According to the Centers for Disease Control and Prevention, falls are a preventable public health problem, but nevertheless, one in three people age 65 and older falls every year. The rate of deaths related to falls has risen in recent years, and the associated direct medical costs are estimated to be over 30 billion dollars.
Consequences of Falls
Up to 30 percent of people who fall are significantly injured with cuts, fractures and head trauma. Many, especially people over age 75, end up in a long-term care facility for a year or more. A single fall can rob someone of their independence and ability to function daily.
How to Make Your Home Safe
The CDC reports that half of the people who fall do so at home. While some falls may occur independent of environmental factors, homes can be made safer by taking the following steps:
Inside the Home
- Remove clutter: Furniture and other belongings can block clear pathways.
- Improve lighting, but reduce glare from windows: Combining poor lighting with vision problems that often accompany aging can lead to trips and falls. Glare from windows can cause a temporary obstruction of vision.
- Install handrails and grab bars or railings: These make it easier to get up and down stairs, in and out of bathtubs and on and off the toilet. Using non-slip mats in the bathtub is an added safety measure.
- Wear the proper shoes while indoors: Socks can slip on floors and age-related reduced sensation in the feet can make it hard to feel the floor or balance properly. Wearing lace up shoes (which stay on better than slip-ons) with non-skid soles is safer.
- Secure rugs: Double-sided tape can be used on loose scatter rugs and any irregularities in carpeting should be repaired.
- Use assistive devices: People should use prescribed canes, walkers or prostheses. Using a gripper can help reduce the use of step stools when trying to reach items in hard-to-reach places. Installing a chair-lift system can make it easier to get up and down stairs.
- Get a home safety evaluation: Occupational therapists are experts in home safety and can point out fall hazards. They can also recommend modifications that are individualized for each person’s home. A doctor or other health professional can provide a referral for these services.
Outside the Home
- Install or repair railings: Stairs, stoops or long sidewalks should have sturdy railings.
- Be vigilant about walking: Walk slowly and carefully and stay in well-lit areas. Curbs are a particular safety hazard, so getting assistance from another person is prudent.
- Wear proper shoes for the weather: Lace-up shoes or boots with non-slip soles are safest.
- Be aware of changing surfaces: Pollen in the spring, leaves in the fall and snow and ice in the winter can make pathways slippery. Have someone clear sidewalks of weather-related obstructions or any other debris that accumulates. In winter, carry a small bag of sand, ice-melt or cat litter to use in public areas that may not be cleared.
Other Ways to Prevent Falls
Falls can happen for other reasons even if the home has been made as safe as possible. Older adults should see their primary doctor to discuss the following risk factors:
- Health conditions: Several common health conditions can put older adults at risk for falls including disorders involving the eyes or ears, muscle weakness, arthritis and other joint disorders, high blood pressure, osteoporosis, breathing difficulties and foot problems.
- Medications: Side effects of medicines are another reason for falls. Sedatives, antidepressants and blood pressure medicines are just a few examples. Some people take over-the-counter remedies that can also increase the risk of a fall—diphenhydramine in particular. This drug has been identified by the American Geriatrics Society as inappropriate for seniors except for special situations. Diphenhydramine is available alone as an allergy or sleep aid, and it comes in combination preparations for a number of uses. Seniors should provide their primary care doctor with a list of all medicines (including over-the-counter drugs or supplements and herbal preparations) they are taking. In some instances, changes can be made to reduce the risk of side effects.
Seniors can take further control of reducing their falls risk by taking a three-pronged approach to physical activity. Physical therapists can be useful partners in designing a program to meet anyone’s needs.
- Aerobic exercise: The CDC recommends 150 minutes each week of moderate-to-brisk exercise. To get to this goal, the activity can be broken up into 10-minute segments. Determining whether it is strenuous enough can be measured by the ability to hold a conversation with someone else while exercising, but not being able to sing a song. Exercising every day also reduces the risk for many chronic diseases, keeps the brain sharp and strengthens the heart, lungs and muscles.
- Muscle-strengthening exercises: Strong muscles support bones and joints and help to reduce the risk of falls and fractures. According to the National Institutes on Aging, muscle strengthening or resistance exercises should be done two or more times each week.
- Flexibility and balance exercises: Flexibility wanes with age. Stretching before and after exercising can increase flexibility and improve balance, as can doing simple balance exercises involving the wall or chair. Tai Chi, a martial art that enhances awareness of the body and involves slow movements, has been found in research studies to improve balance and strength in older adults and significantly reduce the risk of falls particularly among adults age 70.
Anyone with medical conditions or who is taking prescription medication should check with a healthcare professional before beginning any exercise program.
Less than half of people who fall at home never inform their doctors. It’s important for seniors to understand the scope of the problem and their personal risks in order to maintain their independence for as long as possible.