ELDER MUSIC: Chamber Music
Unnecessary Personal Update

Home Safety for Elders: Preventing Falls

category_bug_journal2.gif Last Friday, we discussed home maintenance for elders. It was about general upkeep and decorating so I think it is important to talk about safety issues too.

Twelve or 14 years ago, I ran the website of the Professional Team Physicians, mostly orthopedists who treat the injuries of pro sports players – famous and not.

The site was aimed at accomplished amateurs who were equally prone to ACL (anterior cruciate ligament), meniscus and other joint traumas that often require surgery and sometimes lengthy at-home recovery.

One of the most popular stories we ran was about how to prepare a home for a safe recovery when the patient is likely to be on crutches, hobbling about with a cane or moving around tentatively until fully healed.

What's good for a young athlete applies equally to an elder's well being because among people 65 and older, falls are the leading cause of injury deaths and serious injuries, and about half of all falls happen at home. So that's what we'll concentrate on today.

Number one: throw rugs: Get rid of them. Failing that, use heavy-duty, double-sided tape to attach them to the floor and replace the tape regularly for optimum stickiness.

Put away toys. That's what we told young parents and it could apply to grandparents who keep playthings around for when the kiddies visit.

Even without grandchildren, there are all sorts of things to remove from walking areas: piles of newspapers, magazines and books; clothing; shoes; golf bags leaning against the wall; musical instruments.

Years ago, I damaged a boyfriend's guitar when I tripped on it, but in old age it might have been me too. Whatever you accumulate, place it where no one can bump into it.

Particularly, keep anything at all off stairs, and it should go without saying that all stairs should have strong handrails.

Cables, cords and wires. Make sure none of these cross traffic areas. If a cord must run along a wall to reach an electrical outlet, tape it to the wall or use staples that are made for that purpose available at all hardware stores.

Remember, too, that electrical cables should never be placed under rugs, mats and carpeting. That is a fire hazard.

Grab bars. In the shower, tub and next to the toilet – at least one and preferably two in each place.

Non-skid mats in the tub and on the bathroom floor. Soap residue is extremely slippery.

Arrange your kitchen with most frequently used items on lower shelves so you don't need a step stool to reach them. When you must use one, be sure it has rubber-grip feet and is stable.

Because our eyesight fades with age, lighting is important. Brighter lights may be necessary. Stairwells should be well lit with switches at both the top and bottom of the stairs. It is good to add lighting to dark corners and nightlights are useful to guide us to the bathroom in the dark.

Recently, I discovered a new falling hazard the hard way: a too-long bedskirt that I tripped on while making the bed. So check your home for anything in which you might get your foot tangled.

(By the way, if anyone knows where to buy bedskirts with a 12-inch drop, do let me know. There seem to be none any shorter than 14 to 18 inches. Who sleeps in beds that high off the floor anyway? And wouldn't that be another fall hazard?)

In future posts, I'll talk about other kinds of home safety measures for elders, but if I've missed anything about falls today or you have other suggestions, please leave them below in the comments.


At The Elder Storytelling Place today, Lois Cochran: A Wet Monday


Comments

There are two things I would like to suggest:

Keep collapsable step ladders somewhere near, in the kitchen or any other room that you are likely to have to reach for something on a high self. Experience shows that if the step ladder is not nearby, then many try and stretch up to reach for the object. Thus putting their back and head (if the object falls down) at risk.

Put small lightweight baskets at the top and bottom of the stairs. Get into the habit of carrying things on the stairs in the basket. You can carry the basket with one arm and the other hand is free to use the stair rail. The old sailor's rule "Always have one hand free" should be used as much as possible when you get older.

Great article!

In the midst of having 2 bathrooms remodeled, my husband had an emergency quadruple bypass. We did have grab bars installed, but the best changes were comfort level commodes. I wish someone would tell hotels -most with what my plumber calls kiddie stools. They are a challenge for aging knees. Mary in Missouri

Pets: On the one hand they say pets are very good for us (and they are), yet they do get in the way. We're frequently waltzing around our two cats and one dog.

I thought about bathtub rails this morning. I am in a hotel that does not have them and the pebbled floor surface of the tub seemed not enough to keep me from slipping,although I managed to get out of the tub okay. All tubs should have them, especially in hotels!

I echo kenjo's comment. My mom lived with us the last four years of her life, and I enjoy all the safety features we installed in the bathroom. Hotel tubs make me nervous.

I am always baffled that hotel chains don't decide to do something that makes them stand out--safe bathtubs, big towels--that made them more attractive than the competition.

Another fall prevention tip is to have lots of sturdy things to grab onto to if you start to slip. My mother broke ribs grabbing onto to a fortunately lightweight TV set, which toppled over..

Lots of good things to consider in this post.

I was going to add pets, but someone beat me to it. I wouldn't advocate giving up a beloved pet, but be aware that many falls are caused by an animal affectionately winding around ones legs.


We need to be careful when taking medications that might make us drowsy, dizzy or unsteady, and thus more likely to fall.

Even without meds, we can become less sure-footed as we age.

So we need to pay closer attention to everything around us as we move about than we needed to when we were young and could rush around "multi-tasking."

Keep an eye out for the open cupboard door, the liquid on the floor, the stones on the driveway.

Several years ago, my mother (now 94) fell and broke her hip. Company had just arrived and some snow dropped from their luggage onto the kitchen floor. My mother, in a hurry, didn't see the resulting water on the floor. Down she went.

Note to self: Do not be in a rush. Pay attention!

I had grab bars installed in my shower and next to the toilet after breaking my hip. I also removed all scatter rugs.

Instead of a step ladder I use a grab bar to reach things on the highest shelves and only store seldom used items there.

A couple of years ago I took one fall after another until I figured out it was my tennis shoes that had a toe which if I wasn't careful and there was uneven ground ahead (these all happened outside), they would grip it and throw me. I didn't get rid of them but I learned to raise my foot higher when walking and became more aware of what shoes I am wearing-- in the house and out. A lot of hiking tennis shoes have those kind of toes for runners and they can catch on many things. So I'd add watching out for what footwear one is using inside or outside.

Re: bathtubs in hotels. Does anyone actually use them as bathtubs and not just use the shower? Recently I was in a hotel with a nice big shower were the tub used to be. Wonderful! And without the risk of climbing in and out of a tub which is a challenge for someone with short legs.

Although I have some older characters in my episodes about quilting and sewing circles, in retrospect I always wish I had included more. After reading this post, I wondered if anybody has had experience with using some "fall-breaking" pads that you wear around your legs? Sounds like a good idea but could be too uncomfortable....

Having been handicapped for over 30 years, I can attest to usefulness all of the tips offered here. However, the biggest thing we need to do is: SLOW DOWN. I get in trouble if I try to rush. The biggest lesson I've learned is that patience really is a virtue and that it doesn't matter how long it takes to do something -- only that it gets done.

In the kitchen, I keep things I use often at waist to shoulder level. If I have to get down on my knees to reach those lower shelves, I can't get up again. Ditto tubs.

It is really important to keep your wits about you. I forgot that yesterday and almost took a bad fall.

About the bedskirts: One day (coincidentally near an approaching long-distance move), I was ironing--yes, ironing--a bedskirt, and I snapped awake as though from a dream. "I don't have time to manage this kind of drivel anymore!" I cried, and the bedskirts went off to the thrift store.

Solution: Bedspreads, like everybody used to have. Hard to find these days, but so worth it for the ease of use and care.

To this day, when I walk through linen departments and see 22-piece "beds in a bag" (with the associated throw pillows, shams, Euro shams, bolsters, duvets and extra covers, and of course, wrong-sized bedskirts), I still think, "WHY!!?? Why would any sane person spend their time on this stuff?"

Even with this crabbily practical elder perspective, I am guessing that the bedskirts are so long because contemporary beds are so huge. The beds are huge, like much other new furniture, to fit the gigantic McMansions of the late, great housing boom.

And we all know how that turned out.

Paula, I think you've got a point. And I don't even need a bedspread. The quilts I use fall about two inches up from the floor which is fine. I don't need a bed skirt and I'll remove it today.

Regarding gigantic beds, you're right on that too.

Apparently full size, which I have, is being phased out. It's been difficult for years to find bed linens for it. Most sheets, quilts, etc. are for single, queen or king beds.

Good points, good article, Ronni. I guess I should be more concerned about falling than I am, but so far I've stayed on my feet with reasonable attentiveness and awareness of my situation. I still have throw rugs, but except for larger ones, those in our walking path are secured. We don't have grab bars in our bathrooms and haven't needed them so far. I'm fortunate in that I don't have any problem getting out of the tub (it has a no-slip bottom surface).

Regarding beds, my husband and I have a kingsize bed in a smallish condo bedroom. It's marvelous for giving each of us (and our 3 cats) enough room to turn over without waking everybody up. I'd miss it.

Recently, sadly, I was suddenly widowed for the second time......our home was already very safe to navigate, but since it is a large home and lots of acreage, secluded, I signed up/bought and have a medical alert system. I also have a lock box with a key for police/fire and friends/neighbors who don't already have a key. It gives me great comfort to have this. I also keep aspirin and water in my car, purse and on night stand...in case a symptom arises and aspirin is good to take right off the bat. I am 65, very active, in good health and really have a problem with all the ageism, told my Docs, "age" is the new four letter word to me :-)Chronologically I am 65, psychologically, emotionally ,physically, no where near that. Good suggestions by all......

Slowing down really helps but shoes can be a problems. Slip on shoes especially. Slippers or clogs slip off. One of my clogs came off when I was chasing after my granddaughter into pre-school and I tripped over my own shoe and fell flat on my face. I was sore for a couple of days and got cuts on my hands but I think I was lucky.

Vision is often a factor in accidents.

You mentioned poorly lit areas and rooms Ronnie and I would suggest that an investment in small lamps using compact florescent lamps (CFLs) properly placed in such areas.

The CFLs cost a little more but last so much longer than the incandescent bulbs.

The law has changed where many commonly used incandescents will no longer be sold after this year but there will be some people who insist on hanging on to the older style bulbs. (Not all incandescent bulb are being phased out)

CFLs are really cheaper in the long run and you can leave them on longer without worrying about running up your electric bill. They are safe too despite what you have heard by many who oppose the change. An average thermometer has 125 times more mercury in it than a CFL.

If they break sweep up the remains, put it in a plastic bag and put it with your chemicals to be removed by city sanitation workers. Most city's have separate pick ups for chemicals.

Here is a great article in the Seattle Times that will answer most questions about this new law and how the changes will go into effect.

Others have addressed the issue of footwear before I got here--I live in senior housing and I'm appalled to see so many women shuffling down to the mail boxes in ill-fitting slip-on slippers or backless shoes, knowing that several of our residents have fallen from tripping on those, or on loose socks that extended beyond the fronts of the toes! Not to mention that many won't use a cane when they should because "it will make me look old!"
I want to say, "For Heaven's sake, Lady, you ARE old, and that's better than being DEAD from a broken hip!"

Sufficient light can be problematic. We use LEDs (expensive!) and also CFLs wherever we can, but I find that CFLs do not provide the same level of brightness, although they're improving. It's hard to find bulbs of any kind OR lamps at a reasonable price that will produce 100+ watts of light (or the equivalent). Most lamps call for 40 to 60 watt bulbs, which is ridiculous for many people over 55--that is, if they wish to see.

I don't know where Larry resides, but it's great that his city picks up household chemical waste. Our city does not. Reluctantly, we ended up throwing some possibly-questionable items in the trash this weekend, but it was either that or try not to trip over them until the next twice-yearly household waste disposal day comes around. Even then, we'd have had to transport the items to the disposal site ourselves. Supposedly, we live in an ecologically-forward state and city, but disposing of chemical products, old paint, broken CFLs, etc. is neither easy nor convenient!

Great house for sale: on small lake; ten minutes from beach; light, bright and airy. Perfect for family with kids. Not so hot for sixty-something retirees and hopeless for wheel chairs. Make me an offer.

I still enjoy riding my bike, but learned the hard way to habitually pause to get balanced and safely positioned after stopping. Then I carefully swing my not so flexible right leg over center, well balanced on the left one. I once stopped quickly, and fell on my back in the street because my foot hung up on the center bar. I didn't have my helmet on, either (it was a "short trip") and hit my head pretty hard. Riding is great exercise and a lot of fun, but as with many activities, more caution and mindfulness is required to avoid bad spills for us elders.

A friend that I work with recently remodeled her kitchen and she put in lots of cabinet and shelving lifts; in anticipation of aging in place and to make more of her space accessible and usable (She is small at 5 ft) Universal Design Products has some good videos showing how they work. http://www.universal-design-products.com/
I can't remember what they cost her to install; but she likes them so much better than getting out a step ladder.

The comments about tripping on pets reminded me of the Sheltie that I had growing up.

One of my sisters was blind. Whenever she visited we noticed that the dog changed her routine, such as hanging around under the kitchen table and behind or close to pieces of furniture to avoid being stepped on.

When we had one of our bathrooms remodeled in late 2008 we had it designed for "aging in place" - wider pocket doors, seat in oversized shower, shower head that could be used as hand-held, extra studs in walls for future grab bars, etc.

Our builder kidded us that we were only in our 60s and were building as though we were in our 90s.

In March, 2009 my husband had a heart attack followed by pneumonia. He spent 2 months in the hospital and rehab.

When he finally got home we were soooo glad that we had the "aging stuff" done.

[Although he has recovered, it's still nice to know its there.]

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