Falls are common among older adults, causing discomfort, disability, and stress for both patients and caregivers. This article discusses the consequences and causes of falls in community-living older adults, summarizes evidence on risk factors and effective interventions, and explores how to apply this evidence in clinical practice. Key risk factors for falling include previous falls, strength, gait, and balance impairments, and the use of certain medications. Effective single interventions include exercise, physical therapy, cataract surgery, and medication reduction. Evidence suggests that addressing multiple risk factors is the most effective strategy for reducing falls in older adults. Vitamin D has strong evidence for preventing fractures in older men. Challenges exist in incorporating these interventions into outpatient practice, requiring trade-offs between health conditions and patient independence. The case of Mr. Y, an 89-year-old retired salesman, illustrates the complexities of fall prevention. He had multiple falls and a hip fracture, and his medical history included several chronic conditions. His medications contributed to his fall risk, and he experienced dizziness and confusion from oxycodone. After a series of interventions, including physical therapy, medication adjustments, and home safety modifications, Mr. Y's fall risk was reduced. However, he continued to fall due to side effects of cold medications and nitroglycerin. His fall in July 2008 worsened his hip pain, leading to surgery and further rehabilitation. Despite his denial of the significance of his falls, he agreed to a personal emergency response system for his daughter's peace of mind. The article emphasizes the need for a coordinated approach to fall prevention, involving physicians, nurses, physical therapists, and occupational therapists. It highlights the importance of assessing and managing risk factors such as medication use, balance, gait, and strength. The evidence supports the effectiveness of multifactorial interventions, including medication reduction, physical therapy, and home safety modifications. However, there are trade-offs between managing multiple health conditions and ensuring patient independence. The article also discusses the challenges of incorporating fall prevention into clinical practice, including time constraints, competing demands, and inadequate reimbursement. Overall, the article concludes that evidence-based fall risk assessment and management is feasible and effective, with multiple health benefits.Falls are common among older adults, causing discomfort, disability, and stress for both patients and caregivers. This article discusses the consequences and causes of falls in community-living older adults, summarizes evidence on risk factors and effective interventions, and explores how to apply this evidence in clinical practice. Key risk factors for falling include previous falls, strength, gait, and balance impairments, and the use of certain medications. Effective single interventions include exercise, physical therapy, cataract surgery, and medication reduction. Evidence suggests that addressing multiple risk factors is the most effective strategy for reducing falls in older adults. Vitamin D has strong evidence for preventing fractures in older men. Challenges exist in incorporating these interventions into outpatient practice, requiring trade-offs between health conditions and patient independence. The case of Mr. Y, an 89-year-old retired salesman, illustrates the complexities of fall prevention. He had multiple falls and a hip fracture, and his medical history included several chronic conditions. His medications contributed to his fall risk, and he experienced dizziness and confusion from oxycodone. After a series of interventions, including physical therapy, medication adjustments, and home safety modifications, Mr. Y's fall risk was reduced. However, he continued to fall due to side effects of cold medications and nitroglycerin. His fall in July 2008 worsened his hip pain, leading to surgery and further rehabilitation. Despite his denial of the significance of his falls, he agreed to a personal emergency response system for his daughter's peace of mind. The article emphasizes the need for a coordinated approach to fall prevention, involving physicians, nurses, physical therapists, and occupational therapists. It highlights the importance of assessing and managing risk factors such as medication use, balance, gait, and strength. The evidence supports the effectiveness of multifactorial interventions, including medication reduction, physical therapy, and home safety modifications. However, there are trade-offs between managing multiple health conditions and ensuring patient independence. The article also discusses the challenges of incorporating fall prevention into clinical practice, including time constraints, competing demands, and inadequate reimbursement. Overall, the article concludes that evidence-based fall risk assessment and management is feasible and effective, with multiple health benefits.