Fall prevention in the elderly at home

Home is our sanctuary. It’s where we feel safest and most secure, surrounded by familiar sights, smells, sounds, colors, textures, belongings, memories, and routines.

As more older Americans choose to age in place during their retirement years, making home (however “home” is defined) even safer takes higher priority—especially when it comes to learning how to prevent falls in elderly.

Three steps to prevent falls at home

Because falls are one of the leading causes of acute injury, premature disability, and even death in older people, preventing falls in the elderly is critical consideration. Several proactive steps for elderly fall prevention can help to minimize the chances of falling at home.

1. Wear sensible, no-slip shoes in the house

   While many dutiful, well-socialized people still hear Mom’s voice saying “Shoes off in the house,” breaking that lifelong habit may be the best thing seniors could do for their own safety when it comes to fall risk in the home. And that’s borne out by evidence-not just opinion. A study of 765 people aged 64 to 97 confirmed the findings of previous studies, finding that people who regularly wore socks, slippers or went barefoot were significantly more likely to fall in their homes, and while the finding for bare feet may come as a surprise to people who think they’re as nimble as a housecat, the study’s authors noted, “People who are barefoot or wearing socks without shoes may also be more prone to falls as a result of slipping or trauma from unexpected contact.” (“Trauma from unexpected contact” is a dense phrase covering everything from “stepping on a Lego brick after the grandkids visit” to “smashing/stubbing/catching a toe on the leg of a piece of furniture.”)

   

   People who are barefoot or wearing socks without shoes may also be more prone to falls.

2. Check your hems

   Free-flowing dressing gowns, robes, airy athletic pants and yoga gear are all some of the delightful comforts of being able to dress and be exactly who we want to be when we’re at home. But if those items of clothing drag on the floor, they constitute trip hazards. If fabric trails on the floor under or near your feet when you walk, spring for a tailor or have a friend with sewing skills take those yoga pants up a half-inch.

3. Make an appointment for a comprehensive check-in with your physician

   Fall prevention at home in the elderly begins with a baseline of overall good health and wellness, and a strong collaborative relationship with your doctor is a first step. If you’re already living alone or about to embark on a new stage of life aging in place, talk to your physician about his or her expertise in preventing falls in the elderly. Chances are, you’ll be guided through an evaluation of medical risk factors that may require adjustments and potential modifications to your current routines, so be prepared with notes.

Fall prevention checklist

Your fall history: Have you fallen before? Have you had near-misses? Do you get dizzy when you stand up from a chair or sofa? Have you ever had to sit down rapidly or grab onto a piece of furniture or a countertop after rising because you felt you were about to fall? Has anybody ever had to reach out suddenly to steady you because they were afraid you would fall? These questions and more comprise your fall (and near-fall) history, and they can help you and your doctor to tailor a fall prevention plan centered around your personal risks factors and strategies to minimize your exposure to hazardous situations. Physical therapy or a structured exercise plan may be part of your doctor’s final recommendations.

Your medications: Not every medication increases the chances of falling, but many do, and many drugs interact with each other to increase fall risks where one medication alone originally did not. The danger increases when the number of daily prescriptions, over-the-counter, and supplements you take rises above five. Review current medications and dosages with your doctor and see if there are any that can be reduced, discontinued, or swapped out for different preparations that are less likely to cause a fall due to dizziness, weakness, or other side effects.

Your existing health conditions: If you have diseases, disorders, and/or conditions that compromise balance, vision, hearing, produce joint pain with movement, or reduce your feeling/sensation in feet and legs, these factors could increase your risk of falls. Your doctor will want to evaluate your gait (the way you move and walk) and work with you to mitigate these risks to the extent it is possible, possibly in also work in cooperation with occupational or physical therapists who can design a regimen of balance and strength exercises if you need them to reduce the chances of tripping or falling.

Turn your home into a safe haven

Fall prevention in the elderly begins with modifying the home: First, to strip away everything that could potentially cause unnecessary, unanticipated stumbles, trips, slips, or falls, and then to add extra safety features that can help prevent them.

Items to remove:

• Clutter and piles near walkways

• Throw rugs, unsecured bath mats, and worn carpets with loose threads or holes

• Extension cords

• Furniture with visually obscured edges feet that are easy to stumble/trip over

• Loose tools and maintenance items stored in the yard, garage, and driveway

• Broken, uneven, cracked, or otherwise dangerous steps, sidewalks, patios, pathways, and other walking surfaces

• Ladders (hire help, ask someone for assistance, or use assistive devices to reach higher than you can otherwise reach unassisted)

Items to consider adding (as budget permits):

• More light, everywhere (overhead, lamps, sconces, night lights); install motion-sensors and/or consider using voice-assisted technology to make turning lights on and off easier, without having to hunt for switches in the dark

• Grab bars in and around showers, toilets and bathtubs

• Hand rails on both sides of staircases, and/or a chair lift/elevator

• Single-floor living accommodations

Let technology help with fall prevention in the elderly

Even the best-laid plans can go awry from time to time (that’s why they’re called accidents, not intentionals). As cellular and Wi-Fi technology and the Internet of Things evolve, along with artificial intelligence and connected medicine, researchers and health policy experts are working together to find new ways to improve the health of our senior population as members of the Baby Boom generation enter their golden years.

Fall detection technology is already helping seniors and their families feel safer and more secure in their homes today by alerting emergency responders and caregivers when an older person needs help or when a device detects a fall.

But evidence for the role of technology in keeping seniors safe is only beginning to emerge. In a small-scale University of Illinois pilot study (part of the National Institutes for Health Women’s Health Initiative), 67 women over the age of 60 were tracked for a week using active monitoring technology. In this pilot research, “data extracted automatically from the devices could accurately predict the participants’ risk of falling, as measured by physical examinations of unsteadiness in standing and walking.” (emphasis added)

While the widespread application of predictive fall-monitoring technology may be a way off, every older person living at home today can benefit from the additional peace of mind offered by a Personal Emergency Response System (PERS), which can help to drastically reduce response time when a fall in the home does occur. Combined with smartphones and communication apps that link sandwich generation caregivers to their loved ones more seamlessly than ever before, technology is helping to eliminate many of the sources of persistent stress and worry about Mom and Dad’s safety at home.

We may not yet know how to prevent falls in the elderly 100 percent of the time, but we do know a great deal about how to mitigate the risks. Fall prevention in the elderly at home is a matter of systematic planning and execution to create a more secure environment for our independent seniors.