For Canadians with osteoporosis, a fall isn't just a stumble — it's the event that leads to a hip fracture. Roughly 95% of hip fractures are caused by falls, and among elderly Canadians, the one-year mortality after a hip fracture is 20–30%. This guide covers what to change at home, what to buy, and what programs can help pay for it.
Osteoporosis weakens bone structure silently — most people don't know they have it until something breaks. The fracture risk from any given fall is dramatically higher with low bone density, which is why fall prevention matters so much more once you've been diagnosed.
A hip fracture in an older Canadian isn't just painful. It typically requires surgery, weeks of hospital care, and months of rehabilitation. One in four patients never return to independent living. The mortality numbers are sobering: comparable to many common cancers in the 12 months following the fracture.
The good news is that home falls are largely preventable. Most happen in predictable locations during predictable activities — getting up at night, stepping in or out of the shower, descending stairs. Systematic home modifications, footwear changes, medication review, and balance training together produce a measurable reduction in fall rates.
The bathroom is the highest-risk room in the house for falls. Wet floors, awkward postures when getting in and out of the tub or off the toilet, and poor lighting at night combine to create serious hazards.
Nighttime and early morning are high-fall periods because blood pressure regulation and balance are both slower when you first wake up. The transition from lying to sitting to standing is a fall event waiting to happen if the environment isn't set up right.
Stair falls cause some of the most severe fractures. Descending is typically more dangerous than ascending because of the balance required and the consequences of a misstep.
Reaching for items on high shelves is a common cause of backward falls. Wet floors around the sink and dishwasher are another underappreciated hazard.
The living room has two main hazards: floor clutter and furniture that's too low or unstable. Coffee tables, glass-topped furniture, and decorative objects on the floor all create trip risks.
Grab bars are only safe if they're installed correctly. A bar that pulls out of the wall under a 150-pound load is worse than no bar — it creates false confidence and can cause a fall.
The standard requirement is mounting into wall studs. In most Canadian homes, studs are 16 inches apart. If your grab bar location doesn't align with a stud (common in tile bathrooms), a licensed contractor can install blocking behind the wall or use toggle anchors rated for 250+ lbs of dynamic load. The Ontario Ministry of Seniors' Affairs and similar provincial bodies recommend professional installation for weight-bearing grab bars.
Professional installation typically runs $150–300 CAD per bar, including hardware. DIY installation is possible for experienced homeowners who can locate studs and use appropriate anchors, but errors are common in tile walls. The bar itself costs $30–100 CAD at Home Depot or Rona depending on material and finish.
What's on your feet matters as much as what's on your floor. Unsafe indoor footwear is a leading contributor to home falls.
What to wear: hard-soled slippers with a heel strap (the strap prevents the slipper from sliding off mid-step). The sole should have a textured grip surface. Avoid slip-on mules or backless styles entirely — the shuffling gait they induce is a significant fall risk.
Non-slip socks with rubberized tread are acceptable on carpeted surfaces but should not be worn on hardwood, tile, or vinyl flooring. The rubber grips on carpet; on smooth hard surfaces they can still slip, particularly when pivoting.
Going barefoot on hardwood or tile floors is a fall risk, especially in the first few minutes after waking when proprioception (your body's sense of foot position) is still waking up. Keep slippers beside the bed rather than across the room.
Multiple medications increase fall risk, and many Canadians over 65 take several simultaneously. The interaction between drugs — not just individual medications — is often the problem.
The main categories of fall-risk medications:
In Ontario, pharmacists can provide a free MedsCheck review specifically focused on identifying fall-risk medications. This is a structured appointment — typically 30–45 minutes — where your pharmacist reviews your complete medication list and flags interactions or fall-risk drugs. Ask at any Ontario pharmacy. Similar programs exist in other provinces under different names; BC PharmaCare covers a medication management review, and Alberta's drug benefit program supports medication reviews through pharmacists.
Poor vision is a direct fall risk. Depth perception, contrast sensitivity, and peripheral vision all decline with age and with common conditions like cataracts, macular degeneration, and uncorrected refractive error.
In Ontario, adults 65 and over receive annual eye exams at no charge under OHIP. In most other provinces, eye exams cost $80–120 for adults, with some coverage for seniors through provincial health plans (BC covers exams for adults 65+ annually; Alberta does not have universal senior coverage but some extended plans do). If cost is a barrier, ask your optometrist — many participate in the Canadian Association of Optometrists' Eye See…Eye Learn and similar community programs.
Two specific vision issues warrant mention. First, bifocal and progressive lenses change depth perception, particularly on stairs — looking through the bottom of progressive lenses while descending stairs is a documented fall risk. If you use progressives, consider keeping a separate pair of single-vision distance glasses for stair navigation. Second, cataract surgery is consistently shown to dramatically reduce fall risk in studies — the improvement in contrast sensitivity and visual acuity appears to translate directly to fewer falls. If cataracts are affecting your vision and surgery has been recommended, don't delay it out of surgery anxiety.
Balance is a trainable physical skill. It declines with age if not actively maintained, and improves measurably with structured practice. Minimum effective dose from the research literature: three sessions per week, approximately 30 minutes each.
Tai chi has the strongest evidence base for fall prevention in older adults. A Cochrane systematic review found that tai chi programs reduced the rate of falls by approximately 21% compared to control groups. This is a large effect for a non-pharmaceutical intervention. Tai chi is available across Canada through community centres, the YMCA, and dedicated tai chi schools; group classes typically run $10–20/session or monthly memberships. Virtual classes became widely available during the pandemic and remain an option.
For people with vestibular disorders (inner ear problems causing dizziness or balance disruption), physiotherapy from a vestibular-trained physiotherapist is the appropriate treatment — generic balance exercises won't address the underlying vestibular dysfunction. Ask your GP for a physiotherapy referral specifying vestibular rehab.
Simple daily balance exercises that can be done at home: single-leg stance (hold for 10–30 seconds per side, progress to eyes closed), tandem walking (heel-to-toe along a straight line), weight shifting side-to-side while standing at a counter. Ten minutes daily produces meaningful results over 8–12 weeks. See our balance training guide for a full progression.
For individuals at very high fall risk — those with severe osteoporosis, history of previous falls, neurological conditions affecting balance, or living in long-term care — hip protectors offer a last line of defence.
Hip protectors are padded shorts or undergarments with hard or soft shields positioned over the greater trochanter (the outer prominence of the hip). When worn at the time of a fall, they absorb or redirect impact force away from the femoral neck. The evidence for their effectiveness in community-dwelling (non-LTC) adults is mixed but has improved with newer designs and better adherence tracking.
For community-dwelling Canadians, hip protectors cost $80–200 CAD. In Ontario, some OHIP+ eligible residents and long-term care residents may have coverage under the LTC home's program. Ask your occupational therapist or fall prevention coordinator whether your province or care setting covers them — several provincial LTC programs include them in the care plan for residents with documented fall risk.
The upfront cost of home modifications stops many Canadians from making needed changes. There are funding programs available that significantly reduce out-of-pocket costs.
Canada Mortgage and Housing Corporation (CMHC) administers RRAP, which provides forgivable loans for eligible homeowners and renters to modify their homes for accessibility. The program covers grab bars, ramps, wider doorways, and other modifications. Eligibility is income-tested and availability varies by region. Contact CMHC at 1-800-668-2642 or visit cmhc-schl.gc.ca for current program details and application periods.
Ontario residents can claim 25% of eligible home renovation expenses (up to $10,000 in eligible expenses, so up to $2,500 back) through the Seniors' Home Safety Tax Credit. This applies to grab bars, handrails, stair lifts, wheelchair ramps, and similar modifications. The credit is refundable — meaning you receive it even if your tax payable is zero. Claim it on your Ontario provincial return.
BC Seniors' Home Renovation Tax Credit offers a 10% non-refundable credit on up to $10,000 of eligible expenses for residents 65+. New Brunswick and PEI have senior home modification grant programs for low-income residents. Contact your provincial seniors' ministry for current program details — these change periodically.
Many municipalities also offer subsidized handyperson programs specifically for seniors — small home repairs and safety modifications done at low or no cost. Call 211 (available across Canada) to find local programs in your area.
If you're starting from scratch, do these first:
For more on medication treatments for osteoporosis that protect bones once a fall does occur, see the osteoporosis medications overview. For the exercise side of bone protection, see the exercise program guide.