The National Council on Aging held Falls Prevention Awareness Week from September 21 to 25 this year, and the campaign’s message was that falls are preventable. That is true, and most of the advice focuses on strength, balance, medications, and home safety. What gets far less attention is what a fall, or the fear of one, does to an emergency plan.

Most evacuation plans are written for a person who can stand up quickly, carry a bag, and walk to a car. For an older adult living alone, especially one who has fallen before, each of those assumptions is a point of failure. This piece connects the two subjects: the fall-risk picture, and the specific changes that make an emergency plan hold up for someone who is at risk of falling.

What the fall data says

The CDC reports that more than one out of four older people falls each year, and that fewer than half of those who fall tell their doctor. About 37% of those who fall are injured badly enough to need medical treatment or to restrict activity for at least one day. The CDC’s fall statistics also put older-adult falls at roughly 4.5 million emergency department visits a year, including about 1.4 million hospitalizations, and identify falls as the leading cause of traumatic brain injury among older adults.

The NCOA describes falls as the leading cause of injury-related death for Americans 65 and older, and puts the annual health care cost of non-fatal older adult falls at $80 billion, based on 2020 data.

Two things in that data matter for emergency planning. First, fall risk is common, not exceptional, so a plan that ignores it ignores a large share of the people it is written for. Second, many falls are never reported. A household can have a real fall history that no relative, neighbor, or physician knows about, which means the people who would help in an emergency may be working with an incomplete picture.

The CDC also notes that many older adults who fall, even without injury, become afraid of falling and cut back on everyday activities, which leads to weakness and a higher risk of falling again. That loop affects preparedness directly. A person who has stopped using stairs, stopped going out, and stopped carrying loads is also a person for whom an evacuation is much harder.

Where falls and emergencies collide

Emergencies make falls more likely and make their consequences worse. Four patterns are worth planning around:

  • Power outages. Dark hallways, stairwells, and bathrooms are fall hazards. A household without battery lighting in those places is betting that nobody needs to move at night.
  • Evacuation under time pressure. Rushing with bags, pets, and medications in hand while navigating stairs or uneven ground is when a fall happens.
  • Being alone when it happens. After a fall in a storm, flood, or heat event, help may be slow to arrive, and phone networks may be congested.
  • Lost aids. Glasses, hearing aids, canes, and walkers get left behind or damaged. Without them, even a short walk becomes a risk.

What to add to the evacuation plan

Ready.gov’s guide for older adults and caregivers frames preparation as three steps: assess your needs, make a plan, and engage your network. It asks the person to identify the mobility limits and assistive devices the plan must account for, and whether an accessible evacuation route and shelter have been identified. The changes below put that into practice for someone at risk of falling.

Plan the route around the body, not the map

Walk the path from the bedroom to the door to the vehicle, and note every step, threshold, rug, and slope. If stairs are involved, decide in advance who helps and where the handrails are. If you use a wheelchair, walker, or cane, confirm that the device fits through the exit and that there is a realistic way to transport it. A plan that says “drive to a relative’s house” is incomplete if nobody has confirmed that you can get from the front door to the car.

Leave earlier than the plan says

Older adults who live alone should treat official evacuation “warnings” as “go now” signals. Extra time is the best protection against rushing. If a storm is approaching, leave before conditions make travel difficult, and arrange transportation ahead of time rather than counting on a last-minute ride. Our evacuation plan guide covers destinations and routes, and the timing advice applies doubly here.

Keep a go bag that can be carried

A packed bag you cannot lift is not a go bag. Pack for the lightest weight that covers the essentials: medications with a current written list, copies of key documents, glasses, hearing aid batteries, and a phone charger. Keep it by the door or at waist height, not on a high shelf or in a basement. Our household go-file guide lists what to copy.

Build a check-in network with real names

Ready.gov recommends engaging a support network of family, friends, caregivers, neighbors, and others who can help in an emergency. For someone living alone, turn that into something specific:

  • Name at least two people close enough to reach you quickly, and one out of town. Our out-of-area contact guide explains why that third call matters.
  • Give a neighbor a key or entry code and tell them which room you are usually in.
  • Agree on a daily check-in in any emergency, such as a text by a set hour, and what happens if it does not come.

Decide how you will call for help after a fall

If you cannot reach a phone from the floor, you cannot call for help. Options include wearing a phone on the body, using a voice-activated assistant that can place calls, or a personal emergency response device. Choose one, test it, and make sure your neighbors know it exists. Whatever the method, put it in the written plan.

Fix the hazards that an outage makes worse

Reducing fall risk and preparing for emergencies overlap more than people expect. A few low-cost steps do both:

  • Put plug-in or battery-powered night lights in hallways, bathrooms, and on stairs.
  • Keep a flashlight within reach of the bed and another in the bathroom. Avoid candles, which add a fire risk to the fall risk.
  • Clear the exit path of rugs, cords, and clutter.
  • Store water and supplies at waist height instead of on the floor or high shelves.
  • Ask your doctor or pharmacist about medication side effects that affect balance, and bring that list to a fall-risk conversation.

The NCOA’s Falls Prevention Awareness Week messaging emphasizes staying active and maintaining strength and balance. Those goals fit naturally into a preparedness plan, because a stronger, steadier person is a more mobile person when an evacuation order arrives.

Start with one conversation

Pick one day this week to do three things: walk the exit path and mark what needs to change, write down the names and numbers in your support network, and tell one person how you would call for help after a fall. If you are the adult child or neighbor rather than the person at risk, offer to do the walk-through together. A fall plan and an evacuation plan are the same document for a person living alone, and the time to write it is before either one is needed.