Preventing Falls in the Elderly
The occurrence of a fall in an older adult can have a devastating effect both emotionally and physically. It is an abrupt reminder that with increasing age comes frailty and impending loss of independence. That realization can have a serious impact on the older person’s sense of self-esteem, and may lead to feelings of sadness, loss, embarrassment, and fear of another fall.
The physical consequences of a fall can be life-changing. A large percentage of nursing home admissions are directly related to injuries sustained in falls. Two of the most serious injuries--head trauma and hip fracture--can be life-threatening.
Factors that contribute to the occurrence of falls in the elderly include:
- Impaired vision caused by cataracts, glaucoma, and macular degeneration
- Impaired hearing
- Decreased muscle tone
- Problems with balance and gait
- Medications for depression, anxiety, insomnia, pain, and blood pressure
- Cognitive changes
- Neurological problems
- Poor safety awareness
Therefore, focusing on preventing falls in the home is important, and will become even more crucial as the population ages.
Bathtub Transfer Bench
A large percentage of falls in the home occurs in the bathroom. It can be a room fraught with hazards, but fortunately there are many do-it-yourself modifications that can make it an elder-friendly environment:
- Install grab-bars in the tub or shower. Make sure they are positioned at an appropriate height for the person who may be doing the grabbing.
- Place a non-slip mat in the tub or shower, and a non-slip rug (secured with double-sided tape or Velcro) next to the tub.
- Use a shower chair and a hand-held shower for walk-in shower stalls.
- Use a bathtub transfer bench in tubs to avoid falls while attempting to step into the bathtub.
- Wash with liquid soap or shower gel to avoid dropping slippery bars of soap.
- Place a raised toilet seat with armrests on the toilet to make it easy to get on and off.
- Store frequently used items within easy reach to avoid stooping and bending.
Falls in the bedroom are most likely to happen when a sleepy person gets up to use the bathroom in the middle of the night. Minor changes can make a big difference in safety:
- Place a lamp with an easy-to-find switch on a nightstand next to the bed. A touch-triggered lamp is ideal.
- Install a nightlight along the path from the bed to the bathroom, or leave the bathroom light on and the door slightly ajar.
- Clear any obstructions--including shoes and furniture--that may lead to a fall in a darkened room.
- Ensure that the bed is at an appropriate height for the sleeper so that it is easy to get in and out.
- If assistive devices such as canes or walkers are used, make sure they are kept within reach of the sleeper at night.
- Encourage the older adult to sit at the edge of the bed for a minute or so prior to standing. This can prevent a sudden drop in blood pressure which can cause dizziness and falls.
- Use a bedside commode for individuals who get up to use the bathroom several times a night.
Lighting, clutter, and furniture placement are the three main safety-related issues in the living room, and only a few simple changes are needed:
- Lamps operated by wall switches should be used whenever possible to avoid having to walk into a darkened room. Lamps triggered by motion sensors can be used instead if necessary.
- Avoid the use of extension cords unless they can be placed out of the way, along the baseboards.
- Make sure there is a clear pathway to the couch and chairs. If a walker is used, the space should be wide enough for the walker to pass through easily.
- The use of low coffee tables should be evaluated. They are frequently placed close to the couch, obstructing the clear pathway. They are easy to trip over, and are of no use in helping to break a fall or catching one’s balance.
- Throw rugs should be secured to the floor with double-sided tape to decrease the risk of falls.
Falls in the kitchen are often related to spilled liquids or items that are difficult to reach. A few easy modifications can help:
- Keep frequently-used items within easy reach. Store favorite pots and pans in a location that is easily accessible without having to bend and stoop.
- Use reaching tools or “grabbers” for lightweight items that may be difficult to reach otherwise.
- Clean up spills as soon as they occur.
- Avoid using slippery floor wax on kitchen floors.
- Remove kitchen throw rugs or secure them with double-sided tape.
A Few Other Suggestions
- Encourage the use of shoes and slippers with non-skid soles. Shoes with laces or Velcro closures are generally more secure than slip-on shoes.
- Using a cane or walker can make for a steadier gait. An elderly person who is “furniture walking” is at a high risk for falls and is in need of an assistive device!
- Stairs should be properly illuminated and have railings installed on both sides. Non-slip treads should be installed if possible. Carpeted stairs can lead to unstable footing if the carpet is too springy.
- Consider the use of a Personal Emergency Response System for elderly people living alone. A cordless phone or cell phone that can be carried from room to room may provide a measure of comfort as well.
- There are several phone systems on the market that include an emergency "pendant" that can be clipped to a pocket or carried from room to room. Some are pre-programmed to dial 911, and others can be programmed to dial a selected phone number. Unlike Personal Emergency Response Systems, these phones do not have a monthly fee. Knowing that help is available at the push of a button can be comforting to elders living alone.
Phone System with Emergency Pendant
Emergency pendant can be easily carried from room to room for added security in case of a fall.