Fall Prevention at Home in the Elderly
Every 11 seconds, an older adult is treated in the emergency room because of a fall – 2.8 million of us, every year. Fall prevention at home in the elderly, disabled, and for those aging in place is a critical need. The next time you are out with a few friends, take a look around – one of you will sustain a fall this year – yes, 1 in 4 seniors age 65+ fall each year.
Kind of scary, right? Well, brace yourself for this fact – every 19 minutes, an older adult actually dies from a fall. These statistics from the National Council on Aging are meant to give you a reality check.
Just like the injury I never thought I’d have, I didn’t think it would happen to me. But as we age, we need to be more realistic and prepare for what could happen; what statistics show probably will happen.
The truth is, anyone can accidentally fall, no matter what age you are. But falls are harder on older adults, and we don’t always recover as fast or as well as those who are younger. Falls can result in serious injuries, like broken hips, broken bones, and head injuries.
Unfortunately this was the case for my dad.
My dad was getting along pretty well in his early 90’s. He was on very little medication, was a healthy weight, and stayed pretty active for someone his age. He definitely had some short-term memory issues, but was still driving around town, going to church, planting his delicious tomatoes every year, doing his word puzzles, BBQing, and enjoying life with family and friends. We used to meet just about weekly for coffee or lunch with chocolate milkshakes.
Here’s a picture of him at one of the milkshake places. I love that smile!
He had some minor falls periodically. I remember one day I called him and he said he fell in the hardware store parking lot. He said a few nice people helped him but he had some cuts and bruises. Of course I rushed over there to check him out, and he was mostly ok. He didn’t even remember why or how he fell. He just did.
A couple of months later, I received a call from his wife saying he had fallen and was taken by ambulance to the hospital. Turns out he had gotten up to take some pain reliever, tripped over some clothes that were on the floor near his side of the bed, and fell and broke his hip.
This was the beginning of the end of the life of a vibrant man who I loved immensely. I still cry when I think about how much his life changed at that moment.
In the weeks that followed, he was in the ER, ICU, and med/surg room at the hospital, and then in hospice care at the VA hospital. He was on meds that made him extra confused, delirious, and occasionally hallucinate. By the time we got him weaned off the meds and stable, it was too late for surgery to fix the hip, too late for anything but palliative care. He was ready to go.
I spent every day with him. My boss at the time let me work remotely from his hospice room. I would play music he liked and ocean sounds (he loved the beach!) on my computer, talk to him whether he was awake or not, put lip balm on his dry, chapped lips, and gave him a little taste of whiskey every now and then until he didn’t want it anymore (shh, don’t tell the nurses). Then I drank it. I arranged for a private agency caregiver to be with him during the nights so he wouldn’t be alone. He passed away one early morning in October, as the caregiver sat next to him in the dark.
This personal experience is one major reason that I do what I do now. I want people to be safe in their homes, and when I advise people to “remove the clutter and don’t have anything on the floor,” it comes from a very personal place.
I don’t want bad things to happen just because there’s a pile of clothes next to your bed. Or because you lost your balance in the bathroom. Or because the lighting wasn’t good enough and you tripped. Or because you don’t want to use the cane or walker. Or because you weren’t holding on to the handrails and fell down the stairs.
Falls can also cause other problems. Once someone falls, they are often scared they will fall again, and may start to limit their activities, like what they do around the house or leaving the house to visit with friends. This can lead to social isolation, depression, feelings of helplessness, anxiety, and general physical and mental decline.
This is not always the case, however. Some people experience a fall and broken hip, get a hip replacement, recover and do physical therapy, and are absolutely fine. Some even have the other hip done too. Or a knee, or shoulder.
Why do some people fare better than others? Well, some of it has to do with genetics, overall health, or with the physical condition you are in before the accident occurs. Generally, if you’re in pretty good shape, you’ll get through the experience easier and with less recovery time.
Answer these questions:
- How’s your balance?
- Can you stand on one leg for 5 seconds without falling over?
- Do you hold onto furniture as you walk through your home?
- Are there any areas of your body that are weak or unusable?
- Are you on any medications that make you dizzy or lightheaded?
- Do you have trouble getting up from a chair or couch?
Fall prevention at home in the elderly is very doable. There are simple things people can do to protect themselves from future harm.
How To Prevent Falls In the Elderly
This video from the National Council on Aging describes 6 steps you can take today to reduce your fall risk. Take a look, then I’ll go into more detail below.
6 Steps To Prevent A Fall
In review, here are the 6 steps for fall prevention:
- Start a balance improvement/exercise program
- Talk with your doctor about your risks
- Discuss your medications with your doctor or pharmacist
- Get your vision and hearing checked
- Keep your home safe
- Talk with your family and ask for support
Start a Balance Improvement/Exercise Program
You’ve probably heard the phrase “use it or lose it.” This pretty much sums up the physical part of aging. If you don’t use your muscles and keep them strong, they’re not going to support you or be of use when you need them. Like when you’re trying to get out of the bathtub, or off the couch.
Now I’m not saying you have to train like Arnold Schwarzenegger. But some daily strengthening, balance and flexibility exercises will go a long way in keeping you safe from falling, and improve your overall health.
Here are some good examples:
- Tai Chi
- Yoga or Chair Yoga
- Water Aerobics
- Silver Sneakers Fitness Program
- Community Fall Prevention Programs
Many community and senior centers, YMCAs, hospitals and medical clinics offer these classes, or you can buy DVDs online, or stream classes so you can do them from anywhere that has an internet connection.
The Silver Sneakers Program is a free fitness program (offered by many qualifying health plans) for people aged 65+. Check your eligibility.
Find your local Areal on Aging office for recommendations of classes and programs near you.
Don’t forget to talk with your doctor about which fitness program would be best for you.
Tai Chi Demonstration
Talk With Your Doctor About Your Risks
Talk with your primary care physician about any potential risks you may have for falling. If you’ve had a fall or are afraid of falling, let your doctor know. He/she can recommend the best course of action, and can authorize treatment, physical therapy or DME (durable medical equipment) that may help and be partially or fully paid for by your health insurance or Medicare Part B. See which medical equipment is eligible for Medicare coverage.
Discuss Your Medications with Your Doctor or Pharmacist
It’s important to discuss all the medications you are taking with your doctor or pharmacist to determine if any of them may cause dizziness, lightheadedness, blurred vision, drowsiness, weakness, or anything else that could make you lose your balance, or impair your vision, memory, mobility, or agility.
All of these side effects put you at greater risk for falls and other unwanted accidents.
Also talk with your doc about any symptoms you may have, like needing to go to the bathroom frequently. If you’re half asleep and rushing to the bathroom, you may fall on the way.
Check Your Hearing and Vision Annually
Impaired vision or hearing can definitely increase your fall risk. Get yourself checked out annually because your prescription may have changed a little and you don’t realize it.
Remember in the video when the man was walking down an outdoor path and didn’t hear the person behind him? He could have easily walked in front of that person and caused an accident. If you have hearing aids, please wear them.
If your vision is impaired, there are so many things that can go wrong in a day. Everything from tripping over an object you don’t see, to missing the burner on the stove and burning yourself. If you have glasses or contacts, please wear them.
There are simple home modifications available to help with vision and hearing impairments.
Keep Your Home Safe
Does your home fit you? Does it fit your current and future abilities?
This is the place you should focus on the most to help prevent falls and allow you to age in place well.
Talk With Your Family & Ask For Support
Talk with your family and close friends and let them know that you’re working on fall prevention. Ask them for their support.
Here are some ways they can help:
- Help you declutter, re-arrange furniture & put everyday items within reach
- Take an exercise class with you
- Get bids from a contractor or handyman to help install necessary items like grab bars or modified steps
- Be with you when you’re feeling unsteady, or hire someone to be there
- Hold your arm while taking a walk
- Assist you in the bathroom
- Check on you in person or via telephone
- Get groceries and run errands for you
Don't Let Falls Happen To You
Don’t be one of those scary statistics. Don’t let falls happen to you. Don’t let pride get in the way of keeping yourself safe! Protect yourself by adapting and decluttering your environment, improving your strength and balance, and using an assistive device when you need one.
My dad always used to say “all you need to succeed in life is a positive mental attitude.” I would add – “and a safe home environment.” But just about, Dad. Just about.