Fall Prevention in The Elderly – High Risk for Falls?
Are you at high risk for falls? Are you elderly? Then yes, you are at high risk. This article is about fall prevention in the elderly.
Now there’s a headline I never thought I would be writing about! However, after nearly falling in my closet yesterday while trying to take off my jeans….I thought, good gracious. Here I am, high risk for falls!
I’m a retired nurse practitioner and thinking back to my old nursing classes, I remember how BORING it was to study some of the phases of Erikson’s stages of development.
It was all pretty interesting until you got down to stages 7 and 8. It was fun to see a baby or toddler do something and proudly tell your friends, that’s a typical activity from stage 1 or 2 etc. The experts we were. But get down to those last couple of stages and it wasn’t so much fun. Learning how to deal with aging parents. You think that’s for the future, or that’s for someone else. Not so.
Erikson’s Stages of Development
- Trust vs Mistrust (birth to 18 mo) – Stage 1
- Autonomy vs Shame and Doubt (18 mo to 2-3 yr) – Stage 2
- Initiative vs Guilt (3 -5 yr) – Stage 3
- Industry vs Inferiority (6 – 11 yr) – Stage 4
- Identity vs Confusion (12 – 18 yr) – Stage 5
- Intimacy vs Isolation (19 – 40 yr) – Stage 6
- Generativity vs Stagnation (40 – 65 yr) – Stage 7
- Integrity vs Despair (age 65 to death) – Stage 8
So, here we are right smack in the middle of Integrity vs Despair. Now I’m not going to school you on this development stage, rather I’m going to focus on high risk for falls (you notice I’m right here with you). We’ll review some tips on how to prevent or reduce the likelihood of a bad fall.
First off we need to look at exactly how many falls are occurring among our age group. According to the CDC: You might be surprised, I sure was!
- About 36 million falls are reported among the elderly each year, resulting in more than 32,000 deaths (This is astounding to me!)
- About 3 million elderly adults are treated in the ER for a fall injury. (Been there, done that, how about you?)
- One out of every 5 falls causes an injury such as a broken bone or head injury. (Both my parents had hip fractures.)
- Each year at least 300,000 elderly are hospitalized for hip fractures. (Both my parents.)
- More than 95% of hip fractures are caused by falling, usually falling sideways. (My dad fell like that, and he passed away within a week.)
- Women fall more often than men and account for 75% of all hip fractures. (My mom turned over the bed and had a hip fracture.)
What Can We Do?
Well, there are lots of things we can do to prevent falls in the elderly! Let’s review some of the more realistic, everyday kinds of things that are within our power to improve. We can’t change our age or genetics, but we can work on risk factors.
It goes without reason that we want and need to be as healthy as we can for obvious reasons. But here are some things we can work on. Just the knowledge of how some of these things impact our risk for falls is eye-opening.
- Pursue Optimum Weight: Obesity is associated with a higher risk for falls. But underweight folks are at more risk for fractures! Now, this may give comfort to some people, but really now. 🙄 Bone density is not proportionate to body weight.
- Stay active, exercise, and do light weights. The stronger your core body strength is, the more likely you can recover and prevent a fall when you stumble, and you will.
- Do Tai Chi.
- Review your medications with your physician and eliminate any that are not absolutely necessary. Ask about side effects. Some medications, especially for blood pressure cause lightheadedness and dizziness (orthostatic hypotension). Muscle relaxants, sleeping pills, and pain medications can have major side effects.
- To counter orthostatic hypotension, sit on the side of the bed for a few seconds before getting on your feet, stand, and wait again. Same with rising from a chair. Stand there for a few seconds before you take off.
- If you have reached the point that you need an assistive device like a walker or cane, don’t be embarrassed. Your good health is most important!
Let’s look at fall prevention in the elderly by assessing our environment – the living area, bedroom, bath, and kitchen.
- Downsize and declutter. It’s time to sort through things! Decluttering a home will make it safer for you to get around in and it’s easier to clean.
- Sort through those things that you have been hanging on to and let the children take what they want now. Discard what needs to be trashed and give some of the other things to charities. Keep small mementos and let the rest go.
I know that’s easier said than done. We downsized four years ago and even after all the things we sold and gave away, we still put boxes in the attic. Those boxes haven’t been touched in four years now…..so how important were they after all?
- Be watchful of throw rugs or accent rugs. I’m not going to say remove them, because we all use rugs at our doors, etc. Do make sure they are non-skid or secured to the floor with that double-sided tape made for carpets.
- Make sure larger rugs are secure and don’t have corners that curl up that cause you to trip.
- Electrical plugins that are in the floor, keep any cords out of the walkway.
- Position furniture so that you can move around freely and not have to zig-zag through a maze of tables and furniture. Downsize remember.
- Keep walkways free and uncluttered.
- Use nightlights in the living area, or leave a lamp on here and there. If you or the hubby worry about the light bill, think about the consequences of a fall with a broken bone! Consider using LED nightlights (as many as you want!). They cost about $0.17 a year to run!
- Pets. Most of us have them and we really have to be on our toes watching out for them. They don’t mean to hurt us, but they walk softly, quietly, and quickly and can be at your feet without you knowing it in a nanosecond. We always put our dog in his crate when we have company. He is very loving, but he is also very big. We both have to be very aware of where he is at all times and I figure it’s inevitable that he will cause one of us to fall eventually. I hope not.
- Wipe any spills up immediately.
- Forego waxed floors. Do people still wax floors anyway?
- Do not get up on countertops! Well, that’s kind of a no-brainer, most of us don’t have the strength to get up on the countertop. But, don’t use a step stool and then get on the countertop!
- Don’t use a step stool at all if you can avoid it. And if you must have something, just use one with one step.
- Anything that you have stored in upper cabinets that requires the use of a step-ladder to get to – stop using it! This gets into the decluttering again. I have cabinets in my house that takes a 6-ft ladder to reach! Needless to say, there are things up there, that might as well have been thrown or given away because it’s not worth the risk to try to get them down. My Christmas dishes….I haven’t seen them in four years. Should I decide that I must have them, I’ll get one of the grandchildren to get up there and hand them down. Then I’ll store them within reach if they become that important. Isn’t that what grandchildren are for anyway)))
Bedrooms account for 30% of falls that occur in the home.
- Use nightlights or leave the bathroom light on with the door cracked.
- If you must have absolute darkness to sleep, use an eye mask and remove it before getting up.
- Keep your phone on the nightstand.
- Keep a flashlight on the nightstand in case of a power failure.
- Consider your bed height. Too low makes it harder to get up, and too high can results in falls when sliding off the bed.
- Don’t throw clothes, pillows, or anything else on the floor when you go to bed (Guilty!)
- Keep a chair or sturdy stool where you change clothes. Mine is in the closet. It’s a dressing stool and the perfect height for sitting when putting on my shoes.
Another thing we have in our closet is an LED light that is stuck on the wall. You can get them at Amazon. We figure in case of a tornado and if we can’t get to Carrie’s house where they have a safe room, the closet would be the best place for us. So we keep one of those lights stuck on the wall there.
My last fall occurred in the bathroom, on a wet tile floor. I call myself being careful, but I still fell. Water on a tile floor is deadly. I was lucky not to have broken anything. It has made me more vigilant about getting in and out of the shower and tub.
We were fortunate to be able to add some safety features when we built the house we are living in now. Thanks to Carrie’s prompting, we have one bathroom that has a shower with a seat, a handrail in the shower, and handrails by the bathtub and toilet. The shower door has a flat threshold in case one of us has to roll into the shower at some point. All the doors in the house are wide enough to accommodate a wheelchair.
Now, this may not be your case and you may have lived in your house forever without safety features. We did too for many years. If your house is older or has no handrails you can buy them that be secured to tile walls etc.
- Non-slip bathmats
- Shower seat
- Shelf for soaps and shampoo so you don’t have to bend over
- Raised toilet seat
- Make sure drains work freely and water doesn’t pool on the floor of the shower.
We don’t have stairs in this house, but the main thing I can say about them is to avoid them like the plaque! Sometimes you can’t of course, so here are a few fall prevention tips for the elderly.
- Handrails on both sides when possible
- Remove any rugs at the top of the stairs
- Keep stairs clear of all objects – pretty Pinterest pictures show plants and decor decorating steps. Avoid this.
- Good lighting
- Good lighting
- Install handrails for steps
- Repair any loosened bricks, tiles, or wood
- Keep the area clear of water hoses or spills
- Remove tree roots that protrude from the ground
- Baggy clothes or pants too long can lead to falls
- Sock feet! Just don’t walk around the house in sock feet! But if you must, use socks with non-skid soles like they use in the hospital. Alligator feet that’s what we called them….they look so bad it will prompt you to put your shoes on!
- Flip Flops are cute and comfy in the summertime, but at this point, it’s best to avoid them.
- Houseshoes should be the type that has a back, not slides, and has non-skid bottoms.
- Be vigilant when you’re out shopping or traveling. Use the handrail on escalators!
- Stay off ladders. Let someone younger do that.
- Stay out of the attic. We recently rented a storage building just so we wouldn’t have to struggle to put the Christmas tree and decorations up n the attic again. Of course, we found lots of other things to put in that building too)))
On one of our recent trips, I found myself with my rolling suitcase, purse, and sweater, teetering on the escalator step trying not to touch the handrail. Covid you know! I finally decided that I was better off holding on to the rail and just using hand sanitizer when I got off.
I hope these tips have been helpful and not too depressing! It’s hard when you come to the realization that these are things we must be aware of in order to protect ourselves from falls as much as possible. And even when we are doing our best, we can trip walking across a flat floor with sturdy shoes and good light! It happens. It doesn’t take a banana peel does it!
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