Fall risks are generally divided into two broad categories: modifiable ones and those that are not. The focus of this article is modifiable risks, in other words positive actions you may take to reduce fall risks. Many falls are preventable and efforts you can exercise just may help you maintain your lifestyle.
Environmental Fall Risk Factors
Our homes are where we spend a significant portion of our lives and most homes have several factors that imperil us. The first step in making our homes safer is to have a risk assessment performed. Familiar items can become invisible to us so the risk assessment is best performed by an individual from outside the home, ideally someone with special training such as an Occupational Therapist, but a friend or neighbor may suffice.
It is particularly important if utilizing the services of a friend to employ a tool or checklist. These can be obtained online from sources such as the Minnesota Safety Council Home Safety Checklist or the Centers for Disease Control and Prevention.
Many factors are well publicized and others may come as a surprise, such as throw rugs, waxed linoleum floors, electrical cords, and uneven or loose steps. With minimal assistance these items are frequently easily modifiable to make the home a safer place.
Home Safety Equipment and Alterations
The bathroom is generally found to be the most problematic in most homes with at least 66% of bathrooms in one study having at least one risk factor (Gill, Williams, Robinson & Tinette). Gill et al also found that it would be a mistake to assume that age-restricted housing designed for older adults is safer.
Homes for older adults should have grab bars installed in the bathrooms. Inexpensive and easily installed it is important that they be installed by an individual who can insure their stability. There is little value in a grab bar that does not hold when needed.
Lighting is another factor that may result in avoidable falls. Even people without alterations in eyesight may be at risk as poor lighting casts shadows disguising risks. When coupled with decreased vision or bifocals poor lighting increases the chance of falls and injury.
Stairways should be equipped with appropriate hand rails and they should be maintained in a good state of repair.
Personal Activities that Increase Fall Risk
Activities of daily living can either be performed safely or can be a hazard. Something as simple as putting on a pair of pants may result in a fall if attempted while standing. It is common for one to get his leg caught up in the leg of the pants. Increased age often prevents rapid recovery of balance resulting in a fall. Consider how sitting down while putting on pants may change the outcome.
It is no surprise the women generally fall inside and men more frequently fall outdoors. Risky behavior is often the catalyst. When reaching for something above a standing position utilize proper step stools with a handle to be held onto for stability, not a kitchen or folding chair. If climbing a ladder have someone available to steady the ladder. These actions are not a loss of independence but maintenance of independence. Falls often result in loss of independence.
Safety is often a result of taking time to consider our actions. Most falls around the home are avoidable with planning and awareness. Making simple and generally inexpensive alterations in the environment and safety consciousness can help in maintaining independence, health, and welfare.
References
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C. (1999). Prevention of falls in the elderly trial (PROFET): a randomized controlled trial. The Lancet, 353. 93-97.
Gill, T. M., Williams, C. S., Robinson, J. T., & Tinetti, M.E. (1999). A population-based study of environmental hazards in the homes of older persons. American Journal of Public Health, 89(4), 553-556.
Ness, K.K., Gurney, J.G., & Ice, G.H. (2003). Screening, education, and associated behavioral responses to reduce risk for falls among people over age 65 years attending a community health fair. Physical Therapy, 83(7). 631-637.
Dan Paul Burgess - I am a 55 year old masters prepared registered nurse and board certified in emergency nursing. I consider my work to be a ministry and ...
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