I have worked in healthcare for 25 years with adults who have experienced traumatic brain injuries and have acted as my mother's caregiver.
Who Is at Risk of Falling, and Why Should You Care?
Falls are one of the biggest fears of the elderly. A fall can easily cause significant injury and put an end to one's ability to live at home independently. Unfortunately, millions of elderly fall each year.
For these reasons, preventing falls at home is critical, and a prevention program should be implemented. Engaging the physician is a crucial first step, but there are many things families can do, themselves, to modify the home environment to help ensure an elderly loved one's safety.
For millions of us who are caring for our parents or grandparents, there is a lot to learn. This article will give you a start.
3 Ways to Prevent Falls at Home
1. Eliminate Hazards
The first step in preventing falls at home is to assess the home environment, identify items that may create risks, and eliminate them. It's certainly wise to have your home professionally evaluated by a therapist (i.e. occupational therapist). However, even a close look around by family members can be beneficial and help improve the safety of a loved one's living environment.
Here are some basic things to look for throughout the home:
- Clear pathways: Make sure walkways are unobstructed. Boxes, chairs, tables, and so forth, should not be placed in walkways or near doorways where they can cause a person to trip and fall. Likewise, power cords or other cords should never be in a walkway.
- Make sure floor coverings are secure: It's often best to remove small rugs that create an elevated surface, curl up, or catch a toe. All carpeting and other floor coverings should be glued down. Try to eliminate any unevenness. For instance, raised sills can be a problem.
- Remove/replace unstable furniture: Chairs that roll or swivel are particularly hazardous. They can move as a person tries to sit down or get up, causing them to tumble to the floor. Rocking chairs can also be a problem. On the other hand, chairs with arms can help elderly people get up more easily. Remove beds that are too tall (i.e. when their feet can't touch the ground when sitting on the edge). Be sure to remove any small benches that might tip over easily.
2. Make Basic Home Modifications
Fall prevention often requires home modifications. Some modifications are minor, but others may require a bit more work. We'll break it down room by room.
The bathroom is the most common place for a fall to occur.
- Installing a small nightlight in the bathroom can reduce the risk of a fall.
- Installing grab bars can help a person steady themselves when entering or exiting the shower or bathtub. It's critical that these be mounted securely on wall studs so that they can bear the weight of an adult. (The suction cup style grab bars aren't recommended.)
- Bathroom, bathtub, and shower floors should be secure and have a non-skid surface. Decals can be put in tubs and showers to provide a surface that isn't too slippery.
- A shower seat is best in the shower. Some showers come with an included seat, or you can purchase an affordable shower chair/bench.
- If you have a separate shower, it is preferable to have no ledge to step over or onto.
- Tubs can be problematic because you need to lift your leg up high to get in, requiring you to momentarily balance on one leg. There are specialty walk-in tubs available if your budget allows. If this is not possible, an affordable tub bench can help individuals who have difficulty either getting down into the tub or getting up out of it.
- A raised toilet can facilitate sitting down or getting up because you won't have to sit down as low. Many of these have arms to help as well.
- Keep commonly used items—a lamp, telephone, tissues, and so forth—at the elderly individual's bedside so that they won't have to get out of bed unnecessarily.
- There are stabilizing arms or rails available to install on beds to help a person get out of bed if necessary. As indicated above, the bed should be low enough that the person can put their feet flat on the floor when sitting on the edge of the bed. (This is true of all chairs as well.)
- Either remove any small rugs or secure them to the floor.
- Make sure that all shelving is secure and that items are not stacked such that they might tumble out when opening a cabinet door.
- Try to place everything so that they are within reach. Avoid having to use a stool or stepladder.
Other Home Modifications
- Plugging in nightlights around the house can help the elderly see better at night and prevent them from tripping or bumping into walls and furniture.
- Making sure that light switches are near doorways can help since entering a darkened room creates a significant fall risk.
- Handrails on stairways are a necessity. This is true of outdoor steps as well. Of course, it is ideal to avoid stairs altogether; a one-story home is preferable. Moving is sometimes the best option if a home is two story, but if this isn't possible, then modifications to move critical items to the main floor may be needed. There should be a bedroom and bathroom available on the main floor. Ideally, laundry rooms and other necessities should not require the person to use stairs either.
- Don't forget to consider the outdoor environment as well. Look for uneven pavement in the driveway, sidewalks, and so forth. Again, outdoor steps should have a handrail. Curbs leading to a mailbox can present problems too. If the mailbox can't be relocated, then painting the curb might draw attention to the height change. Be sure any hoses and garden tools aren't left across a pathway.
3. Consult a Professional
A good fall prevention program at home requires input from professionals like doctors or occupational therapists. A physician can provide useful information and make referrals where necessary to help an elderly individual move around the house safely.
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- Get vision and hearing assessments because both can increase the likelihood of a fall.
- Sleep problems and bladder control issues may result in increased risk.
Interrupted sleep patterns and an urgency to urinate can cause an elderly person to get up more often in the middle of the night. These issues should be addressed with the physician.
- Assess balance and strength. A doctor or therapist will be able to recommend therapies to improve these areas and prevent falls and fall-related injuries.
- Adaptive or assistive aids like walkers or a special cane can be ordered by the physician/therapist. These items can often be covered by Medicare or other health insurance.
- Talk to their doctor about the medications they are taking. Some may have side effects that can impair balance, including dizziness and lightheadedness. Your doctor may recommend a different medication.
Other Ways to Reduce the Risk of Falling
Beyond modifying the home environment, there are other small changes that can be important in an effective fall prevention program at home.
Consider Clothing and Footwear
Wearing pants, robes, or dresses that are too long and drag on the floor can be potential slipping hazards.
A sturdy shoe with non-slip rubber soles will help reduce the risk of a fall. Walking in socks and other shoes that have little grip is also a risk factor.
Difficulty tying shoestrings can result in strings that drag along the floor. Therefore, velcro is sometimes a better option.
Use Extra Care When Getting Out of Bed
Getting up too quickly can sometimes cause dizziness, and ultimately, a fall. If this happens to you, a good preventative measure is to sit up slowly and remain on the side of the bed for a minute before standing up.
Continue to Be Active
Exercise is the best way to maintain good strength and balance. In particular, weight-bearing exercises such as walking is often recommended. However, stability must be sufficient in order to do this safely.
As indicated above, consulting with the doctor is recommended before any increase in activity is undertaken.
Consider an Action Plan In Case a Fall Does Occur
Despite your best efforts, a fall or some other emergency can still happen. It's best to be prepared by knowing how the individual will get help and get it quickly. A fall is bad, but laying there unable to get help for hours or even a day or two is much, much worse.
One possible solution is a medical alert system that allows the individual to summon help immediately by pressing a button they are wearing. These systems are generally very affordable and provide the 24-hour security that's needed. Some medical alert systems are even able to sense a fall automatically and will send help even if a person is unable to request help themselves.
With some attention to detail and pre-planning, many potential falls can be prevented. When they do occur, it's likely that the negative outcome can be minimized if a good response system is in place.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2010 Christine Mulberry
Nell Rose from England on June 13, 2010:
Hi, these are great ideas. I think that most people do a small area but forget about other parts of the house. I always remember putting a proper rail on the stairs for my parents, but we forgot to do one in the bathroom for a while. but eventually we sorted it out. great rated up. nell
Support Med. from Michigan on June 11, 2010:
Valuable suggestions! Voted-up/rated!
Peg Cole from North Dallas, Texas on June 10, 2010:
Mulberry1, This is so completely true. . . you have really hit the nail squarely here. Much of what you write about here has come to pass in my Mom's house.
You're right, the bathroom is the first place to begin looking. We started out installing the hand rail in the bathtub to help in getting out of the tub. That progressed to an elevated toiled seat with arms to make things easier there. Then came the shower seat which later became a shower transfer seat after a fall in the home required hip surgery.
These tips are valuable for everyone, including the elderly and those who look out for their safety. Sometimes it's difficult to step in and make things happen - not waiting for the elderly parent to decide it's time to fix things. Reducing the risks of falling will really improve the chances for living on your own even into your 80s and 90s!