by Meg Pemberton MHA BSN RN CCM CSA
Think falling is only for the “aged?” If so, it’s time to think again. Not too long ago, I experienced a rather unglamorous fall. I nearly “face planted” in the kitty litter as I was scooping and cleaning. I can chuckle now but in the moment I shared a few unglamorous words (not to be shared here). My fall got me thinking. In the hospital setting, the elderly can and do fall. Much is done to prevent such accidents with great success. How do caregivers manage to keep their loved ones safe from falls at home? After all, if I could fall so easily, those older than I certainly can and do. The following tactics can help you keep your elderly parents from falling. But first, a few statistics to underscore the importance of fall prevention.
Falls: A Leading Cause of Death in the Elderly
The Centers for Disease Control and Prevention (CDC) estimates that some 29 million elderly Americans fall per year. About 7 million of these falls lead to serious injuries. Injuries include fractured skulls, hips, legs, arms, and ribs. Recovery from such injuries is difficult and lengthy with prolonged acute care and rehabilitation hospitalizations. Ultimately, these injuries lead to approximately 27,000 deaths per year. Falls have become the number one cause of death from injuries among the elderly.
Fall Safety Starts in the Home
Have your parents fallen at home? Their environment could be the culprit. Have you been able to take time to evaluate your parents’ home for hazards? If your parent has ever had home health care (nursing, physical therapy, companion or personal care) a home safety assessment will have been completed. However, you don’t need a health care professional to complete an assessment. Here is a short list of things to look for and/or implement.
- Be sure pathways and hallways are clear. De-clutter.
- Remove or secure any trip hazards such as throw rugs, shoes, and other items left on the floor. This includes power cords.
- Be sure there is adequate lighting in hallways, bathrooms, closets, stairwells, and in entry ways.
- Ensure there is adequate lighting from the bedroom to the bathroom; install nightlights as needed.
- Place nonskid strips or a nonskid mat in the bathtub/shower. Add handrails or grab bars in the bathtub/shower and next to the toilet.
- Make sure that dishes, pots, pans, and food are easily accessible without overreaching or climbing on unsteady chairs or step stools.
- Stairwells should be well lit (a light at the bottom and the top with a light switch at bottom and top) and free of items waiting for the next trip up. A handrail is mandatory. Treads should be even and secure.
- Ensure pathways into and out of the home are flat and secure (no loose pebbles, gravel or flagstones). This applies to the pathway to the mailbox as well. Better yet, have the mail delivered to the door if possible.
- Landscaping should be maintained so overgrowth from plants and shrubs do not become obstacles.
When assessing the home leave no stone unturned. If something looks loose, unsteady, or in the least bit hazardous, check it out closely. My parents had a really big, unwieldy, ugly, wooden screen that they used to hide the kitchen entrance from those coming in the front door. Every time I visited, I folded it up and put it away only to find it back in place on the next visit. I was convinced it would fall on one of my parents. Thankfully it never did.
Their Home is Safe, Now What?
Despite our best efforts to ensure our elder’s environments are safe they can and do still fall. Limited flexibility and loss of strength and muscle tone can cause the elderly to fall. We need to consider the overall health and wellness state to do our best to ensure safety. If your parents or loved ones have or experience any of the following, they are at risk for falling.
- Reduced flexibility and loss of balance due to decreased activity and chronic disease.
- Acute illness, medical procedures, and hospitalizations can further reduce mobility and flexibility.
- Chronic pain due to arthritis or other medical conditions.
- Changes to vision.
- Medications singularly can cause dizziness, slowed motor responses, and low blood pressure which increase risk. Seniors taking multiple drugs increase the risk exponentially.
Observing your parents and other elderly loved ones for any of the above is essential to avoid falls. Visiting their primary care physician and their eye doctor with them is an opportunity to ask questions, to learn more about their health, and to understand how their medications may be adding risk for falling. Ensure they maintain regular appointments with both.
What Not to Wear
I’m fairly certain that I fell into the cat litter because I was wearing socks and slipped when I reached beyond, far beyond, what I was capable of. How many people actually wear shoes around their home? How many of us think, “If I just stretch a little bit further…” Surprisingly or not, it’s what our elderly are wearing or not wearing that can increase their risk of falls. Just a few wardrobe changes can increase their safety. Encourage your parents to:
- Wear comfortable, low heeled, rubber soled shoes instead of socks, slippers or worse, going barefoot.
- Avoid loose clothing that can billow out and catch on furniture and other items.
- Use rather than wear a cane or walker if recommended. (My dad used to wear his cane rather than use it. Most often it was hanging from his wrist or he just dragged it along behind him.)
Falls happen. At age 65, one in four seniors will fall. The risk increases each year. Prevention is not an absolute. However, simple modifications to home, wardrobe and behavior can mitigate the risk. The CDC provides a good tool to use as a check list. You can find it here. Completing the safety check list is a smart start to keeping your elderly parents from falling.