Reduce the risk of falls at home
Accidental falls are a serious cause of worsening function and even death in older adults. The first fall is often the sentinel event in a downward spiral towards decreased independence and increased mortality. This is why fall prevention is so important. —Dr. Petrina Craine
One in four adults over age 65 falls each year. Older adults are at a higher risk of falling for various reasons. One reason is the loss of muscle that impairs good balance and strength. Another is declining brain function that can lead to memory loss and confusion. A third is the use of multiple medications that can cause side effects (e.g., dizziness) that can literally help tip an elderly person over.
An estimated 60% of falls happen at home—leading to potentially serious injuries like fractures (broken bones) and head traumas. Studies have found that among older adults, about 30% to 50% of falls at home are caused by living environment issues, such as poor lighting, slippery floors (the bathroom is particularly dangerous), and uneven surfaces.
Thankfully, experts believe that falling is not an inevitable part of aging. Similar to modifying your diet for better health, making simple and inexpensive changes to your home, even room by room, can eliminate potential fall hazards.
How do I make my house fall-proof?
Consider recruiting an occupational therapist. They can do a walk-through of your home and suggest what is needed to make your home safer. The National Association of Home Builders has a listing of Certified Aging-in-Place Specialists. They can install fall-prevention equipment.
Start with your entryway. Many homes have steps leading up to the front door, which can be a hazard for anyone, but especially older adults.
- Steps should be in good condition. Surfaces should be even. Nothing should wobble! And they should also have a handrail on both sides.
- Check that your outdoor areas have good lighting. And, if possible, get a motion sensor light that automatically turns on when you’re near the house.
- Welcome mats and small rugs inside your entryway may seem like an inviting touch, but they’re also a tripping hazard. Getting rid of these or securing these items with non-slip guards are ways to help lower fall risk.
Fall prevention for your living spaces
A few key modifications that we all could benefit from is reducing clutter, improving lighting, securing home structures, and making everyday items easily accessible.
- Reduce clutter in all living areas. This includes the living room, den, and dining areas. Depending on your space, clutter can be anything—a hall table or end tables in the living area, plants and piles of books in your den, or decorative pieces in your bedroom. Even just having too much furniture can make it easier to fall as it can be harder to maneuver around.
- Think about increasing the lighting inside your home. Brighter lights can compensate for vision loss—which worsens with age—making it easier to see floors, stairs, and potential hazards. Consider using LED lighting to brighten your spaces. The bulbs last longer, so you don’t need to change them as often (another fall risk). They also use less electricity—a benefit that can save you money.
Other fall-proofing changes to consider:
- Carpeting or large area rugs are safer than floors, which can be slippery. If you have area rugs, keep them slip-proof with rubber rug padding or double-sided tape.
- Remove small area rugs as they are more likely to cause slips.
- Install no-slip strips on wood or tile floors. There are transparent ones that won’t be noticeable to the naked eye.
- Make sure cords and wires are near walls and out of the way of walking areas.
Tips to fall-proof your stairway
Going up and down stairs is another potential trap for falls.
- Install lighting and switches at the bottom and top of stairs.
- A banister is great, but they too can become wobbly with age. Check to see if they are still stable. Experts also recommend putting a handrail on both sides of the staircase.
- Decorative non-slip strips make wooden stairs less slippery. As vision declines with age, stairs themselves tend to blend together. Placing colored duct tape (maybe not the prettiest home improvement) or brighter non-slip strips can make each step more distinctive and safer.
Make the bathroom fall-proof for seniors
The rush to get to the bathroom, especially in the middle of the night, can be the perfect storm for a fall. Older adults tend to have more issues with incontinence—problems with controlling feces (aka poop) and urine. I’d rather my patients blush from owning a bedside commode, urinal, or diaper rather than found crying—or worse dead—from a fall stemming from a late-night run to the bathroom. —Dr. Craine
The bathroom is often considered the place in the home to privately retreat, relieve, and relax. The combination of hard and slippery surfaces makes it a danger zone. About 80% of falls in the home occur in the bathroom, making it arguably the most important room to fall-proof.
- Install grab bars—one next to the toilet and one or two in the tub or shower. This can help provide a strong, sturdy structural support as you bathe and shower. An occupational therapist can recommend the right length and height. You want to be sure that the bars are very secure in case you ever lose your balance. Grab bars no longer have to look like medical equipment. They come in a variety of styles and colors—even matching your towel racks.
- Place a heavy rubber mat in the bath or shower to prevent slipping.
- A hand-held showerhead gives you the flexibility to bring it to where you are instead of having to carefully maneuver in your slippery shower or tub.
- Replacing a bathtub shower with a walk-in shower is a safer and more accessible—though pricier—option.
- Get a photosensitive nightlight, which turns on when it’s dark.
Make your bedroom fall-proof
The bedroom is another space that requires fall prevention modifications.
- Older adults may need a railing along the side of the bed to help with getting in and out of bed. Most railings fit between the mattress and box spring.
Keep the path from the bedroom to bathroom clear—free of clutter—and well lit with nightlights. This is especially important for getting up in the middle of the night to go to the bathroom.
Prevent falls in the kitchen
- A common risk to falling in the kitchen is when you are using step stools or chairs to try to reach dishware or appliances on high shelves. Move everyday items to a shelf where they’re easy to reach.
- Immediately wipe up any spills on the floor.
- Don’t walk on freshly cleaned (e.g., washed or waxed) floors until they are completely dry.
What should I do if I fall at home?
Stay calm, take a few breaths, and assess if you are hurt. If you’re not seriously injured, carefully roll onto your side before getting up. If you can’t move, call 911.
If you’re worried about falling, always have a mobile phone with you. Or get a medical alert system or a wearable emergency response system that can be easily activated when a fall is suspected.
Not all falls are created equal. A fall or near fall can be a symptom of underlying disease that could be brewing. When in doubt about the cause of a fall or near fall, seek medical attention as soon as possible. —Dr. Craine
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