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Jim with granddaughter

Preventing Falls As We Age

Jim with his granddaughter.
Preventing falls around grandchildren is important too.

Falls are bad regardless of age. However, as we get older their impact on us is magnified. Much of this is due to our general physical body becoming less flexible and able to withstand the impact of a fall. Also, the chances of falling increases due to balance issues, dexterity, and a general notion that we can still easily do the things we did when we were younger. Certainly at this time with the winter weather, the chance of falling outdoors increases greatly, with wet and icy shoes also a distinct hazard indoors.

Today, I want to start out by providing statistics about falls in the older population. I will then wander a bit into the risk factors, and offer things we can do to lessen and prevent falls. Finally, I will provide a good checklist to consider by the Seniors Helping Seniors office of Greater Marion County Florida and The Village’s Educational activities.

National Council on Aging statistics indicate one in four Americans aged 65+ falls each year. Every 11 seconds an adult is seen in an emergency room and one in five results in serious injury. Moreover, falls are the leading cause of fatal injury to older adults (every 20 minutes an adult dies in a fall) and the most common cause of their non-fatal trauma-related hospital admissions. Statistics indicate that in 2015, full financial impact of falls was approximately $50 billion. By 2020, this figure is projected to increase to over $67 billion. Research shows there are also psychological impacts to falls. Once a person falls, there is a tendency to develop a fear of falling again, the loss of independence, the need to relocate, and they can develop feelings of isolation and depression. A circular cycle has been created where the fall leads to fear, which leads to less activity, which leads to decreased strength, leading to increased risk for a fall, resulting in a fall – and on and on in the cycle.

Risk factors that lead to falls include: previous falls; fear; hazards in the home; medications; eyesight; physical weakness; and even poor nutrition. Each of these should be addressed through discussion with their physician, specialists in balance, family members, senior care health professionals and nutrition experts. Safety determinations and review of the home should be considered.

Here is a checklist of items in the household or the surrounding physical area that might indicate a need to improve safety and prevent falls.

  • Are there handrails by the stairs, on both sides of the steps and are they securely fastened?
  • Are the stairs solid and secure – no loose boards or cement if outside?
  • Are floors even, with no loose tiles, boards, laminate, or carpet?
  • Are rugs secure with tacks, non-skid pads, or double-sided rug tape?
  • Is there adequate room in the bathroom to move safely, and to get in and out of the tub or shower safely?
  • Is the tub or shower free of soap build-up that could make the surfaces slippery?
  • Are there non-slip strips or suction cup mats in the bathtub or shower?
  • Can shower heads be adjusted to easily change shower direction or height?
  • Are there grab bars mounted at the toilet, bath, shower, and are they located strategically and securely?
  • Has a greater height “hospital” stool been installed to assist in getting up?
  • How is the shower curtain rod secured – with screws and not just suction cups or spring rod?
  • Are loose bath mats secure with non-slip or double-sided rug tape?
  • Are regularly used items in the home, such as dishes, food items, and bedding, towels and clothes within easy reach?
  • Does the step stool being used have a rail on the sides or a bar at the top to hold on to?
  • Do cupboard doors close completely and stay closed?
  • Are cabinet latches and knobs secure and easily reached and held?
  • Are chairs sturdy and stable, and with armrests to assist in getting up?
  • Do dark spaces contain adequate lighting?
  • Is a lamp and telephone located near the bed?
  • Do the lamps have shades that aid in preventing glare?
  • Are night lights installed in hallways, bathrooms, bedrooms, and stairways?
  • Is lighting uniform throughout the home?
  • Are light switches located both at the top and the bottom of stairs?
  • Are hallways and rooms clutter free without scattered obstacles that limit safe movement? Are newspapers, plants, and furniture out of the way of general traffic movement in the home – to eliminate tripping over them?
  • Are there electrical or phone cords crossing traffic areas as a tripping hazard?
  • Is the type of carpet pile a problem in tripping or getting around with a walker or wheelchair?
  • Do walkways outside the home have loose bricks, stones, or pavement? Are there uneven joints, chips or holes?
  • Is the outside lighting in good order and adequate to “light the way” about and into the home?
  • Are gutters clear of leaves and debris?
  • Are bushes and plants trimmed so they are not a tripping hazard by overlapping areas of the walk?
  • Does a plan exist for calling for help if needed?

Personal things to observe:

  • Does the person’s shoe sole material enable slipping?
  • Would a different shoe – possibly without laces – help in balance and stride?
  • Are spills cleaned immediately to prevent slipping?
  • Does the person stand on countertops to reach items?
  • Is the person’s clothing loose fitting or long and a source of tripping?

This is not an all-inclusive list but contains a great deal of things that must be looked at if falls are to be prevented. I will not be covering the issue of when steps must be taken to totally change the environment to that of limited or constant care – an issue falling outside fall prevention.