How to prevent falls in the elderly

Janie Rosanbalm, RN

Falls are the leading cause of fatal and nonfatal injuries in the age group of 65 or older in the United States.  Most falls in this age group occur in the home during everyday activities.  The number of falls, and the severity of injury resulting from falls, increases as people get older.  Two thirds of seniors who fall have a repeat fall within six months.

There are several contributing factors that cause falls.  Loose objects within the home can cause up to 25% of falls within the home.  Such loose objects include loose rugs, electrical cords, pets, walkers or crutches.  Many prescription and over-the-counter medications have side effects that can make one feel unbalanced and fall.  Some of these medications are taken for depression, sleep and high blood pressure.  Some disease processes such as osteoporosis (weak bones) can also lead to a fall. 

Falls in the elderly are very common and are a costly healthcare concern.  With the help of friends, family, and neighbors, 40% of the falls in the elderly can be prevented by identification of unsafe home conditions. 

The following list provides some suggestions for the community of friends and family to use to assess a senior’s home and make it a “safe” place for them to reside for the remainder of their years.

1.       Seniors should wear shoes with non-skid soles.  Low heels are also recommended.

2.       The home should be well lit so one can see things one might trip over.

3.       Use nightlights in the bedroom, bathroom, hallways and stairs.

4.       Use carpet tape to fasten down loose rugs.

5.       Senior ladies should not wear long nightgowns.

6.       Avoid putting electrical cords across pathways.

7.       Put grab bars on bath tubs, shower and toilet areas.

8.       Handrails should be placed on both sides of the stairway.

9.       Keep stairs free of clutter.

10.   Cover stairs with non-slip treads.

11.   Rubber mats should be used in bathtub or shower floors.

12.   Leave the bathroom door unlocked so it can be opened from both sides.

13.   Seniors should be encouraged not to climb on stools or stepladders.  They need to ask someone else to do jobs that call for climbing.

14.   Use non-skid wax if a floor requires wax.

15.   Repair any sidewalks or walkways so they are smooth and even.

16.   Arrange storage so it is at counter level.

17.   Arrange furniture to provide an open pathway between rooms.

18.   If the senior has to go to the bathroom often at night, consider a bedside commode. 

19.   If using a cane or walker, make sure the senior is using it correctly and all the time.

20.   The senior’s hearing and vision should be checked on a regular basis.  Usually vision is checked every year and hearing is checked every two years (more often for both if a problem is identified).

21.   Sore toes and feet can cause a senior to become unbalanced.  The senior should seek medical attention for any complaints in his/her feet.

22.   If the senior complains of dizziness, weakness, confusion or just unsteadiness on his/her feet, they should seek medical attention.  He/she should describe exactly what they are experiencing.

23.   When a senior has been lying on a couch or bed, advise them to rise slowly and sit for a minute or two before standing up.  This will help their blood pressure adjust to the position.

24.   Encourage regular exercise especially walking.  Exercises that help strengthen the muscles used for walking and lifting are great.

25.   Limit alcohol intake.

26.   Maintain a diet with adequate calcium and vitamin D.

27.   Make sure medications are clearly labeled and stored in a well lit area according to the instructions.

28.   Consider putting a telephone in every room or place a cell phone in a pocket or walker for easy access.

If the senior does fall, he/she need to be instructed not to panic.  Assess the situation and determine if an injury has occurred.  Slide or crawl to the nearest couch or chair and try to get up.  If the senior can not get up, he/she should call for help.  If the senior is alone, he/she should crawl slowly to the telephone and call 911.  A personal emergency response system may be necessary to provide immediate assistance.  Contact the local hospital for more information on the personal emergency response system. 

References:

Easton, Andrea. “Fall Prevention and Home Safety: The Role of the Home Health Professional,” www.ceoncd.com/CD/cd0009/AB0059/ab0059.htm.

“Falls and Hip Fractures Among Older Adults,” National Center for Injury Prevention and Control, Atlanta, Georgia, 30341, November 13, 2000.

“Falls in Seniors,” www.nvipc.org/Educational/srfallsfaminfo.html.

Fuller, George. “Falls in the Elderly,” American Family Physician, April 1, 2000.

 “Protocol for the Management and Prevention of Falls in Older People,” Mental Health Services for Older People, July 2003, Review July 2004.

“20 Facts on Patient Falls,” www.therapydynamics.com.

“What Causes Falls in the Elderly? How Can I Prevent a Fall?” American Family Physician, April, 2000. www.aafp.org.

9/04

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