Fall Prevention in the Home
Deaths from falls increased 30 percent from 2007 to 2016 in the United States. If rates continue, by 2030 there
will be seven deaths every hour caused by a fall, said
Maureen A.M. Burke, OTR/L, aging-in-place specialist at
Emory University’s Cognitive Empowerment Program,
Goizueta Brain Health Initiative.
“The thing about the brain is that there are so many areas
within it that can develop plaques or lack of blood supply,” Burke says. “This may happen in those areas where
balance is centered, so even if your person is using a cane, sometimes people will fall. If someone is falling without
any noticeable reason, it could be because something is going on in the brain.”
The number-one risk factor for falling is age, Burke says,
adding that one in four adults 65 and older have fallen.
“Regardless of anything else, it’s simply age. The scary statistic is that falls are the primary cause of injury-related deaths. Falls that result in injury but not death can be life-changing. Those who have a diagnosis of mild cognitive impairment or any form of dementia have an increased risk of falling compared to their counterparts who do not.”
For someone already diagnosed with a memory loss condition, using a cane can be difficult.
“If someone is on the border between a cane and a walker, the walker is easier for someone with dementia because it’s two-handed, and it just makes more sense. It has wheels in the front, and they can push it along.
“For many years in memory care, we would rarely use canes unless someone was high functioning and had a cognitively high level because canes can be more complicated. We would never use a cane that has a large square bottom because
these are difficult for someone with dementia. They’re much more complex.”
Bars on walls and in showers are helpful if they are properly placed and secured. Bright orange or yellow tape on the bar helps the person to see it.
“I find the clients who have dementia need things to be intuitive. It has to be there so they will hold it. It’s not going to work if you have to teach them ‘grab over here’ or ‘grab over there.’ It has to make natural sense.”
HIGHEST RISK AREAS: Bathroom, Bedroom, Stairs
Bathroom
Falls in the bathroom are twice as likely to result in an injury than in the living room where you may fall on the couch or carpeted floor. The bathroom is all about hard surfaces. The most dangerous movement is getting out of the shower, particularly if there is a threshold to step over. An aging-in-place specialist can offer better advice for redesigning your bathroom than a regular contractor.
Bedroom
Getting out of bed to go to the bathroom in the dark is when most people fall, not always because of balance, but because of blood pressure changes. Sit on the edge of the bed and count to five before getting up. Use amber-toned nightlights in the bedroom and bathroom. They are less disruptive to sleep cycles. Also, keep a charged phone and flashlight by your bedside. Keep all items in your closet within the range of your shoulders and hips so you don’t have to lean over or get on a step stool to reach something overhead.
Stairs
Ideally, railings should sit on both sides and always extend beyond the first step and the top step; these two are where most people fall. Illuminate the area with bright white LED lighting. As for carpeting, avoid dark and busy patterns and stick with orange and red for visibility.
This article is based on an AFA Care Connection webinar that offered advice on preventing falls and their resulting injuries. Maureen A.M. Burke, OTR/L, has 35 years of experience as an occupational therapist. She is an instructor at Emory University’s Cognitive Empowerment Program, Goizueta Brain Health Initiative, Atlanta, GA.
- Age: Particularly those over 65 and with a memory loss condition.
- Medications: Be extra aware of their side effects.
- Poor vision: Replace yellow lightbulbs with LED lighting.
- Hearing loss: This may cause decreased spatial awareness.
- Pain or numbness: The reason for this is when we hurt, we change the way we move.
- Bladder or bowel urgency: Burke says, “The majority of the clients I work with in rehab facilities wear pads. We don’t want you rushing to the bathroom.”
- Psychological Wellness: Depression and anxiety can increase falls.
- Body weakness: A weak lower body affects the ability to walk or stand.
- Self-care challenges: Particularly showering, putting on shoes and using the toilet.
- Poor footwear: Avoid slip-ons and flip-flops.
- Clutter: Remove things from the steps and skip the scatter rugs.