Preventing Falls in the Elderly: 9 Proven Strategies for Safety
The Silent Epidemic: Understanding Falls Among Aging Adults
Every year, a staggering number of aging adults experience falls —
moments that can shift their lives from independence to vulnerability in an instant.
These seemingly random incidents often have preventable causes,
whether it's a cluttered hallway, an unexpected side effect from a medication,
or just a poorly lit stairway.
Understanding the importance of fall prevention is not just about evading minor inconveniences;
it's about
ensuring continued quality of life
maintaining independence
minimizing severe health risks.
In this article, we'll explore 9 actionable strategies every individual and caregiver should know
to create a safer environment and reduce the risk of falls.
Whether you're an elderly individual aiming to safeguard your home
or a loved one looking out for an aging family member, these insights are vital.
I. Assistive Devices: More Than Just Support
For many older adults and individuals with mobility issues, assistive devices aren't just tools; they're lifelines.
These devices, ranging from canes and walkers to rollators,
provide the crucial support needed to navigate the world with confidence.
But, like any tool, their effectiveness relies heavily on choosing the right one and using it correctly.
Choosing the Right Tool for the Job
The world of assistive devices is diverse, and what works wonders for one person might be unsuitable for another.
Let's take a closer look:
Shuffling or Small-Stepped Gaits
If you or your loved one tends to take small steps, shuffle, or exhibit a festinating gait,
a rollator might not be the best choice.
It can outpace the user, leading to potential forward falls.
A standard two-wheel walker offers better support in such cases
and in post-surgical recoveries like total knee replacement or hip replacement.
Three-Wheel Walkers
While some folks swear by the nimbleness of a three-wheel walker,
it doesn't provide the same stability as its two-wheeled or four-wheeled counterparts.
Plus, the lack of a seat means you're without a resting spot if fatigue sets in during a walk.
Canes
Ideal for offloading an affected leg, but not the best tool for general balance.
The quad cane (above), while popular, might even be a trip hazard itself due to its base.
Personal Experience
Just to share a quick story, I once had a patient
who began experiencing hip pain after hip replacement surgery a couple of years prior.
Using a rollator, she complained of significant discomfort.
X-rays didn't provide any insights.
After switching to a two-wheel walker and adjusting her gait pattern,
her pain miraculously subsided.
The lesson?
Sometimes, the device makes all the difference.
Proper Use of Assistive Devices and Common Mistakes
Knowing which device to use is half the battle; the other half is using it correctly:
Always lock the brakes before sitting down on the rollator’s seat.
The photo above shows the brakes in a locked position
It sounds simple, but this oversight has caused more than a few unplanned tumbles.
Transitioning Safely: Proper Technique for Standing Up and Sitting Down
It's tempting to use your walker to help you get up or sit down...
...but this can lead to falls.
CORRECT TECHNIQUE: Instead, when standing up, push up with your hands from the chair or bed before grabbing your walker.
Similarly, when sitting down, ensure you feel the chair or bed behind you before releasing the walker and using your hands to guide you down.
Consistency is Key
Always use the device, even if you're only moving a short distance.
Many falls happen during short, familiar trips because people feel they don't need their assistive devices.
"Furniture walking", or relying on walls and furniture for support instead of the walker, defeats its purpose.
Maintenance
Regularly check the device for wear and tear.
Replace worn-out rubber tips on canes and walkers.
Ensure rollator brakes are working efficiently.
PRO TIP: Consider labeling assistive devices with an emergency contact number.
If the individual is found after a fall,
having a contact number readily available can expedite
getting help.
A Word on Gait Belts
For caregivers, a gait belt is an essential tool when assisting someone known to be at risk for falls.
It provides a safe way to guide and support an individual, ensuring their safety and the safety of the caregiver.
If you're a caregiver, don't skip this step; it's a simple measure that can prevent numerous accidents.
Ensure the belt is snug but not too tight, and always hold onto the belt (not the person) to provide support.
Caregivers should use proper body mechanics when assisting to avoid injuring themselves.
I have seen many caregivers with back problems, shoulder pain, and wrist issues.
Some of these problems come from overuse but paying attention to the body mechanics
might prevent many of these injuries.
II. Clear Vision: See Your Way to Safety
It's no secret that our eyesight tends to diminish as we age.
What might surprise you, however, is how profoundly vision affects balance and stability.
Clear, unobstructed vision is an essential component of safe mobility.
Ensuring that eyesight remains as sharp as possible is critical in the fight against falls.
Glasses: Your Constant Companion
Remember those reading glasses you sometimes leave on the nightstand?
Or are those distance glasses only used when driving?
They should be your constant companions.
Here's why:
Improved Depth Perception
As we age, our depth perception can waver.
Using glasses tailored to your vision needs can significantly improve depth perception,
helping you identify and avoid potential trip hazards.
Clear Boundaries
Ever misjudged the edge of a step or curb?
Glasses can help define edges more clearly, reducing the risk of missteps.
Regular Eye Exams: A Must
Yearly eye exams are more than just a routine checkup; they're a preventive measure.
Changing Prescriptions
Our vision can change subtly over time, often unnoticed.
Regular checkups ensure that you're always equipped with the correct prescription.
Eye Diseases
Conditions like glaucoma or macular degeneration can creep up without noticeable symptoms in the early stages.
Catching them early can help manage or slow their progression.
An Eye-Opening Incident
I once worked with a patient who consistently misjudged the step down from his apartment.
Despite numerous instructions and attempts to correct his technique, the issue persisted.
When delving deeper into potential causes, I discovered that he hadn't had an eye exam in several years.
His glasses, reflecting an outdated prescription, were the culprits behind his missteps.
After updating his eyewear, the difference was night and day.
This experience serves as a powerful reminder of how essential regular eye exams and up-to-date prescriptions are for safety.
Well-lit Path
While it's crucial to wear glasses and keep them up-to-date, ensuring the home environment supports clear vision is equally vital.
Adequate Lighting
Whether it's a trip to the restroom in the middle of the night or making your way to the kitchen, well-lit paths can significantly reduce the risk of tripping or bumping into obstacles.
Contrast & Markings
For those with severely compromised vision,
using contrasting colors (like brightly colored tape)
can help highlight edges, steps, or other potential hazards.
III. Clear the Path: Reducing Trip Hazards
You might recall our discussion on "Home Modifications for Aging in Place" where we dived deep into crafting a safe haven.
But here, let's address the sneaky trip hazards lurking in plain sight.
Roll Up Those Rugs
Or better yet, get rid of them altogether.
Those pretty area rugs might be aesthetically pleasing, but they're notorious culprits for causing trips and falls.
If you're sentimentally attached, consider using double-sided tape or non-slip mats to secure them.
Declutter, Declutter, Declutter
Have you ever found yourself doing a not-so-graceful dance around a magazine pile, a stray shoe, or a toy?
Time to Marie Kondo your space!
Keeping walking areas clear isn't just about tidiness; it's a lifesaving measure.
If you haven’t touched it in months, consider storing or donating it.
Pets - Cute Companions, Caution Required
Your furry friend isn't deliberately trying to trip you, they're just always excited to be around you!
It's crucial to be extra vigilant when moving around, especially during their hyper moments.
Consider designating safe play areas for them, away from walkways.
Regular Rounds
Make a habit of periodically inspecting your home for new potential hazards.
As time goes on, items accumulate, furniture gets shifted, and new risks can emerge.
A regular check ensures your pathways remain safe.
IV. Balance: The Art of Steady Movement
Our sense of balance can feel like a topsy-turvy seesaw as we age.
It's not just your imagination — legitimate physiological changes make staying upright a tad more challenging.
The Why
With age, muscle strength diminishes, reaction times slow down,
and even inner ear structures (vital for balance) can deteriorate.
Someone suffering from peripheral neuropathy
can find their balance greatly decreased
because of the decreased sensation in the soles of the feet.
Combine these factors, and it's clear why you might not feel as steady on your feet as you once did.
Steady as You Go
Before you answer that ringing phone from across the room
or respond to someone suddenly calling out to you, take a moment.
It's okay to let the phone go to voicemail or ask someone to wait a moment before responding.
Remember, sudden turns or abrupt changes in direction
can throw off even the most sure-footed among us.
Balance-Boosting Exercises
There's good news amid this balance conundrum.
You can improve it!
Simple exercises like heel-to-toe walking, leg lifts, and standing on one foot (with support, of course) can work wonders.
If you’re keen on group activities,
Tai Chi and yoga classes are popular options that focus on balance and core strength.
Plant your feet firmly on the ground
Stay aware of your surroundings
Avoid making sudden turns.
If you remember nothing else, let it be this:
moving slowly and deliberately is the name of the game.
That lightning-quick reflex you had in your 20s?
Give it a break.
Safety now takes precedence over speed.
V. Changing Positions Safely
The Unexpected Spin of Positional Changes
As we age, a simple act like transitioning from lying to sitting or from sitting to standing can cause lightheadedness and dizziness.
This lightheadedness, dizziness, and sometimes, fainting, could be caused by orthostatic hypotension
which is a drop in blood pressure that occurs when you stand up from a seated or lying position.
The symptoms associated with orthostatic hypotension are responsible for many falls.
To counteract these symptoms, you can employ the "Count to 10" technique.
The "Count to 10" Technique Explained
The principle is simple yet effective. Before making a significant positional change:
Stand, sit, or lie still for a moment.
Breathe deeply and steadily.
Slowly count to ten.
This brief pause allows the body, particularly the circulatory system, to adjust and equilibrate,
thereby reducing the dizziness that might arise from a quick position change.
It's a tool that requires no equipment, just a bit of patience.
The Correct Mechanics of Getting Up
Before standing, especially from a deep chair or couch, scoot to the edge
Plant both feet firmly on the ground
Lean forward
Use your arms and leg strength to push yourself up
Safety First
If you're aware that you often feel dizzy,
ensure that you have sturdy support nearby, like a table or chair,
when transitioning to a standing position.
Hydration Helps
Dehydration can exacerbate feelings of dizziness.
Drink adequate water throughout the day.
Keep Essentials Nearby
To avoid frequent positional changes, especially at night, keep essentials like water, glasses, or a phone within arm's reach.
Remember, the goal is always to prioritize safety over speed. It's better to take an extra few seconds for a safer transition than to hurry and risk a fall.
VI. Footwear: Treading Safely
The Ground Connection: Why Shoes Matter
It's easy to overlook, but the type of footwear we choose plays a pivotal role in our stability and balance.
A stable base can mean the difference between walking with confidence and a potential trip or slip.
As we age, the importance of safe, secure footwear becomes even more crucial.
Not only do our feet often face issues like swelling, bunions, or arthritis,
but our bones and joints also require more cushioning and support.
A good pair of shoes can be a valuable investment in one's safety and mobility.
Common Footwear Faux Pas
Walking in Regular Socks
Without non-slip soles, regular socks can make smooth surfaces like tiles or hardwood a slipping hazard.
Slick Soles
Shoes with smooth or worn-out soles can be a recipe for slips, especially on wet or polished surfaces.
High Heels or Elevated Platforms
These might look stylish, but they significantly affect balance and are not the best choice for daily wear, especially for older adults.
Flip-flops or Slides
While they're easy to slip on, they provide no ankle support, and the foot can easily slide out.
Loose-Fitting Shoes
Shoes that don't fit snugly can lead to unexpected movements, increasing the risk of trips.
Old, Worn-Out Shoes
Beyond the sole issue, shoes that have lost their shape or structural integrity can affect gait and balance.
The Ideal Footwear for Stability and Comfort
Non-Slip Soles
Shoes with rubberized or textured soles can provide better traction, reducing the risk of slips.
Arch Support
Proper support can help distribute weight evenly, reducing foot fatigue and aiding balance.
Easy-to-Use Fasteners
Velcro straps or slip-on designs can be especially beneficial for those who have difficulty with laces or simply want a faster, safer shoe-wearing experience.
Low, Stable Heels
A lower center of gravity aids in balance, and a wider heel provides more surface area for stability.
Breathable Materials
Shoes made of breathable fabric or material can prevent excessive sweating, reducing the risk of the foot sliding within the shoe.
VII. Medications: Beware of Side Effects
Many of us take medications to manage various health conditions...
...but it's essential to understand that sometimes these very solutions...
...come with their own set of challenges...
...especially when it comes to balance and cognition.
Potential Culprits
Many common medications can influence balance or cloud judgment.
These include but aren't limited to:
sedatives
dizziness
drowsiness
confusion
antidepressants
dizziness
drowsiness
weakness
antihistamines (allergy medications)
drowsiness
blood pressure medications
dizziness
lightheadedness
opioid painkillers
dizziness
drowsiness
confusion
While these drugs may be crucial in managing health conditions...
...their side effects can increase the fall risk.
Stay Informed
Knowledge is power.
Make it a point to attend regular medical check-ups.
Discuss your complete medication list with your doctor...
...emphasizing any recent balance or mental clarity changes.
Sometimes, adjusting a dosage or switching to a different medication can make all the difference.
Pharmacists: Key Healthcare Providers
Ever consider your pharmacist as one of your key healthcare providers?
You should!
Pharmacists are trained to spot potential drug interactions...
...that might slip through the cracks during doctor visits
...thus preventing side effects that can lead to falls
VIII. Know Your Surroundings: Awareness is Key
Always Be Alert, Especially in Uncharted Territories
When navigating the world, especially as we age...
...it becomes increasingly crucial to be keenly aware of our surroundings.
While familiarity can often breed a sense of safety...
...even our usual environments change.
Whether it's a new object on the sidewalk...
...or a wet floor sign in a grocery store...
...these sudden changes can be trip hazards.
City Streets & Urban Pitfalls
It's not just in the wilderness where one must be wary of where they step.
Cities, with their bustling nature and constant evolution, can be minefields for potential falls.
Curbs and Pedestrian Crossings
Always be on the lookout for curbs, especially when they're not marked clearly.
Rain or wear can make them slippery.
Parking Lots & Dividers
Parking lots can sometimes be chaotic, with dividers, speed bumps, and potholes.
Always tread carefully and look out for potential trip hazards.
Wet Areas in Supermarkets
Spilled liquids or recently cleaned floors can be extremely slippery.
Look out for wet floor signs, and if you happen to spot a spill, alert store personnel.
Potholes and Dislodged Manhole Covers
These can be serious trip hazards, especially when they're not immediately visible or are obscured by rainwater.
My experience with a renowned singer in New York City stands as a cautionary tale.
A mispositioned pothole cover led to a broken kneecap, surgery, extensive rehabilitation, and months of therapy.
IX. Staying Alert: Minimizing Distractions
Limit Multitasking
While it may seem efficient, doing several tasks at once...
...can divert your attention and make you less aware of potential hazards.
If you're walking, focus on walking.
Watch Where You’re Going
It sounds simple, but actively observing your path can help you spot and avoid obstacles.
3. Pause and Assess
Especially in unfamiliar environments, take a moment to stop and assess the surroundings.
Look for any potential hazards before proceeding.
Don’t Use Your Phone While Walking
Using smartphones or other devices while walking can significantly reduce your awareness.
Always ensure you're stationary and safe when using them.
Be alert, be aware, and prioritize safety above all else.
The Dangers of a Wandering Mind: A Personal Anecdote
It's not just external distractions that can pose a risk.
Sometimes, our wandering thoughts can lead us astray.
Many years ago, my mother had a fall while ascending a flight of stairs...
...resulting in a broken shoulder.
When asked about the cause of her fall...
...she reflected and admitted, "It was my fault, I did not pay attention, I was thinking about something else."
Curious, I inquired further about her distraction.
Her response was both surprising and enlightening:
"I was thinking about a fight I had with my sister... 40 years ago."
This story serves as a poignant reminder that our minds, powerful as they are, can sometimes pull us into memories, worries, or daydreams.
These moments of mental distraction, especially during physical tasks, can lead to unforeseen accidents.
It's a lesson in the importance of mindfulness and being present in our actions.
When navigating any environment, especially one with potential hazards...
...it's crucial to stay engaged in the present moment.
The past and future can wait; your safety in the now cannot.
Securing Your Steps: Embrace a Safer Future
The journey to aging gracefully in the comfort of one's home...
...begins with the simple acknowledgment that falls, though common, are preventable.
Each step we've explored...
...from selecting the right footwear...
...to maintaining a mental presence in our surroundings
...underscores a commitment to well-being and self-preservation.
By implementing these strategies and staying consistent...
...you are embracing a lifestyle that prioritizes security, health, and happiness.
If you found this article helpful, consider sharing it with others who might be on a similar journey.
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Join the "Aging Comfortably in Your Own Home" Facebook group.
There, you'll find a supportive network ready to assist and inspire you every step of the way.
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Home Modifications for Aging in Place
Disclaimer
Although we strive to provide the most accurate information possible, please note that this chart is provided for informational purposes only. It is not a substitute for professional medical treatment, advice, and/or diagnosis. Always seek out the advice of a physician or other qualified health provider when seeking information for a medical condition or medication. This information is not to be taken as medical advice. Always consult with your physician when changing/stopping/starting any medication, supplement, or exercise program. This material is provided on an 'as is' basis. We make no warranties, expressed or implied, and hereby disclaims and negates all other warranties including, without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, we do not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of this material.
