
• Smart Home Technology: Some systems can be programmed to automatically turn on lights in response to motion, reducing the risk of navigating a dark room.

What to Do After an External Fall

Even with the best prevention, falls can still happen. It’s important to have a plan in place.

1. Stay Calm and Assess the Situation: Before trying to get up, take a moment to determine if you are hurt. If you are in pain, remain still.
2. Use a Medical Alert System: If you have one, activate your medical alert device to call for help. Having a wearable device ensures you can call for assistance no matter where the fall occurs.
3. Use Available Aids to Get Up: If you are uninjured, use a nearby sturdy piece of furniture to help push yourself up slowly. Always avoid using flimsy items that could topple over.

Conclusion: Proactive Steps for Lasting Safety

Understanding what is an example of an external fall empowers older adults and their caregivers to take control of their environment. By systematically identifying and addressing these extrinsic risk factors—from securing loose rugs to installing proper lighting—you can create a safer living space and significantly reduce the risk of falling. Taking proactive measures is an essential part of healthy aging and maintaining independence.

For more information on evidence-based fall prevention strategies, visit the CDC Falls Prevention resources.

Frequently Asked Questions

What is an example of an external fall?

An example of an external fall is slipping on a wet bathroom floor, tripping on a loose rug, or falling over an uneven surface on a sidewalk. The key characteristic is that the cause originates from a hazard in the environment.

What is the difference between an intrinsic and extrinsic fall?

An intrinsic fall is caused by a person's internal factors, such as dizziness from medication or a balance disorder. An extrinsic fall is caused by an external, environmental hazard, such as poor lighting or clutter.

Are all falls in seniors caused by external factors?

No, not all falls are caused by external factors. Many falls result from a combination of both intrinsic (internal health) and extrinsic (environmental) risk factors. A person with weak muscles (intrinsic), for example, might be more susceptible to falling when encountering a common external hazard like a loose rug.

How can I identify potential external fall hazards in my home?

To identify hazards, walk through your home and look for potential dangers. Check for unsecured rugs, loose electrical cords, poor lighting in hallways and staircases, and wet or slippery spots in the kitchen and bathroom. Consider creating a checklist to be systematic.

What are some low-cost ways to prevent external falls?

Low-cost prevention methods include using double-sided tape to secure rugs, adding nightlights in key areas, clearing clutter from walkways, and ensuring all light bulbs are working and bright enough. Simple changes can make a big difference.

Does poor lighting count as an external fall risk?

Yes, absolutely. Poor lighting is a major external fall risk because it makes it difficult to see obstacles, steps, or changes in flooring levels, especially for older adults with vision changes. Improving lighting in all areas is a crucial step in fall prevention.

What role does footwear play in preventing external falls?

Proper footwear is an essential part of preventing external falls. Wearing shoes with non-slip soles, both inside and outside the home, can provide better grip and stability. Avoiding walking in socks on slick surfaces is also recommended to minimize risk.