Fall Prevention in the Elderly

Fall prevention in the elderly can improve the safety of your aging parents. Falls are a main cause of serious injuries in the senior population and are often a source of fear in the elderly.

This article includes:

• Hazards In and Around the Home
• Hazards Outdoors
• Decreased Strength
• Bathroom Safety
• Reaching
• Rushing
• Decreased Balance
• Dizziness
• Shortness of Breath
• Decreased Sleep
• Urgency Bowel/Bladder
• Poor Lighting
• Foot Problems
• Difficulty with Concentration

Hazards In and Around the Home

Problems:

• loose carpets, scatter rugs
• slippery/wet floors, walkways
• poor lighting
• clutter such as phone/ electrical cords, shoes, pet dishes, paper etc.
• uneven walking areas
• using step stools
• crowded or poor furniture arrangement
• pets around the feet

Solutions for Fall Prevention in the Elderly:

• remove scatter rugs, tack down carpets
• tape down electrical cords
• install handrails for all stairs inside and outside house
• can install handrails along hallways if needed
• wipe up spills immediately
• fix or mark uneven floors
• nightlight
• keep walkways clear of clutter
• do not stand on ladder, chair, stool; if you do use a step stool, make sure it has a handle; try to organize shelving so items are easy to reach
• use a trolley to carry items or your four wheeled walker basket
• change arrangement of your furniture to open up the space, this is especially important if using walking aids
• watch out for pets underfoot

Hazards Outdoors

Problems:

• blocking vision by carrying too much
• walking on uneven ground
• wet leaves, fallen branches
• snow, ice, water
• raised, cracked sidewalks
• improper footwear for weather
• getting on and off buses
• poor outdoor lighting

Solutions for Fall Prevention in the Elderly:

• walk on wet leaves, snow or ice only if absolutely necessary
• if you must walk on snow, it should be "crunchy"
• walk slowly and pay attention
• try to avoid particularly hazardous areas
• avoid reaching or twisting when walking and standing
• keep one hand free for balance unless using a walker
• use a waist belt pack or backpack instead of carrying a purse
• avoid carrying heavy items
• use portable grocery cart or four wheeled walker basket
• install automatic or timed lighting outside
• place winter grip on rubber tip of cane and shoes

Decreased Strength

Problems:

• lack of physical activity causes weak muscles and stiff joints
• conditions affecting the muscles and joints such as arthritis, osteoporosis, Parkinson’s, diabetic neuropathy and stroke need to be treated specially; consult your physiotherapist or doctor

Solutions for Fall Prevention in the Elderly:

• do exercises daily in bed or chair
• as long as it is safe, walking helps strengthen your legs; go each day and gradually increase your distance
• join exercise programs at recreational centres
• plan regular activity to increase your exercise tolerance – invite a friend
• see physiotherapist for specialized exercises and stretching; see massage therapist for muscle tightness and stretching exercises
• avoid stairs if you do not feel strong enough, particularly if there is no handrail

Bathroom Safety

Solutions for Fall Prevention in the Elderly:

• non-slip mat
• grab bars
• bathtub bench (may be safer than a bath chair as senior can access tub while seated)
• raised toilet seat
• hand-held shower head
• long-handled spongue
• toilet rails or grab bar by toilet
• good lighting
• use liquid soap dispenser (well-secured) instead of bar soap, shampoo and conditioner
• consider replacing towel rack with reinforced grab bar if senior holds onto
• if strength is an issue, consider sitting for grooming

Reaching (when objects are too low or too high)

Solutions for Fall Prevention in the Elderly:

• keep frequently used items below shoulder height, on easy-to-reach shelves, and/or at counter level

Rushing

Solutions:

• keep things you use often within easy reach
• use cordless phone and carry it around; let the person call back or the answering machine take the message instead of rushing
• take your time, especially when carrying objects
• slow down, plan ahead, rest when tired and always give yourself more time to get to places and things done
• allow enough time to complete tasks
• make a "to do" list to avoid procrastination and rushing
• try to focus on one task at a time

Decreased Balance

Solutions:

• walking aids: cane, four wheeled walker, two wheeled walker, wheelchair, scooter use wall or stable furniture for support
• install handrails as needed
• get up slowly, pause before moving to ensure no dizziness
• increase physical activity (including exercises that improve balance: Tai Chi, Yoga)
• wear glasses or stay in well lit areas
• use good fitting footwear
• regular, balanced meals to give yourself energy
• sit down for dressing or to put your socks and shoes on; can use aids such as a long-handled reacher, long-handled shoe horn and/or a sock aid
• take your time

Dizziness

Solutions:

• sit on side of bed for a few minutes before you stand up
• after standing, pause and take one slow, deep breath before you take a step
• tell your doctor if you suspect your medication is making you drowsy or dizzy

Shortness of Breath

Solutions:

• cut down or stop smoking
• gradually increase physical activity
• eat healthful meals

Decreased Sleep

Solutions:

• normal sleeping for older adults: six hours per night, awaken twice during night with 20 minutes to go back to sleep
• if you can’t sleep after 20 to 40 minutes, get up and do something like read a book or
• listen to music
• avoid caffeinated foods and drinks after 4 pm, try warm milk instead
• do not nap in late afternoon or early evening
• keep bedroom cool and quiet
• ensure mattress is firm and comfortable
• learn relaxation techniques; try a hot bath
• medication can contribute to lack of sleep, talk to your doctor
• increase exercise during day
• decrease alcohol consumption
• try and get outside for 20 minutes per day

Urgency Bowel/Bladder

Solutions for Fall Prevention in the Elderly:

• urinal and/or commode by bedside
• nightlight for night movement to bathroom
• exercises for strengthening the muscles that control urine flow (kegel exercises)
• go to the bathroom before going to bed
• avoid constipation by eating a high fibre diet (veggies, fruit, whole grains), plenty of fluids and exercise
• drink enough fluids so that your urine is light yellow in colour (usually 6 – 8 glasses
• or non-caffeinated drinks). Drinking too little fluid will cause irritation to the bladder and possible a urinary tract infection
• incontinence products for women and men are available at medical supply stores and pharmacies

Poor Lighting

Solutions:

• use non-glare bulbs that are 100 watts or greater
• wear sunglasses when in the sunlight or when there is a glare
• remove reading glasses when walking
• pause and give your eyes time to adapt to changes in light when entering and/or leaving a room

Foot Problems

Solutions:

• wear proper fitting supportive shoes with low broad heels
• choose shoes that offer better support than slip-ons
• talk to podiatrist (foot doctor) about calluses, bunions, corns, ingrown toenails; corn plasters are not recommended for people with diabetes, heart or blood vessel disease
• buy slippers that fit properly and are enclosed around the heels
• if your shoes are loose and you can’t afford a new pair, buy insoles or wear extra socks
• maintain good posture, consult physiotherapist if necessary
• talk to footcare specialist, nurse or occupational therapist about proper foot care when decreased feeling/ sensation due to diabetes
• keep your feet propped up above your heart when sitting or lying if you have swollen feet

Difficulty with Concentration

Solutions for Fall Prevention in the Elderly:

• tape a list of emergency phone numbers by your phone
• program important and frequently called telephone numbers into your phone if it has this option
• eat regularly to prevent physical weakness and mental sluggishness