Source: Gordon Walker

Falls in the Home

Falls are the leading cause of fractures, injury and deaths among persons over the age of 65. The prevention of falls greatly improves the chances of staying at home.

Falls can happen any time and any place, but two-thirds of falls by senior citizens occur in the home during everyday activities like walking across a cluttered room, slipping on a throw rug or a wet floor, standing on a stool or using the stairs. Many of these accidents could be prevented by an item as simple as tape, a bathtub grab bar, or by the repair or installation of a stairway railing.

There is a pattern to falls and their aftermath. An injury followed by hospitalization, decreased independence and mobility, and relocation to an institution is too often the norm. A fall can be a major life-changing event that causes many elderly people to lose the opportunity to stay at home.

Just the fear of falling can create considerable anxiety-a form of paralysis. This condition can erode self-confidence and lead to severe restrictions in daily activities, which in turn can cause social isolation and depression.

The number of falls and severity of injury increases with age. The cost of falls to older persons, their families, and other taxpayers is huge. An estimated $20 million is spent annually in the United Sates for hospital and nursing home treatment of fall-related injuries. Hip fractures alone number 300,000 per year, or nearly 1,000 each day, and cost an averge of $35,000 per patient. Approximately 25 percent of these patients make a full recovery, 40 percent require nursing home admission, and 20 percent will die within a year.

Preventing Falls

The good news is that falls are not a natural consequence of growing older. Steps can be taken to prevent falls by identifying the major risk factors and taking some common sense precautions. The New England Journal of Medicine has reported a study that demonstrates how relatively simple prevention strategies can drastically reduce the incidence of falls. Here are the risk factors with possible remedies:

Problem: Falling at home. A recent study conducted at the University of Buffalo has shown that costs related to institutional care for a control group were nearly four times higher than for a treatment group of frail elderly who received in-home environmental improvements.

Solution: Investigate ways to make the home safer, then take appropriate measures.

• Stairs:
  Provide enough light. Keep stairs free from clutter, and use sturdy handrails.
• Bathroom:
  Install handrails. Use non-skid rugs on the bathroom floor and tub. Use a nightlight.
• Kitchen:
  Avoid climbing, but when you do, use a stable stool with handrails. Arrange storage at counter level. Do not wax the floor.
• Living area:
  Keep electrical telephone cords and other items out of pathways. Remove throw rugs.

Problem: Balance and walking problems -- muscle weakness leading to difficulty safely using the toilet and bathtub.

Solution: participate in exercise programs that increase strength and range of motion. Learn safer ways to bathe.

Consumer Tips

Adult children should discuss these issues with their parents and investigate their parents' home to identify and address risk factors for falls. This is particularly important before a parent is discharged from a hospital or nursing home.

Occupational therapists can be a great help. Ask your parents' doctor to prescribe a home assessment. Your local Area Agency on Aging may have a home safety program and could make recommended modifications so often necessary to prevent falls. For a peace of mind, there's no place like a safe home.