Introduction
The CDC (Centers for Disease Prevention and Control) indicates in recent posts that “Each year, millions of older people-those 65 and older-fall”. These falls can often be serious and there are strong indications that for seniors or those recovering or those with disabilities each successive fall increases the probability of an additional fall. In fact, also according to the CDC, there were 9.6 Million non-fatal injuries in the senior population due to falls, in the year 2015. An additional 33 thousand were fatal in that same year. (Go to the cdc.gov site for sources). These facts are clearly sobering but even more concerning since so many of these falls take place at home and could easily be prevented.
Contributing Factors to Home-based Falls
Seniors and others that have lost some level of independence face many challenges in the home, some intrinsic and others extrinsic, some related to home safety and some, surprisingly, related to caregivers. Here are some common factors that we all need to keep in mind:
- Loss of full motor control
- Medications that cause drowsiness and or dizziness
- Home-safety issues that increase the dangers of mobility
- Improper support devices to aid mobility
- Lack of ongoing, appropriately paced physical activity
Of all of these clearly the easiest to eliminate or mitigate fall into a single category above: Home-Safety issues. This is probably the most critical of all of these since the elimination of any items in this category is likely to profoundly and significantly reduce the risk of falls in the home.
Caregivers and Their Role in Home Safety
Family caregivers or hired caregivers, for seniors and others, need to be acutely aware of fall-risk dangers in the home and help those in need of assistance avoid these dangers. Caregivers need to be proactive by ensuring the safety of those they care for through awareness, communication and correction of hidden and/or obvious home dangers. This can be accomplished through vigilance and involvement. For example caregivers should try to put themselves into the shoes of those they care for and predetermine what challenges they face in and around the home. It is challenging enough for those in need of care to merely accept their position of aging, disability or otherwise, and therefore caregivers need to be sensitive to the feelings of seniors and others while still be vigilant in keeping the home safe. Caregivers really do need to behave as unsung heroes or angels, operating in the background, and without making seniors or others in care feel worse for their loss of some independence.
Risk Mitigation and Steps to Safety
The CDC as well as other sources provide significant yet intuitive advice on how to minimize the risk of fall and injury. In fact the National Council of safety provides some excellent direction in its recent article “Slip, Trip and Fall Prevention will Keep Older Adults Safe and Independent” ( click here for source). Most of us can leverage a little thought on this topic and easily come up with a checklist of items to evaluate in our homes to make them safer for older adults, those recovering, or disabled. Provided below is a good start and may give you some additional thought and guidance. Please note that naturally, this is offered as a suggestion and not medical advice.
Kitchen Safety
- Cooking Equipment, Utensils, Dishes, Glasses and Food should be stored appropriately and easy to reach
- No kind of throw rug or similar placed on a kitchen floor
- Floors should always be free of any kind of spills (Oils, food, etc)
- Use counter-top toasters where feasible, making them easily accessible
- Where higher cabinets must be accessed a step stool with a handrail is should be easily accessible
- Non-skid floor cleaners only for cleaning the floor
General Concerns with Carpeting
- Wall-to-Wall carpeting should be completely and properly installed – no loose edges, tears, buckles or holes
- While not always possible, solid colors are better in that they provide greater consistency for those that are mobility challenged – they also show edges more cleaning
- Deep Piles and Shag styled carpets should be avoided
Bathroom Concerns and Safety
- Ensure that bathroom mats are slip-resistant (and not old wherein the slip-resistance has worn) – ensure they are placed near the showering/bathing area
- Ensure that there are mirrors at various levels to ensure that the client is not struggling or reaching to use a mirror
- Where possible install grab bars near the toilet, bathtub and/or shower
- The bathtub/shower floor should be non-skid, if this is not the case then ensure that non-skid safety strips are installed
- Where feasible use a soap dispenser mounted in a very accessible area in the Shower/Bath
- Where required, a shower chair is placed in the bathing area
- The toilet seat should be the raised type or a toilet seat with armrests should be fitted to the toilet to ensure safe balance when sitting or getting up from the toilet
Bedroom Safety
- Key safety items should be within reach of the bed, for example on the night table. Consider safe lamp, flashlight, phone, cane, etc.
- If appropriate, a raised height mattress to help with getting into/out of bed
- The floor, particularly around the bed, should be free of clutter, papers and any other items
- Nightlights are appropriately placed in the bedroom and along any routes to the bathroom
Outdoors and Around House/Apartment
- This category naturally only applies in some cases
- Ensure all walkways are clear of debris, branches, leaves, rocks and similar
- Ensure all stones and masonry are solid not loose in anyway
- Ensure all walkways and driveways are as level as possible
- Ensure that all walkways are clean and not coated with moss, algae, Oil and/or other slippery substances
General Living Space Concerns
- In areas that could be classified as pathways ensure that low furniture items are moved aside. Examples include coffee tables, folding end tables, ottomans, floor plants, etc
- Light switches are all in working order and not obstructed
- No Loose Rugs or throw rugs that can slide
- Rooms and moving space are clear of furniture obstructions
- Where applicable use sound activated lamps
- Where applicable use glow-in-the dark markers on various items that require manipulation, for example cabinet handles, light switches, etc
- All electrical cords for power, data, phone, etc are properly routed and secured and not anywhere near pathways or living spaces
- All furniture in proper condition, sturdy and secure
- Several cordless phones available, each marked with glow in the dark markers, and ensure that they can be located audibly (i.e. have a locate handset feature)
- No loose tiles or floorboards
- Night Lights appropriately placed throughout the house
- Infrared sensor lights in certain areas where brighter light is required at night
Technological Considerations
- Install carbon monoxide detectors were appropriate
- Install smoke detectors were appropriate
- If required, based on level of independence, arrange for medical alert device/subscription
- Install detectors that also have emergency lights and/or install motion detected lighting where appropriate