Preventing Falls | Care for the Elderly in Our Lives

As we age, our bodies just aren't as resilient as they once were! I'm in my mid-forties, a time of life most of us consider "middle aged." Yet I'm familiar with how dangerous our homes can be. My grandfather died from falling while he took a shower, and I have fallen twice at home - once injuring my ankle badly enough to send me to the hospital.

As a real estate agent, I've noticed many homes that have conditions that could lead to injuries at any age, but it's especially important to take care of these things if we're providing care for elderly patients. Their lives might depend on it!

Keep reading to learn how to reduce the risk of falling at home with simple preventative measures as well as exercises that will improve balance and gait.

It has long been believed that human beings are born with just two innate fears: loud noises, and falling. (At least one study theorizes that this may not be entirely accurate, however!) It would be safe to say that as we grow, some of us even like the thrill of taking a sharp plunge. Where would amusement parks be without some death-defying terror built into them?

But as we reach middle-age and beyond, falls are more likely to lead to real problems. Take a look at this information from the Centers for Disease Control:

• Around a third of all people of retirement age have fallen within the last year, but half of them never talk to their doctors about it.
• Falling is the leading cause of injuries (both non-fatal and fatal).
• In 2010, more than 27,000 people died as a direct result of taking a fall.

Injuries from a fall can be minor - cuts or scrapes, but can turn deadly, too. Traumatic Brain Injury (TBI) can cause death. In fact, according to the CDC, TBI was present in 46% of all fatal falls among the elderly. Even when it doesn't cut a patient's life short, TBI can harm their ability to concentrate, remember things, or process information. It can also cause physical symptoms like headaches, and many other symptoms that decrease quality of life.

Between the two extremes we find fractures. Hip fractures, wrist and forearm fractures, and leg fractures aren't uncommon when taking a fall, and the healing process is usually pretty straightforward. When a bone punctures the skin (allowing bacteria to enter the body) or when the faller has a chronic disease, the risk of infection increases. This can complicate healing. In some cases, elderly patients may find themselves placed in nursing homes for weeks or months simply to recover from a fracture.

Two things are involved in every accident:

1. The person
2. The environment

At Dr. Mary Tinetti's website, FallPrevention.org, visitors will find tips to help them evaluate an individual's risk:

• Can he or she stand on one leg for more than five seconds without losing balance?
• Does he lower himself into a chair without "plopping" into it?
• Can she rise from a chair steadily and without struggling?
• Does he walk heel-to-toe, taking a normal stride length to do it?
• Does she walk a straight path and turn steadily?

A single "no" response to these questions indicates a risk factor. The more risk factors an individual has, the more important it will be to address them promptly - before an accident takes place!

Although it isn't always possible to control the environment, especially when out and about in public, it is advisable to pay close attention and address risk factors at home, too. Clutter, narrow walkways, stairs, and more can contribute to unsafe conditions. More than half of all falls take place at home!

Let's take a look at how to reduce risk to the person through exercise and medical care, and then to consider how to make our home "grown-up proof!"

The videos below offer techniques for improving strength and balance. These are just a few of many exercise activities that can help with preventing falls, but please consult a doctor before attempting to use these exercises yourself or with another person!

Illnesses

Heart ailments, inner ear infections, osteoporosis, arthritis, neurological conditions, and a variety of other health concerns, including some cancers, can affect an individual's ability to keep (or recover) their balance. Good treatment and exercises that improve muscle tone, strengthen the supporting tissues, and help a person maintain their equilibrium can all help reduce the risk of falling - even if the health condition itself isn't fully curable. The videos shown here include balance exercises and core strength exercises that are designed to be safer for seniors, but as always, consult a physician before undertaking any exercise program.

Medications

So many health concerns arise as we age, and often they are treated with medications. Side effects of medications can cause changes in bone density, vision, and balance, just to name a few. Interactions between drugs can cause or worsen side effects. It's important to keep an accurate, detailed list of medications and to discuss them with every doctor treating a patient. If possible, the list should be readily available in case of a fall: in the person's wallet or purse, for instance, with a second copy stored safely at home.

Vision & Hearing

Our ability to see well helps us avoid tripping, while good hearing can ensure we aren't startled. Annual vision and auditory checkups, along with appropriate tools like glasses or hearing aids, can improve an elderly person's safety.

Lifestyle

It's often advised that drinking a daily serving of wine can actually improve heart health, but as they say, too much of a good thing can be bad, indeed! Excessive use of alcohol or medications that impair perceptions pose an immediate risk. Intoxication of any type can impair reflexes.

Diet, too, can affect our ability to withstand a fall. By eating healthy and maintaining a proportional weight will ensure that we have the strength and energy to stay active longer. By staying independent and mobile, we can also stave off depressive episodes. (Up to 5% of all elderly people experience depressions, but among those who experience a loss of independence or who are moved into nursing home care, the rates are as high as 52%, according to the CDC!)

Vitamins

A good multi-vitamin's always a smart plan at any age, but seniors will benefit particularly from calcium and vitamin D supplements.

Next, let's look at the environment.

Exterior

Sidewalks and driveways should be maintained in good repair. Cracks can appear suddenly and change imperceptibly, creating a tripping hazard like the one shown in this photo. This concrete patio had a minor crack that fractured after an extended freeze-thaw cycle this winter. If it had been repaired while the crack was smaller, the repair cost would have been no more than a few hours and maybe a hundred bucks if we needed several kits, but now it will cost much more and poses a risk to the healthiest of us.

Shrubs and trees can snag on clothing and cause a startle response or misstep. Keeping them trimmed is a good idea.

Stairs

Even two or three steps leading from the front yard to the doorstep can become difficult to navigate as the years pass, yet some seniors find themselves living in homes with stairs between living and bedroom areas! If they are too hard to climb, a resident might avoid them, causing a chain reaction: Less activity > Loss of strength > Lower mobility.

It may be possible to build a gently sloping ramp to make access to the outdoors easier. Inside, however, may prove to be a challenge. A chair lift can make stairs easier to navigate, and under certain conditions, U.S. military veterans may be eligible for a grant to purchase and install one. (See HISA and Adapted Housing Grant links from the Veterans Administration.) These lifts are available in outdoor models, too.

Handrails should be installed and used whenever climbing or descending stairs. Reflective tape and non-skid treads can help make the edges of stairs safer and easier to see, too.

If stairs are carpeted, check to ensure that the carpet is securely affixed to each and every stair! Remember when I mentioned a fall that landed me in the hospital? I thought my left foot was secure enough - my toes may have been off the edge, but the rest of my foot was flat - that is, until I shifted my weight to step my right foot onto a stair below. The carpet slid forward and carried me with it. It sent me tumbling to the bottom of the staircase! For wood stairs, small nails at the base of each tread and the base of the step can ensure this kind of accident doesn't happen.

Spills and other wetness, such as entryways where people have entered from the snowy or rainy outdoors, can be dangerous and take just a moment to wipe up if you store a nearby towel for the purpose.

Floors

You may have noticed that I said to tack down carpet with nails rather than to simply put non-skid pads. Although non-skid stair treads and throw rugs look attractive, they pose a double risk. "Non-skid" does not mean immovable! They can cause a tripping hazard, and may slide, too. Their ability to stay put is only as good as the manufacturer makes it. I used some on wooden stairs and found them troublesome.

For this same reason, all small or lightweight rugs should be removed. (The good news is that removing this rugs usually will give a room a larger appearance!) Big area rugs tend to be heavier and can be tacked with double-sided tape, but should still be evaluated as a tripping risk. If they can catch a foot easily, it's best to remove them, too!

Some flooring materials can be slippery, either while wet or while dry. There are two possible fixes for this. One is to tape blue painter's tape to the soles of each pair of shoes. This means shoes would need to be worn all the time, and checked often to make sure the tape hasn't worn off beneath the shoe. The alternate method is to use a non-skid wax product like the one shown here.

Lighting

Replace light bulbs as needed. Consider whether a slightly higher wattage can provide better lighting, but don't get bulbs that are too high-wattage because this can pose a risk of fire. Especially replace any bulbs that flicker!

Keep flashlights handy in areas that may get darker at certain times of day (or if a circuit breaker goes off!) Utility rooms, back patios, garages, and basements are areas that I often need to pull out a flashlight when I'm showing houses.

Ensure that rooms with inadequate overhead lighting have added lamps that are easy to turn on. These rooms, as well as the sleeping area and bathroom, will be safer if nightlights are used.

Furniture

Whenever possible, using arms with armrests and non-slip footing is a good idea. Higher seats and a straight back are often recommended by doctors to encourage back support and ease of rising. Some recliners now have seats that lift a person, but I haven't heard anything about whether the medical community thinks they are helpful or not.

Remember being in oh, maybe first or second grade and thinking that soap on a rope might just be THE perfect dad's day gift? Well, as it turns out, there really *is* a great reason to buy soap on a rope - it's less likely to drop into the tub! If you don't have such a wonderful gift handy, liquid soap can serve the same purpose.

Setting the water heater's maximum temperature to 120 degrees or less will hep prevent burns and the falls that happen when scalding water hits sensitive skin.

Other safety devices include hand-held shower heads, shower chairs, and handrails in the tub, according to Louis Stokes of the Cleveland VA Medical Center. The VAMC also recommends using a raised toilet seat to making using the toilet easier and prevent struggles that can lead to dangerous falls in a small area where head trauma's likeliest to result.

Whether you're a care provider for your loved one or you're planning a smarter, safer future for yourself, I wish you many happy days of comfort in the years to come.