Preventing falls in the home


  1. Checklist for Preventing Falls in your Home
  2. Don't Let a Fall Be Your Last Trip
  3. Getting Up From a Fall
  4. Preventing Falls
 

Checklist for Preventing Falls in your Home

Repair broken sidewalks, driveways, and outside stairs, watch for uneven sidewalks, and be very careful walking on sidewalks at night.

Install hand railings on outside stairs.

During icy or snowy conditions stay indoors.

Place non-skid adhesive strips in bathtubs or showers. Use non-slip rugs or mats.

Wear shoes with non-skid soles or purchase and apply non-skid pads on shoes. Avoid wearing high heels, crepe or leather soled shoes.

Wipe up spills immediately.

Use step stools with handles for reaching high areas in your home.

Do not climb stairs while carrying packages which obstruct the visual field.

Increase lighting in your home by using the highest watt bulb allowed for the light fixture. Use frosted bulbs to reduce glare.

Always turn on lights before walking into a dark room, even if you are only going in for a moment.

Keep the light on in the bathroom at night, or use a night-light.

Make sure stairs are well lit and there is a light switch at both the top and bottom. Mark edges with non skid contrasting strips.

Have sturdy handrails that run the full length on both sides of all stairways, extending slightly beyond the first and last step. Use handrails!

Install grab bars over the bath tub or on the shower wall. Replace towel racks with sturdier grab bars.

Make sure all carpets have short, dense pile and edges lie flat. Tack down loose edges with double-sided carpet tape or tacks. No shag carpets!

Scatter rugs slide and are hazardous, use skid-proof rugs or runners.

Give yourself time to adjust you balance when getting up from a sitting or lying position.

Watch were you are stepping when using stairs, place the foot firmly on the stair.

If you begin to fall try not to tense or reach out your arm, relax into and roll with the fall.

Develop a buddy system to check on senior relative, neighbors and friends periodically.

Do not place items on stair risers, these create a hazard when ascending or descending a staircase.

For outside stairs during wet or icy conditions wear slip resistant shoes and boots. Crepe or rubber soled shoes are more likely to result in falling.

Never stand on the top rung of a ladder, and always have someone holding the bottom of the ladder.

If you have only 1 or two stairs, warn people to watch their step.

Never rush to answer the phone or door, use care and watch where you are going.

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Don't Let a Fall Be Your Last Trip

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1-800-824-BONES

Falls are the leading cause of fatal and nonfatal injuries to older people in the U.S. Each year, more than 11 million people over 65 fall -- one of every three senior citizens.

Treatment of the injuries and complications associated with these falls costs the U.S. $20.2 billion annually. A serious national problem now, falls could reach epidemic levels as the population ages in the future.

Who falls?

  • older women -- especially Caucasians and Asians
  • seniors unable to stand on one leg for more than five seconds
  • users of multiple prescription and over-the-counter drugs
  • elderly people who live alone

Falls can occur anytime, anyplace, and to anyone while doing everyday activities such as climbing stairs or getting out of a bathtub or shower.

Where do falls occur?

  • 60 percent: home
  • 30 percent: community
  • 10 percent: in institutions, such as nursing homes

A fall can be a major life-changing event, decreasing your mobility and independence. It can lead to hospitalization. Forty percent of nursing home admissions are due to falls. The number of falls and the severity of injury increase with age. However, falls are not natural occurrences. Many falls can be prevented.

  • Eliminate tripping hazards in your home and install handrails, grab bars and other safety devices.
  • Engage in regular, moderate amounts of physical activity to maintain your strength, coordination, agility and balance.
  • Get an eye examination and physical each year.
  • Check with your doctor(s) about side effects of all your prescription and over-the-counter medications.
  • Wear properly-fitting shoes with nonskid soles.
  • Obtain adequate intake of calcium and vitamin D.
  • Avoid excessive alcohol intake; do not smoke.

Getting Up From a Fall

After you fall, panic is often your first reaction. However, how you react after a fall can cause more injuries than the fall itself. If you try to get up too quickly or in the wrong position, you may make an injury worse.

Remember to take several deep breaths, assess the situation and determine if you are hurt. If you believe you are injured, do not attempt to get up. Instead, call 911 or get help from a family member. But if you feel strong enough to get up, follow these steps provided by the American Academy of Orthopedic Surgeons.

Try to fall on your side or buttons. Roll over naturally, turning your head in the direction of the roll.

If you can, crawl to strong, stable furniture like a chair, and pull yourself up. Approach the chair from the front and put both hands on the seat.

Slowly, being to rise. Bend whichever knee is stronger, keep your other knee on the floor.

Slowly twist around and sit in the chair.

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Preventing Falls

The Problem with Falls and the Elderly
What Causes People to Fall?
Stairs and Falls
How to Avoid Falls
Where to Find Information on Falls in the Elderly

The Problem with Falls and the Elderly

With increased longevity there has been a redefinition of aging. Here are the new categories of aging.

Pre-elderly 55 - 64

Young old 65 - 74

Middle old 75 - 84

Oldest old 85 - 94

Elite old 95 - 99

Centenarians 100 +

Persons aged 65 and older are the fastest growing segment of the population. It is estimated this group will comprise 13 % of the population by the year 2000 (AARP 1992). While currently this segment represents 12.6 % of the population they account for 24 % of trauma fatalities for all age groups. Over 9,300 elderly people die as a result of falls each year representing 40 % of all deaths from traumatic causes in the senior population (Injury Mortality 84 - 90; Schwab & Kauder, Archives of Surgery). This makes falls the leading cause of death for elderly people who are injured.

Injuries related to falls are a prevalent issue in the elderly and occur throughout the year. Approximately 25 % of people aged 65 to 74 will fall each year. As age increases, so does the risk of falling. In the 75 - 84 age group, 33 % will sustain a fall, of those over age 85, 50 % will fall. Almost three quarters of all falls occur in or around the home. There seems to be a high rate of recurrence as well (Injury Mortality 84 - 90). 

Common injuries associated with falls are, femur, hip, knee, pelvis, wrist, and arm fractures; as well as foot, ankle, rib, back and head injuries.

What Causes People to Fall?

Falls occur on all types of surfaces and from heights. The most prevalent mechanisms are falling from stairs, tripping, loss of balance and falling while standing on ladders or furniture. There are many factors associated with falls, some relate to the person and others relate to the home surroundings.

Personal factors associated with falls are often related to aging and medical conditions. Aging factors include decreased muscle strength and narrower gait (stride). Visual changes associated with aging are decreased visual acuity (sharpness), the need for more light to see as well, cataracts, glaucoma and macular degeneration. Illness or disease factors may also predispose seniors to falling. Theses may include dizziness, generalized weakness or loss of muscle strength. Other factors may be part of chronic diseases, like high blood pressure, osteoporosis, arthritis, stroke or heart disease, all can be associated with mobility problems. Taking multiple medications can increase the risk of falling, as will drinking alcohol. Two medications often associated with increased fall risk are diuretics (water pills) and tranquilizers.

Environmental factors related to falls include the type of shoes worn, loose carpet or throw rugs, loose carpet tacks or staples, and electrical cords, wires or obstacles in the walk zone. Poor lighting, especially on stairs and at night. Not having non-slip mats on bathtub floors and lack of grab bars in bathrooms. Having household pets underfoot and carrying objects which block the visual field. Outside the home things such as cracked, chipped, or uneven sidewalks and stairs will increase the risk of falling.

Stairs and Falls

Historically stairs originated from ladders as people began to develop multilevel structures. However, falling from heights has probably been a problem for people since the beginning of mankind. Stairs in castles and palaces were gradually sloped in order to make the ascent to royalty slow and graceful. In the 1600ís standards for building stairs were developed providing dimensions for stairs risers and treads. Riser is the height of the stair, tread is the depth of the stair, and stair nosing refers to the edge of the stair. This standard has not been changed since origination, risers are built to 9 inches and tread to 8 1/2 inches. To put this in perspective a womanís size 7 shoe is approximately 9 inches. The foot size and stride of people has increased since the 1600ís, but the standard for stair dimensions has remained unchanged.

Stairs create an environmental hazard for many people, regardless of structural dimensions. Having clutter on stairs, poor lighting, lack of a sturdy handrail, loose carpeting, loose tacks or staples, lack of non skid treads and lack of visual identification for uneven stair nosing all increase the risk of falling on stairs.

All of these factors place seniors at an increase fall risk, but with awareness and attention to prevention this risk can be reduced.

How to Avoid Falls

Repair broken sidewalks, driveways, and outside stairs, watch for uneven sidewalks, and be very careful walking on sidewalks at night

Install hand railings on outside stairs.

During icy or snowy conditions stay indoors.

Do not stretch lamp or telephone cords across walk zones. Keep walk zones clutter free

Place non-skid adhesive strips in bathtubs or showers. Use non-slip rugs or mats

Wear shoes with non-skid soles or purchase and apply non-skid pads on shoes. Avoid wearing high heels, crepe or leather soled shoes

Keep a night light on and have good lighting in stairways with switches at the top and bottom of stairs

Wipe up spills immediately.

Use step stools with handles for reaching high areas in your home

Do not climb stairs while carrying packages which obstruct the visual field

Use the hand railing and take your time when climbing up or down stairs

Watch were you are stepping when using stairs, place the foot firmly on the stair

If you begin to fall try not to tense or reach out your arm, relax into and roll with the fall

Develop a buddy system to check on senior relative, neighbors and friends periodically

Do not place items on stair risers, these creat a hazard when ascending or descending a staircase

For outside stairs during wet or icy conditions wear slip resistant shoes and boots. Crepe or rubber soled shoes are more likely to result in falling

Never stand on the top rung of a ladder, and always have someone holding the bottom of the ladder

If you have only 1 or two stairs, warn people to watch their step

Never rush to answer the phone or door, use care and watch where you are going

Where to Find Information on Falls in the Elderly

American Association of Retired People
601 E Street NW
Washington, DC 20049

National Safety Council
1121 Spring Lake Drive
Itasca, IL 60143-9858
(800)621-7619

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