Thousands of Rotorua seniors are falling every year promoting payments of over $21 million to the city in claims to help them recover.
And the impacts can be life-changing, and even fatal, a report found.
Across the region, 79,671 falls-related claims were made to ACC by people 65 years and over in the past five years.
This totalled $102,816,078 of active payments, which could be for claims lodged in any year as some have ongoing costs.
The money can go towards medical treatment, compensation for loss of income, rehabilitation, and support services while the person is recovering.
In Rotorua, there were 14,636 fall-related claims over the past five years and $21,820,574 was paid for active claims over that time to the district.
About one in seven Rotorua residents are 65 years or older, growing by 7300 in the past five years, according to Stats NZ estimates.
Last year, there were 16,917 new claims across the region which added up to more than $27.3 million. Of these 3041 were in Rotorua and ACC paid more than $5.6 million in active costs.
The number of new claims related to falls dropped last year, after increasing year on year since 2016.
On top of that, ACC paid $744,000 for funeral grants related to deaths linked to falls over five years, and there were 152 active claims across the region.
In that same time period, there were at least 31 funeral grants in the city totalling $155,012.
ACC provides a funeral grant of up to $6471.17 towards funeral and memorial costs. It can pay the funeral director and those who had already paid for the funeral can be paid back.
Hip fractures were common in older people and could lead to significant disability and death, according to a report by a 2018 Health Quality and Safety Commission.
About 8 per cent of people who fractured their hip died within a month of their injury and 20 per cent within a year. About 50 per cent of survivors had a mobility-related disability one year later.
A separate report by the commission found that malnourishment and orthostatic hypotension (sudden drop in blood pressure) were significant risk factors for falling.
Lakes District Health Board clinical nurse educator for older persons health Veronica Regis said older people were more likely to fall because of medical conditions like delirium, or heart, neurological, or muscular-skeletal conditions.
It could also be side effects from medications or problems with balance, strength or mobility.
Head injuries and hip fracture were the most common injuries.
Regis said age-related changes such as slowed reactions, poor eyesight or memory and a higher prevalence of clinical conditions added to the risk of falling.
Rotorua Age Concern manager Rory O'Rourke said as people aged, their bone density decreased and a fall became "a lot more serious", and the increased frequency was down to the ageing population.
This meant a fall would "quite often" result in broken bones, with a broken hip a major concern.
Falls equally impacted seniors' mental health, he said, with many people losing confidence in their ability to walk, with some not walking again afterwards.
He said the lack of confidence would lead some to not going out, which was particularly concerning for those living alone.
Age Concern Rotorua offered shopping services and had volunteer visitors go to the homes of those who did not want - or were unable - to leave their homes.
O'Rourke took part in the ACC programme, Live Stronger for Longer, which was held at the QE Health and Wellness Centre.
The 71-year-old said it was preventative and he wanted to improve his balance.
The programme was available at different centres across the country and included a range of activities for varying abilities.
To help seniors stay steady on their feet, ACC was funding the trial of a balance training app, Nymbl.
It combined simple body movements with easy brain games, such as trivia, to challenge both the brain and body.
ACC injury prevention leader Kirsten Malpas said the agency's core purpose was to prevent injuries and help people get back to normal life after an accident.
The amount paid to help anyone recover had no impact on their ability to help anyone else, she said.
Rotorua Lakes Council safe and sustainable journeys manager Niki Carling said the council supported the Rotorua Accessibility Group, which advocates in making the city more accessible.
The shared path network was designed to encourage active modes of transport on shared pathways.
A guide to accessible facilities in the city was also recently produced and included mobility parking and accessible walking paths, she said.
A cycling skills for seniors programme is run by the council, aimed at supporting seniors to ride around Rotorua safely and confidently.
The council records and investigates falls or trips on council sites and fixes as needed.
It granted $60,000 to the Parksyde Community Centre last year to establish a new hub on Tarewa Place, to sit alongside the current facilities serving the elderly.