5 Evidence-Based Practices to Help Older Adults Live Independently

More than 1 in 4 older adults fall each year, and the consequences can be life-changing.1

Untreated vision and hearing problems can increase the risk of falls in older adults. | Image credit: Rawpixel.com – stock.adobe.com

Falls are a leading cause of injury-related hospitalizations in people 65 and older, often resulting in reduced mobility, long-term disability, and a loss of independence.2 However, research shows there are practical strategies that can help older adults remain physically independent for longer, beyond just exercise.

This Independence Day, here are 5 evidence-based practices that can help older adults live safely and independently at home.

1. Improve Strength and Balance Through Physical Activity

Regular physical activity is one of the most effective—and researched—ways to help older adults maintain independence. Even simple movements like standing from a seated position or walking heel-to-toe in a straight line can improve strength, balance, and flexibility.3 Studies show that a total of about 3 hours of activity a week can significantly enhance physical function in older adults, including those living in residential care settings.4 This includes improvements in walking speed, grip strength, and performance on balance tests, all of which reduce the risk of falls and functional decline.

Moderate-to-vigorous physical activity can also counteract the harmful effects of a sedentary lifestyle. In one study, just 36 minutes of this type of movement per day was enough to blunt the negative effects of sitting too long.5 Older adults who engaged in over 108 minutes of daily activity actually saw improvements in physical independence, even if they had long sedentary stretches. These data show that movement in any amount counts, and starting slowly with activities like walking, dancing, or water aerobics can make a difference.3

2. Improve Home Safety to Reduce Fall Risk

Making a home safer to navigate can be just as important as improving physical strength. Tripping on rugs, slipping in the bathroom, or navigating poorly lit stairs can all increase fall risk.6

Environmental changes, like installing grab bars in the shower, securing loose rugs, using nonslip mats on stairs, and improving lighting, can reduce hazards. Clutter also adds up, and organizing household items to keep necessities within easy reach and walkways clutter-free lowers the risk of injury further. Footwear matters as well—supportive, non-skid footwear can help prevent slips, especially on stairs or smooth surfaces.

Falls are more likely among individuals with age-related conditions like muscle loss or sarcopenia, poor balance, and postural hypotension.7 In these cases, home modifications can help older adults move safely and confidently through their living spaces.

3. Manage Medications Carefully

Medication-related problems are a common but preventable threat to independence. According to 2019 CDC data, 83% of US adults in their 60s and 70s used at least 1 prescription drug in the past month, and almost 35% used at least 5; the most commonly prescribed were cholesterol, high blood pressure, and diabetes medications.8 These drugs may interact in harmful ways and cause side effects like dizziness or confusion that increase fall risk. Regular medication reviews, especially with a pharmacist or care team trained in geriatric management, can help reduce polypharmacy and identify inappropriate or unnecessary prescriptions.

Effective medication management doesn’t just reduce side effects; it also improves adherence and quality of life, and interventions that combine education with behavioral support have helped older adults better manage complex medication schedules. In one program, older adults with chronic kidney disease reduced their medication load from an average of more than 13 prescriptions to around 11 and decreased the use of risky medications, like those with strong anticholinergic effects.9 These steps support both physical safety and financial sustainability.

4. Prioritize Vision and Hearing Appointments

Untreated vision and hearing problems can increase the risk of falls, social isolation, and even depression, yet many older adults skip exams because they believe they don’t need them.10 Guidelines recommend annual vision screenings and hearing tests every 1 to 3 years for adults 65 and older. These services can catch conditions early and ensure older adults are using the right corrective lenses or hearing aids.

Access and perception remain major barriers. While many Medicare Advantage plans offer vision and hearing coverage, traditional Medicare does not. For example, about 84% of Medicare Advantage beneficiaries in the study reported having at least some vision coverage, compared with just 54% under traditional Medicare; more than half had hearing coverage under Medicare Advantage compared with about a quarter under Medicare. Regardless of coverage, many older adults still reported not seeking care in the past 2 years simply because they thought it wasn’t necessary, highlighting the need for improved patient awareness and adherence to guidelines and insurance plans that allow patients to access the care they need.

5. Use Telehealth or Plan for Reliable Transportation

Transportation challenges are a major barrier to health care access. When older adults can’t get to appointments, they may miss key treatments or early interventions that support independent living. Telehealth can help bridge that gap by offering virtual visits, remote monitoring, and mental health services that can be accessed from home.

However, digital health tools only work when patients know how to use them.11 A study of health technology navigators in the Los Angeles safety-net system found older adults were willing to use digital health tools when provided with hands-on guidance. Researchers also found that health systems that invest in culturally competent technology navigators, especially for older adults with language barriers, can help seniors feel more confident using patient portals and attending video visits. In cases where telehealth isn’t feasible, coordinating transportation to health care facilities remains a vital strategy for preventing health declines that lead to loss of independence.

References

1. Older adult falls data. CDC. Updated October 28, 2024. Accessed July 2, 2025. https://www.cdc.gov/falls/data-research/index.html
2. Vaishya R, Vaish A. Falls in older adults are serious. Indian J Orthop. 2020;54(1):69-74. doi:10.1007/s43465-019-00037-x
3. Health tips for older adults. National Institute of Diabetes and Digestive and Kidney Diseases. Updated October 2019. Accessed July 2, 2025. https://www.niddk.nih.gov/health-information/weight-management/healthy-eating-physical-activity-for-life/health-tips-for-older-adults
4. Valenzuela PL, Saco-Ledo G, Morales JS, et al. Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. Lancet Healthy Longev. 2023;4(6):e247-e256. doi:10.1016/S2666-7568(23)00057-0
5. Hetherington-Rauth M, Magalhães JP, Júdice PB, et al. Physical activity moderates the effect of sedentary time on an older adult's physical independence. J Am Geriatr Soc. 2021;69(7):1964-1970. doi:10.1111/jgs.17141
6. Mayo Clinic Staff. Fall prevention: simple tips to prevent falls. Mayo Clinic. June 14, 2024. Accessed July 2, 2025. https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358
7. Falls and fractures in older adults: causes and prevention. National Institute on Aging. Updated September 12, 2022. Accessed July 2, 2025. https://www.nia.nih.gov/health/falls-and-falls-prevention/falls-and-fractures-older-adults-causes-and-prevention
8. The dangers of polypharmacy and the case for deprescribing in older adults. National Institute on Aging. August 24, 2021. Accessed July 2, 2025. https://www.nia.nih.gov/news/dangers-polypharmacy-and-case-deprescribing-older-adults
9. Massaro L. Medication management led to improvements in older adults with CKD, study shows. AJMC®. July 2, 2021. Accessed July 2, 2025. https://www.ajmc.com/view/medication-management-led-to-improvements-in-older-adults-with-ckd-study-shows
10. Sutton JP, Lee J. Vision and hearing care are essential to seniors’ health, but many believe they don’t need it. The Commonwealth Fund. May 16, 2025. Accessed July 2, 2025. https://www.commonwealthfund.org/blog/2025/vision-and-hearing-care-are-essential-seniors-health-many-believe-they-dont-need-it
11. Wang K, Hernandez AM, Penate V, Abhat A, Casillas A. Digital health implementation among older adults: health technology navigators' perspectives. Am J Manag Care. 2025;31(5):e125-e131. doi:10.37765/ajmc.2025.89736