Pets and Fall Risk: Keep the Dog and Your Balance

The number nobody mentions at the vet

One in four adults 65 and older falls each year, and falls are the leading cause of injury and injury death in that age group.² Pets are a slice of that most people never hear about. The CDC’s injury surveillance estimated an average of 86,629 fall injuries a year treated in U.S. emergency rooms were associated with dogs and cats, and the highest rates were in people 75 and older.¹ Nearly a third of those injuries were fractures.¹

Dogs caused 88 percent of them.¹ Among dog-related falls, 31 percent came from tripping or falling over the dog, 21 percent from being pushed or pulled by it, and 26 percent happened while walking it.¹ Cats are mostly a floor problem: two-thirds of cat-related falls were trips over the animal, and 86 percent happened at home.¹

None of this is an argument against the pet. Over half of adults 50 to 80 have one, and among those who live alone, 82 percent say the pet gives them a sense of purpose.³ That is worth protecting. The argument is for changing a handful of habits so the dog and the hip both make it to next year.

Three ways pets cause falls, and the fix for each

Tripping over the animal at home

This is the cat problem and the small-dog problem. The animal is quiet, low, the same color as the floor, and lying exactly where you are about to step, usually in the kitchen or in the dark hallway on the way to the bathroom.

Give the pet a place that is not your path. Move food and water bowls, beds, and toys out of walkways and into a corner you never cross. Make a house rule to never step over a pet; say its name and make it move, every time, even when it is a nuisance. Put a bell on a cat’s collar and a small light or reflective tag on a dog’s so you can hear or see where the animal is at night.

Light the night route. Many of these falls happen between bed and bathroom, with the pet following. Our lighting guide covers motion night lights, and smart lights that come on when you sit up are the easy version.

Being pushed, pulled, or bolted past

A dog that charges the front door when the bell rings, leans into your legs on the stairs, or lunges at a squirrel on the leash is applying force to a person who may not have the balance to absorb it. This is where the “place” cue earns its keep.

Use it while you cook, when the doorbell rings, and when you are carrying anything with both hands. Be consistent with the release word so the dog learns that mat time ends when you say, not when it decides.⁵

Falling on the walk

A quarter of dog-related falls happen while walking the dog.¹ Two things fix most of them: the leash and the pulling.

Retire the retractable leash. The maker of the best-known one says so itself. Its own instructions warn that a dog running out on the long cord can build speed and pull harder than you expect, “possibly pulling you to the ground,” that a cord caught around a finger under a hard pull “can amputate fingers or break bones,” and that you should not use the leash “with a disobedient or uncontrollable dog.”⁶ A fixed 4- to 6-foot leash, held in a closed hand and never wrapped around the wrist or fingers, removes every one of those failure modes.

Stop the pulling. The AKC’s technique is simple enough to do on tomorrow’s walk: “As soon as your dog pulls, stop, plant your feet,” and wait until the leash goes slack and hangs in a J-shape. Then “praise and reward your dog with a treat at your side, then continue the walk.”⁴ The dog learns that pulling stops the walk and slack starts it. For a person with balance concerns, this stop-and-wait method is safer than the quick-reversal trick some trainers use, because it never asks you to turn fast. When other people or dogs approach, shorten up and keep the dog at your side.⁶

Matching the dog to the person

Most pet falls are a mismatch, not a bad dog. A strong, young large breed that pulls is a different animal from a calm adult that already walks politely, and a tiny dog that lives underfoot is its own hazard. If balance is already a concern, or you are choosing a dog for a parent, ask a shelter or rescue for an adult, medium-sized dog with known leash manners and a low need for hard exercise. Puppies pull, jump, and dart for the first two years.

Plan the hard days before they come. Who walks the dog on ice? Who walks it the week after a knee replacement? If the answers are “nobody,” the dog needs a backup walker, a fenced yard, or a different home, and it is kinder to decide that now. Our winter prep guide covers the ice part.

The rest of the house

A pet lives in the same house as every other fall risk, and the general fixes help here too. Low-pile flooring without throw rugs gives you and the dog sure footing. A clear path from bed to bathroom, with the pet’s bed somewhere else, is the single highest-value change. The full room-by-room list is in our home safety assessment checklist. If a fall does happen with the dog in the way, how to get up after a fall is worth having read before you need it.

If you are hospitalized: the plan for the pet

A pet-related fall often ends with the owner in the hospital and the pet alone in the house, so the pet plan is part of the fall plan. The ASPCA’s checklist:⁷

• Carry a pet alert card in your wallet. It “will alert authorities that you have a pet at home” and lists two emergency contacts.⁷
• Post an emergency contact sheet inside the house, clearly visible, so anyone who enters knows which animals are there and who to call.⁷
• Name a temporary caregiver, such as a neighbor with a key who can feed and walk the pet for a few days. The ASPCA notes this “does not have to be the person who would take your animals permanently.”⁷
• Keep a pet portfolio with vet records, and give copies “to all parties in your pet’s circle of care.”⁷
• Consider a pet trust for an animal with medical needs. A will alone is weak here, since “there is no continuing obligation for the executor under a will” once the estate is settled.⁷

Budget belongs in the plan too. Among older adults living alone, 26 percent say pet care strains their budget and 22 percent say the pet’s needs take priority over their own.³ If a parent is skipping their own medication to pay for the dog’s, that is one of the signs it is time for more help, and local aging agencies and some humane societies run pet-food and vet-care assistance programs worth asking about.

Key takeaways

• Pets cause about 86,600 ER fall injuries a year, highest after 75; dogs are 88 percent of them.
• Three causes, three fixes: move the pet out of your path and never step over it; teach “place” for doors and kitchen; retire the retractable leash and stop-and-plant when the dog pulls.
• Match the dog to the person: a calm adult with leash manners, and a plan for icy days and a walker.
• Write the hospital plan: wallet alert card, posted contact sheet, a temporary and a permanent caregiver, and a pet portfolio.

What’s next

• Light the bed-to-bathroom route: lighting for aging eyes.
• Walk the whole house for trip hazards with the home safety assessment checklist.
• If you use a walker, read cane, walker, or rollator before the next dog walk.
• Know the technique: how to get up after a fall.

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Reviewed by John Smith, CAPS, Certified Aging-in-Place Specialist. This guide is general safety information, not medical or veterinary advice. If a pet has already caused a fall or a near-fall, an occupational therapist can watch the daily routine with the animal in the house and tailor the changes; a certified trainer can fix leash pulling in a few sessions.