A Focus on Safety: Our Eight-Step Approach

“An ounce of prevention is worth a pound of cure.” -Benjamin Franklin

Sadly, falls are the leading cause of unintentional home injury and death in the United States. Older adults are by far the population at greatest risk, with over one-third of all seniors over 65 falling every year. Afflicting seniors disproportionally are such things as arthritis, strokes, problems with balance and eyesight and lower body weakness—and all can increase a senior’s risk of a fall.

Some statistics: Every year, an average of 3.8 million residential fall injuries result in an emergency department visit. The rate of deaths associated with falls increases substantially with age, with the majority of deaths occurring among those over 65. Men are more than twice as likely as women to die from fall-related injuries.

Those are pretty sobering numbers. And unfortunately it’s only half of the story. Though most seniors do survive fall-related injuries, the fear of another fall, or the aftereffects of a fall, can cause seniors to retreat into a protective mode. They may curtail their normal activities, put an end their independent lifestyle, and thus begin to deteriorate both mentally and physically.

Sadly, we hear this story far too often. What begins with an injury from a fall ends with a loved one never really being the same again.

Thankfully, there’s something you can do about it.

Most Falls Are Avoidable with Preventive Measures

With the implementation of a few commonsense safety measures one can ensure a safer living environment for senior loved ones, and drastically reduce or prevent the occurrence of falls. Here’s a simple eight-point plan you and your loved ones should try to remember to follow:

  1. See your doctor 
  2. Have your vision checked
  3. Exercise regularly
  4. Wear sensible shoes
  5. Practice home safety
  6. Light up your home
  7. Use assistive devices
  8. Buy an alert device (just in case)

See the Doctor

The best way to start your fall-prevention plan is by making an appointment with your loved one’s doctor. Prepare for the appointment by writing down all your questions. Make a list of all the medications he or she takes—both prescription and over-the-counter—or, alternately, just bring them all with you to the appointment. It’s vitally important to always keep in mind that the body has physically changed with age. The way medicine affects the body can also change: some medicines, or combinations of medicines, can make one sleepy or dizzy, and can cause one to fall. Ask the doctor to review the list of medications for potential side effects and interactions that could increase the risk of a fall. The physician may want to consider weaning your loved one off certain medications, such as sedatives and antidepressants.

Remind your parent or loved one to be prepared to give their honest medical history and to let the doctor know if he or she fallen before. You may want to have written down the details of falls before the doctor visit, detailing when, where, and how they fell. This list should include those instances when they almost fell but were caught by someone, or managed to grab on to something that prevented them from falling. A detailed history is helpful for your doctor’s formulation of the best possible and most specific fall-prevention strategy.

Have your loved one detail how comfortable they are when they walk. For example, does he or she feel any dizziness, joint pain, numbness or shortness of breath when they are walking? Your doctor may evaluate their muscle strength, balance and walking style (gait) as well.

Certain eye and ear disorders may increase one’s risk of falls. If necessary, ask your doctor for a referral to an occupational therapist. He or she can help you brainstorm other fall-prevention strategies.

Have Their Vision Checked

It’s simple. It’s easy. It makes perfect sense. Have your loved one’s eyes checked by an eye doctor at least once a year. They may be wearing the wrong glasses or have a condition, such as glaucoma or cataracts, which limits their vision. Poor vision can obviously increase one’s chances of falling.

Exercise Regularly

We all need to remember to Keep Moving! Lack of exercise leads to weakness and increases one’s chances of falling. Physical activity, especially as part of a regular exercise program, can go a long way toward fall prevention. With your physician’s blessing, consider low-impact activities such as walking, water workouts or even tai chi, the gentle exercise program that uses slow and graceful dance-like movements. Physical activity, however one gets it, will reduce the risk of falls by improving strength, balance, coordination and flexibility.

If your parent or loved one avoids physical activity because they are afraid it will make a fall more likely, tell the doctor. He or she may recommend carefully monitored exercise programs, or refer your loved one to a physical therapist. The physical therapist can create a customized exercise program aimed at improving his or her balance, flexibility, muscle strength and gait.

The benefits of exercise are too numerous to list here, but they include improvements to both physical and mental health. When one exercises regularly, one is guaranteed to feel better, while reducing their risk of falling. Exercise, quite simply, is the classic win-win.

Wear Sensible Shoes

Here’s another simple, commonsense recommendation: Analyze your parent or loved one’s footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make one slip, stumble and fall. So can walking in stocking feet.

Instead, we recommend properly fitting, sturdy shoes with nonskid soles. Avoid shoes with extra-thick soles, and choose lace-up shoes instead of slip-ons. Make sure to keep the laces tied. If your loved one has trouble reaching and/or tying shoelaces, choose footwear with fabric fasteners for a snug but comfortable fit. Finally, have their feet measured each time you buy shoes, since foot size can change at any age.

Practice Home Safety

Take a look around your loved one’s home and living environment. The living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. We at Good Company Senior Care invest a lot of time in seniors’ homes analyzing safety factors and removing home hazards. We have a very long checklist of items that we consider in every home.

Good Company provides a complimentary home safety assessment to everyone we meet with, whether they hire us or not. It’s that important. Half or more of all falls happen in and around the home. For the purposes of this article, we’ll focus on a few highlights to make the home safer, from the ground up.

Let’s start with the floor: Remove loose throw rugs unless you can secure them with double-sided tape, tacks or slip resistant backing. Remove boxes, newspapers, electrical cords and phone cords from all walkways. Wires should be tucked away or taped to walls and corners. If you have loose floorboards or carpeting, have them repaired right away.

If you have wooden or tile floors, make sure to use nonskid floor wax. All spills should be cleaned up immediately. Importantly, nothing—including papers, books, clothes, and shoes—should be left on the floor. That goes double for areas around steps and staircases. In the bathroom, bathtub, and shower, make sure to use nonslip floor mats only.

There’s an art and a science to arranging furniture (They don’t call it Feng Shui for nothing). This applies to placing furniture specifically to avoid falls and to provide safe, easy access—especially for those seniors who become confused at times. Although changes can sometimes cause stress for your senior loved one, it’s vitally important to get this right. Each home is bit different, so we recommend that you have an experienced professional do the job. But it goes without saying that you can begin the process yourself by moving coffee tables, magazine racks and plant stands out of high-traffic areas.

Finally, keep those items used often by your loved ones in cabinets that are easy to reach, without their using a step stool. Never leave clothing, dishes, food and other necessities out.

Light Up Your Home

With apologies to those who rightly want to save energy, this is not the time to worry about shutting off all the lights at night. To prevent falls, keep the home brightly lit during the day—and strategically lighted at night. The goal is to avoid the senior’s running into or tripping on objects that are hard to see. Place a sturdy, hard-to-knock-over lamp within reach of their bed for middle-of-the-night needs. Place nightlights in the bedroom, bathroom and hallways; and make sure that there are clear paths to all light switches. We recommend switching out traditional light switches for glow-in-the-dark or illuminated switches. Keep lights on near steps or staircases at night. And, finally, keep flashlights in easy-to-find places in case of power outages.

Regarding the common aversion to “leaving the lights on, “ a quick story: One of our clients complained that they couldn’t sleep at night knowing there was a light on somewhere in the house. A soft and silky sleeping eye mask was the right solution for a good night’s sleep.

Use Assistive Devices

The doctor might recommend using a cane or walker. If you purchase a walker, we recommend one with wheels. Two brands of walkers that get high reviews online are Invacare and Guardian.

Other assistive devices can help, too. For example, in the stairway one could install handrails, nonslip treads for bare wood steps, and additional lighting. Or in the bathroom: grab bars and a sturdy plastic seat for the shower or tub, plus a handheld shower nozzle for bathing while sitting down. Another common bathroom improvement is a raised toilet seat, or one with armrests.

Some of these solutions are easily installed and relatively inexpensive. Others may require professional help or a significant investment. If you’re concerned about the cost, remember that an investment in fall prevention is ultimately an investment in your loved one’s independence and your peace of mind.

Buy an Alert Device (just in case)

A handy innovation commonly available to help in an emergency is an alert device. (Think, “I’ve fallen and I can’t get up,” the well-known Life Alert® slogan.) The senior can carry this alert device wherever they go, usually in a watch, bracelet or necklace. In the event of a fall or other accident, they can easily set off the alarm, directly contacting local fire and paramedics. With these devices, help is just minutes away. They save thousands of lives every year.

Reach Out for Help

Some of this information, perhaps a lot of it, might at first seem overwhelming and the many changes suggested a daunting prospect. But remember, you’re not alone. Perhaps the most important thing to do is reach out for help, for yourself or for a loved one. I’m proud to say that Good Company Senior Care has helped thousands of seniors with its complimentary home safety assessment. Many other companies—including home modification companies—do the same. We all share this responsibility to protect our loved ones as they age, just as they once protected us when roles were reversed.

Jack C. Merrick is the co-owner and co-executive director of Good Company Senior Care, an independent, in-home caregiver service with offices in Los Angeles and San Bernardino Counties.