Choosing the right shoes for elderly parents or grandparents is about more than comfort, it's one of the simplest ways to cut fall risk.
Falls are the second-leading cause of unintentional injury deaths worldwide, and older adults carry the highest risk. Research shows most seniors are still wearing the wrong shoes.
Two features stand out above the rest: fit and fixation.
Ill-fitting shoes are the norm, not the exception
A recent review of footwear research found that ill-fitting shoes are strikingly common among older adults.
One study of 100 older adults found 83% wore improperly fitted footwear on at least one foot.
A separate comparative study found seniors in ill-fitting shoes were far more likely to have fallen in the past year, and reported lower balance scores on standard assessments.
The reasons are simple: reduced foot sensitivity with age, infrequent foot checks, and shoes that don't account for how foot shape changes over time.
Why fixation matters just as much as size
Fit alone isn't the whole picture. How securely a shoe holds the foot in place, its fixation, plays a major role in balance.
Backless slippers and open-back shoes force the foot to make constant small adjustments to keep the shoe on. Over thousands of steps a day, that adds up.
One large study covering more than 70,000 falls among older adults found that open slippers were a significant predictor of falls serious enough to need hospital transfer.
By contrast, shoes with proper lace or strap fixation were linked to faster, steadier walking and less heel slippage.
What good fit and fixation actually look like
Length and width that match the foot, not just the size printed on the box.
A secure heel counter that stops the heel lifting or sliding inside the shoe.
Fastening, laces, straps or Velcro, rather than a slip-on design, especially for daily outdoor wear.
Enough room in the toe box without excess space elsewhere.
A word about indoor footwear
This matters even more at home in India, where backless slippers and chappals are the everyday default.
If balance or a previous fall is a concern, a well-fixed indoor shoe is worth considering over a slip-on.
The Silwer POV
Fit and fixation don't get as much attention as cushioning or style, but they're the two features most consistently linked to fall risk in the research.
A shoe that stays exactly where you put it is doing more for stability than any amount of padding.
If it's been a while since your last proper shoe fitting, that's usually the best place to start.
