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Fall Prevention

There’s no place like home... but...

There’s no place like home - and sometimes it seems like there’s no place safer. For seniors, however, the home is where many injuries occur, and most of these are due to falls. Changes that are part of the normal aging process, such as declining vision, hearing, sense of touch or smell and bone density can increase the risk of injury. Injuries can also be more of a problem for seniors because, as the body ages, it takes longer to heal and recover from injury.

You might think that “accidents just happen” and that nothing can really be done to prevent them. Not so. By taking some simple measures, you can considerably reduce your chances of being injured at home. It’s a matter of knowing what the potential hazards are, taking precautions and making adjustments. These changes can make a big difference!

This guide provides advice on how to prevent injuries by keeping your home, yourself and your environment as safe as you can. Checklists allow you to verify and increase the safety of your surroundings and lifestyle.

As the old saying goes: “An ounce of prevention is worth a pound of cure.” Inspecting your home and taking action to prevent home injuries can help you to live comfortably and safely for many years to come. We hope you will find this guide to be a practical tool to help you along the way.

The facts: Seniors and injury

Falls cause injuries and death

Falls account for more than half of all injuries among adults 65 years and over. One out of three older adults experience one fall each year and half of those will fall more than once. Among older adults, falls are the leading cause of fatal and nonfatal injuries.

Nearly half of all injuries among seniors occur at home. The bathroom and stairs are particularly hazardous due to the risk of slipping, tripping and stumbling. Seniors who do fall often limit their activities for fear of falling again. Yet by limiting activities, they are likely to lose strength and flexibility, and increase their risk of falling again. Maintaining physical activity is essential if you wish to prevent falls and injury.

The facts: Aging brings changes

Aging affects each individual differently. Some seniors experience physical limitations that seriously affect their level of activity while others are able to remain quite active. The natural process of growing older, however, generally includes changes in abilities. If you’re experiencing some of the problems associated with the changes described below, consult your health professional and make sure you undertake whatever changes or adaptations will help you cope and compensate.

Vision

Eyes take longer to adjust from dark to light and vice versa, and become more sensitive to glare from sunlight or unshielded light bulbs. There is a decline in depth perception that can make it hard to judge distances. Perceiving contrasts and colors can also be more difficult.

Touch, smell and hearing

Sensitivity to heat, pain and pressure decreases; this may make it more difficult to detect a liquid’s temperature or changes in ground or floor surfaces. Sense of smell diminishes, making it harder to smell spoiled food, leaking gas and smoke. Hearing loss can result in difficulty hearing telephones, doorbells, smoke alarms, etc.; it can also result in a decrease in balance, which can make falling more likely.

Bone density

Bones naturally become less dense and weaker with age. Bone loss (osteoporosis) among seniors can be worsened by lack of exercise and nutritional deficiencies. Bone loss can lead to painful fractures, disfigurement, lowered self-esteem and a reduction or loss of mobility.

Balance and gait

Balance is a complex function involving eyes, inner ear, muscular strength and joint flexibility. Any one of these can change as a result of aging. A general decline in equilibrium can make it more difficult to maintain or recover balance, meaning that a slip or trip can become a fall. The speed of walking, the height to which the heels are lifted, and the length of a person’s stride can change with age. These changes can make it more likely for someone to experience a fall.

Memory

In general, sharp brains tend to stay sharp. Cognitive processing and memory may take a bit longer, but this is a normal effect of aging. This is why it’s important to make lists and keep phone numbers handy.

Most seniors develop effective coping mechanisms as they age. Being aware of the normal changes of aging allows you to plan for home and lifestyle adaptations that will help you retain your health, quality of life and independence.

Keeping yourself healthy and active

What does home safety have to do with fitness and food? Plenty! Spending time and energy on your health can provide a big pay-off. You’ll not only feel better, you’ll be considerably reducing your chances of having a fall or other injury.

Benefits of healthy eating

The foods you eat build and maintain your body. With age, your body continues to need essential nutrients to function correctly. Food deficiencies in seniors can cause or increase the risk of bone loss, heart disease, diabetes, arthritis, etc. - all of which increase your risk of falling.

Healthy eating promotes a healthy heart, strong bones and good resistance to infection and injury. Eating poorly, skipping meals or not eating enough can cause weakness and dizziness, and increase your risk of a fall.

Benefits of active living

Remaining physically active also reduces your risk of falling by giving you more flexible joints, stronger bones and muscles, better heart and lung function, more energy, less fatigue, better sleep and less anxiety and depression. Being active includes everyday activities, such as walking, climbing stairs, gardening and shopping, as well as exercise classes and recreational activities like swimming, golfing and Tai Chi. Whatever your current physical condition, you can engage in some form of physical activity with the help of your doctor.

Physical activity

There’s no time like the present. Even when physical activity starts in later life, it can lead to significant improvements in your health and quality of life. Choose activities that will build your endurance, increase your flexibility and improve your strength and balance. Remember to check with your doctor first and to start slowly.

Keeping track of your medicine

Seniors may be more prone to illness due to the weakening of the body’s natural defenses. It’s not surprising, therefore, that many require a greater number of drugs to treat their health problems. Because seniors also tend to have more than one health problem, they may receive multiple prescriptions or they may combine prescription drugs with over-the-counter products or with natural remedies. Given that the aging body is more sensitive to the effects of many medications, the combinations can cancel the benefits of any or all medications and produce adverse reactions, such as memory loss, sleepiness, agitation and confusion. These effects have been associated with falls and other injuries.

To inform your doctor or pharmacist about all the medications you take, put all your medications, including herbal remedies, over-the-counter and non-prescription medicines in a bag and take it to your next doctor’s appointment or pharmacy visit. If your medication causes dizziness or sleepiness, adjust your activities so you aren’t at risk of falling.

Don’t mix drugs and alcohol.  Alcohol can react with many common over-the-counter medications, including tranquillizers, sleeping pills, cold or allergy medicines, high blood pressure pills and pain medication.

Keeping safe with safety equipment/aids

Many of the products on the market today can make your life easier, more enjoyable and safer. Many are not very expensive, and some would make nice gifts. These products can be found in hardware stores, pharmacies, medical supply stores, mail- order catalogues and other specialty stores.

Useful aids for walking

Canes can be a handy aid for walking, and these days they come in some fashionable styles too. It’s very important to make sure your cane is the right height and the rubber tips are checked every once in a while to ensure they are still in good shape. Wrist straps can be attached to your cane to prevent dropping. A clip can be put on the cane so that it will hang on the edge of a table or walker.

Cane spikes fit over the end of your cane for extra grip on an icy day. Spikes with four or five prongs are best. Many spike attachments flip up or down as needed. The spikes should be flipped up or taken off your cane when you enter a store or shopping mall, as the spike can slip on floor surfaces.

Safety soles are anti-skid detachable soles with studded treads that make walking safer in the wintertime.

The safest design is a full sole that runs the entire length of the shoe. These have to be removed when you are walking indoors, such as in a shopping mall, since they will slip on floor surfaces.

Walkers—If walking for 20 minutes without help is a problem for you, an inside or an outside walker could be worth having. With a walker, you can go further, longer and, with some models, you can even have a seat when you want to take a rest. Many models also come with a basket for carrying packages. Special tote bags, trays, and cane and oxygen holders that attach to the walker can also be purchased.

Appropriate footwear—Comfortable shoes that provide good support can help to prevent falls. Lower heels are easier on your feet and back and are more stable for walking. Elastic laces are available to make laced shoes easier to get on and off. Beware: easy-on shoes or slippers without fitting around the heel (i.e. backless) can be dangerous; shoes with smooth, slippery soles can cause you to fall; and composition soles, such as crepe soles, can stick to carpets and cause you to trip.

Medication organizers (dosettes) are compartment boxes designed to help you keep track of medications. They’re available in drugstores.

Wire/cord clips enable you to tack down electrical and telephone cords along the walls so they don’t run across the floors, where they’re more likely to cause you to trip. You can find these clips at most hardware stores.

Emergency response systems are communication devices that will get help for you in case of an emergency. A variety of businesses and some non- profit organizations are involved in this kind of service. The company will install the device in your home for a minimal price and then charge a monthly fee to monitor the unit. You wear a wristwatch or pendant-type of device with a call button, which you press in case of an emergency.

First aid kits can be a godsend when there’s an emergency. Make up your own first aid kit or purchase one from a reputable provider. Take note of where you keep it.

Asking for help

One of your best aids is your own voice. Don’t hesitate to ask for help when you need it. Most people are delighted to be of assistance, and asking for help may well respond to your neighbors’ and friends’ need to be useful and to enjoy your company! Asking for help is also a way to keep safe by making others aware of your presence and your needs.

Keeping your home safe

Injuries can result from seemingly innocent things around your home - many of which are easily fixed or adapted after you do some detective work to track them down. The following tips will help you avoid trouble before it happens. Your safety depends on it!

Additional Tips

We are concerned about your safety; please consider these “Step Smart Tips” to prevent fall related accidents:

 

Step-Smart Tip #1 - Take Care of Yourself

  • Get regular medical checkups. Talk to your doctor to ensure you are taking appropriate levels and types of medication.

  • Have your hearing and vision checked on a regular basis.

  • Exercise regularly and eat nutritious meals.

 

Step-Smart Tip #2 - Remove Existing Hazards

  • Remove throw rugs or fasten to the floor with double-sided carpet tape.

  • Keep cords out of pathways.

  • Clean up spills as soon as they happen.

  • Use sturdy stepstools with handrails. If you use a ladder, be sure it's the right size for the job and that it’s secured.  Don't be afraid to ask for help!

  • Arrange furniture to minimize obstructions and allow for easy navigation.

  • Have sidewalks and walkways repaired so that surfaces are level.

  • Remove furniture that is not sturdy.

 

Step-Smart Tip #3 - Add Protection

  • Wear shoes with non-skid soles.

  • Turn on lights when walking through dark rooms or hallways.

  • Use nightlights in bathrooms, bedrooms, and hallways.

  • Install grab bars in the bathtub, shower, and toilet areas.

  • Install Anti-slip decals on bottom of bathtub.

  • Use rubber backed rugs in bath/shower area.

  • Install raised toilet seat.

  • Install handrails on both sides of interior and exterior stairwells.

  • Place phones in multiple rooms in case you need to call for emergency assistance.

  • Place telephone and lamp near bed.

  • Acquire a personal emergency response system.

  • Install a seat at the entrance of your home to remove or put on your shoes and boots.

  • To help avoid taking a misstep, you can paint wooden or concrete steps with a strip of contrasting color on the edge of each step or on the top and bottom steps. Don’t rush going up or down stairs. Rushing is a major cause of falls.

  • Some tile and bath cleaning products actually increase slipperiness. Be careful when using such products.

  • Make sure your bed is not too high or low, so that it is easy to get in and out of it. You can purchase short bed rails to steady yourself when getting out of bed.

  • When you use a ladder, never stand or sit on the top three rungs. Maintain your balance by keeping your body centered between the rails, not reaching to the sides and not pushing or pulling on anything.

 

Step-Smart Tip #4 - Modify Personal Habits

  • Move slowly after lying or sitting to prevent dizziness.

  • Always wear well-fitted shoes or slippers with low heels and non-slip soles.

  • Do not wear long skirts, long house coats, or loose slacks.

  • Do not use bath oil.

  • Turn on a night light before going to bed.

  • Turn on a light when getting up at night.

  • Avoid using a ladder or step stool.

 

You CAN prevent falls!

 

Falls are by far the leading cause of seniors’ injuries and injury-related hospitalization. They cause pain and, for many, lead to a move from home to a care establishment. They often cost seniors their independence and quality of life. They also represent huge costs to our health system. Yet most falls incurred by seniors are preventable.

Whether you live in a house, a condo or an apartment, living safely at home requires adapting your environment, your behavior and your lifestyle to the normal changes that age brings.

You need to make sure your home is safe. This may involve installing brighter lighting, moving your furniture around, uncluttering your floors, rethinking the arrangement of your storage shelves, putting in night-lights or getting a good fire extinguisher.

You need to keep yourself healthy and active. Whatever your physical condition, it’s never too late to eat well and to be more active. Consult your health professional if you’re in doubt about a new diet or a new exercise program. Not only will this benefit your overall health and increase your resistance to disease, it will also help you maintain the balance and strength you need to ward off falls and serious injury at home and elsewhere.

 

You need to recognize that assistive devices and gadgets are a smart way to make your everyday life easier, independent and safe. Find out which are available and use them!

Every change you make to adapt your home and to stay healthy will help keep you from falls and injury. We hope that this guide has provided you with many suggestions that will allow you to remain safely in your own home for many years to come.

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