I am the OP. Thanks for everyone's comments. My Dad had a doctor's appointment today and found out his blood pressure is too low, and he is getting light headed when he stands up which is probably contributing to falling. Somehow they did not notice this the other day when he was at the ER with the bump on his head, and my Dad did not say anything to us about feeling this way until today's doctor appointment. Hopefully, his medication can be adjusted now to help with this problem. Between my Dad not telling us things and health care people not telling us things and not communicating with each other it's getting to be a lot to coordinate. I really don't know how elderly people navigate all of this.

He might not have had low BP in the ER.

Pain and fear make the BP go up. Its how I could notice a patient who maybe just had surgery, but was still sleeping, or in the very groggy phase was probably starting to hurt. Their BP would go up.

He easy could have had normal, maybe even slightly elevated BP due to being nervous cause who isn't nervous in the ER as a patient, and I'm sure he was sore after the fall.

My experiences with my dad were very similar to a lot of issues already mentioned.

In terms of structural stability, his feet were physically damaged and couldn't provide the sort of balance help they once did. (Fallen arches, foot changes from long term muscle, bone and nerve related issues, nerve damage that affected the way his bones healed, arthritis, broken bones he couldn't feel, wounds that would develop on his feet that needed casts and bandages and non-weight bearing, etc.) The older he got, the harder it was for him to manage.

His own fear of falling played a huge role in his general decline. He fell repeatedly over the years, at one point breaking a leg and winding up alone on the floor for hours one night til he turned over a table and the crash woke me up. After that he was pretty much wheelchair dependent. He'd participate in rehab immediately after the latest injury, mostly so he could go home, then once there, he'd just slide back to his just-enough-to-get-by habits. Naturally this lead to a general decline.

Over and over, he'd be astonished to find that he wasn't physically able to just get up and do things. It was a huge struggle, and wildly stressful for both of us.

Toward the end of his life, I do think his growing dementia played a role in his inability to calculate the level of risk he might be in, his inability to recover once he lost his balance, etc.

His sense of bodily proprioception got worse and worse both because of his nerve damage and his general physical decline. He lost muscle memory because he'd quit being active.

Sorry to ramble, but it was a long, slow process, made more difficult by the limitations of his insurance and his own unwillingness to be proactive.

I feel it is my duty to tell you it might be the shoes. I fell on the sidewalk when I just took one step back, 7 months ago and hurt my back, and am still not healed. I was wearing new runners I bought online that did not fit well. They were Reeboks and nothing like they used to be - very poorly made. Since I have found better shoes, both New Balance and Saucony, I feel so grounded and solid when I walk. Check his shoes and see if they fit well or are maybe too tight or too loose, or have a slippery sole. Just an idea because of what happened to me. You can step as carefully as possible, take one normal step, and if the shoes are not decent, they can make you lose your balance. Never had this problem in my life before - never ordering shoes online again.

I'm 60 right now, not really old, but what I've noticed is that the fluid in my ears controlling balance, the semicircular ducts, has slowed a lot. I notice problems getting out of bed and bending over to pick up things. I have to do it lots slower than I used to to not lose my balance.

I think the comments about the feet are very interesting. Miranda and other Essentrics instructors often talk about the importance of how much of your general physical well being starts with your feet. She has many exercises you can do to keep your feet thus your balance healthy.

I fell twice really hard while walking off a sidewalk curb and couldn't understand why. A friend said, you have trifocals! Trifocals mess up your depth perception when you look down!

After that i was more careful and have had no problems.

I usually wear bifocals and going down steps is tough. I have to really pay attention.

Anna, i remember how you described how lovingly you cared for your dad, and i appreciated your description of how various factors led to his decline. it's a good lesson for me to read this.

my mom was caregiver to several elderly people, including caring for my dad while also being a senior herself!

my grandpa was living with my mom before he passed. he loved working in the yard and it was his form of exercise. he did it until age 90 when he passed away. he wore rubber slippers and i think this kept his feet muscles agile.

one day the neighbor found him laying down on the grass - he fell, couldn't get up but wasn't injured! he has a soft voice, so i don't think anyone could hear him. when my mom got home, she was shocked to hear what had happened - by then he was up and about.

that day, my brother installed railings all over the yard using metal pipes from Home Depot. my mom left chairs in various parts of the yard so that he could take breaks. he owned a quad cane but didn't need it when working out in the yard.

Have you had your ears checked by an ENT? Ear problems can be caused by allergies and sinus problems.