Here’s a tough question: Is it worse to be afraid of falling and thus overly timid, or not to be afraid of falling and thus reckless?

As the Associate Scientific Director of the Canadian Longitudinal Study on Aging, Lauren Griffith of McMaster University is well aware of the danger that falling presents to older Canadians. “You can be doing just fine and then have an acute event like a fall and things can begin to spiral,” Griffith says. “Once you fall, it tends to increase your fear of falling, and then that fear of falling can be associated with decreased mobility and decreased social participation. For some people, it can put them  on a negative trajectory to losing their  independence.”

Maintaining independence is a critical issue for aging Canadians and, for most, the defining characteristic of independence is remaining in one’s own home without needing a permanent caregiver. At the same time there are some dangers. “About half the injuries in people 65 or older happen at home,” says Griffith. “Bathrooms and stairs are particularly hazardous.” And it is precisely in the bathroom and on the stairs that someone suffering a fall is least likely to be within reach of a telephone should they need to call for help.

Falling and injury: A hidden epidemic

A report by the Public Health Agency of Canada found that falls are a very serious public health issue, accounting for more injury-related hospitalizations than any other single cause besides motor vehicle collisions. And these injuries are worse overall as well. Seniors who are hospitalized for a fall remain in hospital an average of nine days longer than those hospitalized for other reasons. In fact, more than 1,000 Canadians die each year, on average, from fall-related injuries.

“About half the injuries in people 65 or older happen at home.”

So, on the one hand, falling is a serious concern, but on the other, the fear of falling can rob you of the autonomy that keeps you youthful and active longer. Caroline Tapp-McDougall, Chair of Canada Cares, believes that having a plan that mitigates the risk of falling can be all it takes to avoid letting a fall spark the sort of spiral Griffith warns against.

Prompt treatment and response can dramatically reduce the seriousness of complications from a fall. “A Lifeline system, for example, where you have a button that raises an alert if you fall,” says Tapp-McDougall, “can allow somebody quite a lot of independence.”

So, perhaps it’s not a question of being recklessly unafraid or being paralyzed by fear. Instead, it becomes a matter of accurately assessing falling risk and having a prepared course of action for how to get up after a fall, and how to contact someone if you can’t.