Falls can occur for many different reasons, but fortunately there are a number of preventative measures that can be taken by personal as well as professional caregivers to significantly reduce a senior’s risk of falling and incurring a serious injury. Preventing a fall is something to take seriously. I have seen firsthand how a fall many times results in long recovery times. Making sure my loved one doesn’t fall should be on the top priority list for anyone looking after seniors who are fall risks. I am going to provide some tips below, but I want to first make sure people are aware of what the intrinsic and extrinsic risk factors are that cause falls in the home and what the difference is between them. Intrinsic risk factors pertain to the client’s own body as well as the effects of aging and extrinsic risk factors pertain to the client’s home environment. Now that we know the difference, let’s look at a list of both intrinsic and extrinsic risk factors.
Intrinsic Risk Factors Personal Risk Factors
• Advanced age of 65+
• History of previous fall(s) Acute Medical Conditions
• Low blood pressure/orthostatic hypotension
• Stroke
• Seizure Chronic Medical Conditions
• Parkinson’s disease
• Arthritis
• Meniere’s disease
• Poorly controlled diabetes or epilepsy
• Brain disorders Chronic Medical Conditions
• Cataracts
• Glaucoma
• Heart rhythm abnormalities
• Alzheimer’s disease and other dementias
• Osteoporosis Physical Conditions
• Balance and gait (unsteady manner and style of walking)
• Musculoskeletal system − Muscle atrophy due to limited physical activity − Joint stiffness due to calcification of tendons and ligaments − Increased curvature of the spine associated with inability to maintain balance and proper posture
• Mental status − Impaired memory − Confusion − Disorientation
• Vision − Decline in visual acuity − Decreased night vision − Altered depth perception − Decline in peripheral vision − Glare intolerance − Dizziness
Extrinsic Risk Factors/Home EnvironmentCondition of Ground Surfaces
•Uneven walkways
• Floor coverings with loose or thick-pile carpeting, loose mats or sliding rugs, upended linoleum or tile flooring, highly polished or wet ground surfaces
• Clutter, personal items or pets in pathways Bathtubs and Toilets (i.e., equipment without support, such as grab bars) Design of Furnishings (i.e., height of chairs or beds and lack of handrails on stairs) Illumination Conditions (i.e., low intensity or high glare) Extrinsic Risk Factors/Medications Polypharmacy (takes 4 or more medications)
• Drug-drug interactions and side effects
• Cardiac medications
• Hypoglycemic agents Affects the Central Nervous System
• Sedatives/hypnotics
• Antihypertensives/diuretics
• Analgesics
• Antidepressants
• Alcohol Can Cause Urgency in Elimination (i.e., laxatives and diuretics) Can Cause Postural Hypotension (i.e., antihypertensive and diuretics) Treatment Supplies (i.e., tubing for IV medication or oxygen therapy) Extrinsic Risk Factors/Other Type and Condition of Footwear
• Improperly-fitting shoes from edema or other foot problems
• Heavy orthopedic shoes
• Incompatible soles − Rubber crepe soles which may stick to linoleum floor surfaces − Slippery soles − High heels Assistive Devices
• Improper use of device (i.e., bedside rails left up resulting in fall risk from patient climbing over)
• Inadequate assistive devices and lifting devices
• Canes (i.e., wrong height, worn tips, improper use)
• Walkers (i.e., wrong height, broken, wrong type, does not fit home environment)
• Wheelchairs (i.e., brakes not properly working, which can impair transferring techniques and activities)
First and foremost I want to say, Consult Your Doctor, falls and fractures are not an inevitable part of growing older, and many can be prevented. Your doctor can assess your risk of falling and suggest personalized strategies for improving mobility and preventing injury and then a caregiver can help to keep you or your loved one on track with the personalized strategy. Remember, there are minor changes and home modifications that can significantly reduce seniors from falling. Below is a list of some preventive measures you can take.
Engage in Regular Physical Activity
Regular physical activity is the first line of defense against falls and fractures. As people get older, they typically become less active and begin to lose muscle mass and tone. This leads to a decrease in strength, coordination, and flexibility and an increase in fall risk. Work with a doctor or physical therapist to create a exercise program that is right for yourself or an aging loved one. A regular exercise regimen can help seniors improve their stamina and mobility, regardless of their age.
Create a Fall-Proof Environment
A loss of footing (tripping) and traction (slipping) is to blame for most falls. An ideal, fall-proof home environment features even, non-slip walking surfaces throughout. Make an effort to keep rooms free of clutter, especially the floors and walkways
Keep floor surfaces clean and dry but not slippery.
Check that all carpets and area rugs have skid-proof backing or are firmly secured to the floor, including carpeting on stairs. Be sure that all stairwells are adequately lit and have sturdy handrails on both sides. A good tip is to put fluorescent tape on the edges of each step to avoid missteps. Install grab bars on bathroom walls beside tubs, showers and toilets. I have heard some horror stories regarding the suction cup hand bars so beware of those, they may seem strong, but can fail when you need it most.
Use non-slip strips to provide added traction on the floors of showers and bathtubs since the bathroom is one of the most common place falls occur among seniors. Make sure that light switches are located near the entry points of each room to prevent fumbling in the dark. Another option is to install voice- or sound-activated lamps. Reorganize closets, cabinets and other storage areas to minimize the need to bend down or reach up to retrieve commonly used items. Consider hiring a professional organizer and mover. I will list a personal contact below.
Use The Proper Mobility Aids
A lot of people have a mentality of saying that they’re fine and don’t need to use the walker, cane, etc even though these mobility aids can save them from an unnecessary fall.
Choose Appropriate Footwear
Seniors often have a favorite pair of shoes or slippers, but if they’re worn out it can cause a serious fall. Make sure to avoid walking around in socks, stockings, or backless slippers.
Receive Regular Eye Exams
Seniors that have difficulty seeing are more prone to falling. Encourage aging loved ones to wear their eyeglasses and whatever else so they can see their surroundings clearly. Regular eye exams are so important for ensuring a senior is wearing the correct prescription and also screening for eye diseases.
Manage Medications Properly
As we get older, we’re more likely to suffer from a variety of medical conditions that require medications. Seniors with illnesses that affect their circulation, sensation, mobility or mental alertness are more likely to fall. Certain prescriptions cause side effects, such as dizziness, confusion, drowsiness, fluctuations in blood pressure or slowed reflexes, all of which can contribute to a fall as well. Over-the-counter medications and supplements can cause problems as well, so be sure to include these when talking to your doctor.
Falls Should Never Remain Secret
Even though one in every four adults aged 65 and older experience a fall each year, unfortunately fewer than half of these individuals tell their physician about it, according to the Centers for Disease Control and Prevention. Seniors sometimes are afraid to tell people because they’re both embarrassed and can also see the impending reliance on others for assistance. It’s natural to want to keep these incidents a secret, but doing so may only make things worse later on.
Awareness of this problem can help family members work together to come up with solutions and make a senior’s home a safer place. This is especially important if falls are occurring more frequently. Small modifications like reducing clutter and installing grab bars can make a tremendous difference.
Regardless of whether it is you or your aging loved one who experiences a fall, it’s essential to notify a doctor about the event. He or she can make sure no injuries were sustained and suggest ways to prevent future falls. Stay tuned for tips on Safely Picking a Loved One (or Yourself) Up After a Fall.
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Kathleen Mazza-President
Island Transitions
Work: (631) 421-3781
Mobile: (631) 816-6886
Kathleen@islandtransitions.us
(631) 581-9000
SeniorCare Companions, Inc.
150 Islip Avenue, Suite 2, Islip, NY 11751
Phone (631) 581-9000 Fax (631) 446-1584
www.seniorcarecompanions.com
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