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Fall prevention footwear

Key points

  • The right footwear is a simple, effective way to reduce fall risk—choose shoes with non-skid soles, a closed back, and a snug fit.
  • Avoid slippers, backless shoes, high heels, and shoes with smooth soles—they increase the risk of slipping and tripping.
  • Have your loved one wear shoes even inside the house, especially on tile, wood, or linoleum floors.
  • Introduce new shoes gradually and with positive framing to reduce resistance—use phrases like 'these are so comfortable' rather than 'these are safer.'
  • Check shoes regularly for wear and tear—replace them when the tread is smooth or the shoe is misshapen.
  • Keep walking paths clear of clutter and area rugs, and use contrasting colors to help with depth perception.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start by assessing your loved one's current footwear. Look at every pair they wear regularly—slippers, sneakers, loafers, house shoes. Check the soles: are they smooth, shiny, or worn down? If you can slide your hand across the sole easily, it's too slippery. Also check the fit: shoes should be snug at the heel (no slipping) and have about a thumb's width of space at the toes. If the shoe is too loose, the foot can slide forward and cause a trip.

  2. Choose shoes with non-skid soles. Look for rubber or textured soles that grip the floor. You can test this by placing the shoe on a smooth surface and trying to push it—if it slides easily, it's not safe. Many brands now make 'non-slip' or 'slip-resistant' shoes specifically for seniors. For indoor use, consider shoes like Skechers with a rubber sole, or brands like New Balance or Propet that offer wide widths and good traction.

  3. Ensure the shoe has a closed back (a heel counter) and a secure closure. Avoid backless shoes like mules, clogs, or slides, because the foot can slip out. Also avoid shoes that are purely slip-on without laces or Velcro, as they may be too loose. Instead, look for shoes with Velcro straps, elastic laces, or a simple buckle that can be adjusted for a snug fit. This is especially important if your loved one has swelling in their feet, which can change throughout the day.

  4. Have your loved one wear shoes even inside the house. This is a critical shift from the common habit of walking in socks or slippers. Bare feet or socks on tile or wood floors provide no traction and greatly increase fall risk. If they resist, try a pair of lightweight, comfortable indoor shoes that feel like slippers but have a non-skid sole. You can also use non-slip socks with rubber grips on the bottom as a transitional step, but shoes are still preferred for full support.

  5. Introduce new shoes gradually and with positive framing. Don't just throw away their old slippers. Instead, say something like, 'I found these new shoes that are so comfortable and they'll help you walk more safely. Let's try them on for just a few minutes.' Let them wear the new shoes for short periods while sitting, then for walking short distances. Praise them for trying. If they refuse, don't force it—try again later with a different approach, like letting them choose between two safe options.

  6. Check the shoes regularly for wear and tear. Even good shoes lose their tread over time. Inspect the soles every few months. If the tread is smooth or the shoe is misshapen, replace them. Also check the inside for any rough seams or worn padding that could cause discomfort or blisters, which can lead to reluctance to wear them.

  7. If your loved one uses a walker or cane, make sure their shoes are compatible. Shoes with a thick, chunky sole can make it harder to feel the ground, which is important when using a mobility aid. A thinner, more flexible sole with good grip is often better. Also, avoid shoes with a very high heel (even a small one) because it changes the angle of the ankle and can affect balance.

  8. Consider using non-skid adhesive strips or grip pads on the soles of existing shoes if you cannot replace them immediately. These are available at most drugstores or online. Apply them to the bottom of the shoe, focusing on the heel and ball of the foot. This is a temporary fix, not a permanent solution, but it can help in a pinch. Be aware that these strips can wear off quickly, so check them often.

  9. Keep the walking paths clear of clutter and area rugs, even with good shoes. No shoe can prevent a fall if the person trips over a rug or an electrical cord. Remove all throw rugs, secure cords along walls, and create wide, clear pathways. Use contrasting colors on the floor (like a dark rug on a light floor) to help with depth perception, which is often impaired in dementia.

  10. Talk to your loved one's doctor or a physical therapist about a fall risk assessment. They can evaluate gait, balance, and foot health, and recommend specific types of shoes or orthotics. For example, if your loved one has diabetes and loses feeling in their feet, they may need extra cushioning and a wider toe box. A podiatrist can also check for foot problems like bunions or calluses that make wearing safe shoes uncomfortable.

What not to do

  • Don't let them walk in socks or bare feet on hard floors. Socks provide no traction and can cause a slip. Bare feet can also be cold and uncomfortable, leading to poor circulation. Instead, always have them wear shoes or non-slip socks with rubber grips. If they resist, try a pair of soft, non-skid slippers that have a back and a sole.

  • Don't buy shoes that are too big or too small. Shoes that are too big can cause the foot to slide and lead to a fall. Shoes that are too small can cause pain and blisters, making your loved one not want to wear them. Always measure both feet (they can be different sizes) and try shoes on later in the day when feet are slightly swollen. Use the 'thumb test': there should be about a thumb's width of space between the longest toe and the end of the shoe.

  • Don't assume that expensive shoes are automatically safe. Price does not equal safety. Some very affordable shoes have excellent non-skid soles and good support. Conversely, some expensive dress shoes have smooth leather soles that are dangerous. Focus on the features: a rubber sole, a closed back, a secure closure, and a snug fit. Read reviews or ask a physical therapist for recommendations.

  • Don't force a change abruptly if your loved one is attached to their old slippers. This can cause agitation and resistance. Instead, use a gradual approach. Let them keep the old slippers but also introduce the new ones. You might say, 'These new ones are for when you go to the kitchen, and the old ones are for sitting in your chair.' Over time, they may naturally prefer the new ones. If not, try a different style or color that they might like.

  • Don't forget to check the shoes for wear and tear regularly. A shoe that was safe six months ago may now have worn-down soles or stretched-out uppers. Make it a habit to inspect them every month. If you see any signs of wear, replace them. It's better to buy a new pair than to risk a fall.

  • Don't use shoes with high heels or platform soles. Even a small heel (like on some loafers) can shift weight forward and increase fall risk. Stick to flat, low-profile shoes with a heel height of less than one inch. Also avoid shoes with a very thick sole (like some athletic shoes) because they can reduce the ability to feel the ground and increase the risk of ankle rolls.

Practical tools

  • The Non-Slip Shoe Checklist

    Print or write this short checklist and use it when shopping or evaluating current shoes: (1) Does the sole have visible tread or rubber grips? (2) Is the back of the shoe closed and snug? (3) Does the shoe have a secure closure (laces, Velcro, or buckle)? (4) Is there about a thumb's width of space at the toes? (5) Is the heel height less than one inch? (6) Is the shoe lightweight and comfortable? If you answer 'no' to any of these, the shoe may not be safe.

  • Exact Phrases to Introduce New Shoes

    Use these gentle, positive phrases to reduce resistance: 'I found these new shoes that are so soft and they have a special grip to help you walk steady.' 'Let's try them on for just a minute while you sit—they feel like clouds.' 'You can wear them just in the house, and they'll keep your feet warm.' 'I got a pair for myself too—we can match!' Avoid saying 'these are safer' or 'your old ones are dangerous,' which can cause defensiveness.

  • Non-Slip Socks with Grips

    If your loved one absolutely refuses to wear shoes, non-slip socks with rubber grips on the bottom are a better alternative than bare feet or regular socks. Look for brands like 'GripSox' or 'SteadySocks' that have a full rubber pattern on the sole. They are available at most drugstores or online. However, they do not provide ankle support, so use them only as a last resort and keep the floors clear of clutter.

  • Grip Pads or Non-Skid Tape for Shoes

    For a temporary fix, you can buy adhesive grip pads (like 'Dr. Scholl's Grip Pads') or non-skid tape (like 'Sure Step Anti-Slip Tape') and apply them to the soles of existing shoes. Clean the sole first, then press the pad firmly. This can add traction to smooth soles. Check them weekly and replace when worn. This is not a permanent solution but can buy time until you find better shoes.

  • Shoe Horn and Elastic Laces

    If your loved one has trouble putting on shoes due to stiffness or bending, use a long-handled shoe horn to help them slide their foot in without bending. Replace regular laces with elastic 'no-tie' laces (like 'Lock Laces') that allow the shoe to be slipped on and off while still providing a snug fit. This reduces frustration and makes it easier to wear safe shoes consistently.

Discuss with your clinician

Ask your loved one's doctor or physical therapist: 'Can you assess my loved one's gait and balance to recommend the best type of shoe for their specific condition?'

If your loved one has diabetes or peripheral neuropathy, ask: 'Do they need special diabetic shoes or custom orthotics to protect their feet and reduce fall risk?'

If your loved one has had a recent fall, ask: 'Should we have a full fall risk assessment, including a review of their medications and vision?'

If your loved one has foot pain or deformities (like bunions or hammertoes), ask: 'Can a podiatrist evaluate their feet and recommend appropriate footwear or inserts?'

If your loved one is on blood thinners (like warfarin or apixaban), ask: 'What should we do if they fall, given the increased risk of bleeding?'

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