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The CDC (Centers for Disease Control and Prevention) indicate in recent publications that “Each year, millions of older people, 65 years and older, fall.” These falls can often be serious, and there is strong evidence that for older people, those who are recovering, or those with disabilities, each successive fall increases the likelihood of a further fall. In fact, also according to the CDC, there were 9.6 million non-fatal injuries in the elderly population due to falls, in the year 2015. Another 33 thousand were fatal in that same year. (Go to the cdc.gov site for sources.) These facts are clearly sobering, but even more concerning, since many of these falls occur in the home and could be easily prevented.

Factors that contribute to falls in the home

Older adults and others who have lost some level of self face many challenges at home, some intrinsic to independence and some extrinsic, some related to safety in the home and some, surprisingly, related to caregivers. Here are some common factors we should all be aware of:

  • Loss of full motor control

  • Medications that cause drowsiness or dizziness

  • Home security issues that increase the dangers of mobility

  • Inadequate support devices to aid mobility.

  • Lack of continuous physical activity and at an adequate pace

Of all these, clearly the easiest to eliminate or mitigate fall into a single previous category: home security issues. This is probably the most critical of all, as removing any item from this category is likely to profoundly and significantly reduce the risk of falls in the home.

Caregivers and their role in home security

Family caregivers or contracted caregivers, for seniors and others, should be acutely aware of fall risk hazards in the home and help those who need help avoid these hazards. Caregivers must be proactive in ensuring the safety of those they care for through awareness, communication, and correction of hidden and/or obvious hazards in the home. This can be achieved through vigilance and participation. For example, caregivers should try to put themselves in the shoes of the people they care for and predetermine what challenges they face in and around the home. It is challenging enough for those in need of care to simply come to terms with their position of aging, disability or otherwise, and therefore caregivers need to be sensitive to the feelings of the elderly and others while still being vigilant in maintaining the home. sure. Caregivers really need to behave like unsung heroes or angels, operating in the background and not making older people or other dependents feel worse about losing some independence.

Risk mitigation and steps towards safety

The CDC, as well as other sources, provide significant yet insightful advice on minimizing the risk of falls and injuries. In fact, the National Safety Council provides excellent guidance in its recent article “Slip, Trip, and Fall Prevention Will Keep Seniors Safe and Independent” (click here for source). Most of us can use a little thought on this topic and easily create a checklist of items to assess in our homes to make them safer for the elderly, recovering, or disabled. What is provided below is a good start and may give you some additional ideas and guidance. Please note that this is of course offered as a suggestion and not as medical advice.

kitchen safety

  • Kitchen equipment, utensils, plates, glasses, and food must be properly stored and easily accessible.

  • No type of carpet or similar should be placed on the kitchen floor.

  • The floors must always be free of any type of spill (oils, food, etc.)

  • Use countertop toasters when feasible, making them easily accessible

  • When higher cabinets must be accessed, a stool with handrails should be readily accessible.

  • Non-slip floor wipers for floor cleaning only

General Carpet Concerns

  • Wall-to-wall carpeting must be installed completely and correctly, with no loose edges, tears, buckles, or holes.

  • While not always possible, solid colors are best because they provide more consistency for those with mobility issues; they also show cleaner edges.

  • Shag-style rugs should be avoided

Bathroom Concerns and Safety

  • Make sure the bath mats are non-slip (and not old ones where the slip resistance has worn off); make sure they are placed near the shower/bath area.

  • Make sure there are mirrors on multiple levels to ensure the client does not have difficulty or reach to use a mirror.

  • Whenever possible, install grab bars near the toilet, tub, and/or shower.

  • The tub/shower floor should be non-slip, if not, be sure to install non-slip safety strips.

  • When feasible, use a soap dispenser mounted in a highly accessible area in the shower/tub.

  • If necessary, a shower chair is placed in the bathing area.

  • The toilet seat should be of the raised type or a toilet seat with armrests should be installed on the toilet to ensure safe balance when sitting on or getting up from the toilet.

security in the bedroom

  • Key security features should be within reach of the bed, for example on the nightstand. Consider a safe lamp, flashlight, phone, cane, etc.

  • If applicable, a raised-height mattress to help get in and out of bed

  • The floor, particularly around the bed, should be free of clutter, papers, and any other items.

  • Night lights are appropriately placed in the bedroom and along any path to the bathroom.

Outdoors and around the house/apartment

  • This category naturally only applies in some cases

  • Make sure all walkways are clear of debris, branches, leaves, rocks, and the like.

  • Make sure all stones and masonry are solid and not loose in any way.

  • Make sure all walkways and driveways are as level as possible

  • Make sure all walkways are clean and not covered in moss, algae, oil, or other slippery substances.

General concerns about living space

  • In areas that could be classified as pathways, make sure low furniture is moved out of the way. Examples include coffee tables, folding side tables, ottomans, floor plants, etc.

  • Light switches work properly and are not obstructed.

  • No loose rugs or rugs that can slip

  • Rooms and mobile space are free from furniture obstructions.

  • Where appropriate, use sound activated lamps

  • Where appropriate, use glow-in-the-dark markers on various items that require handling, eg, cabinet handles, light switches, etc.

  • All electrical cables for power, data, telephone, etc. are properly routed and secured and are not near roads or living spaces.

  • All furniture in good condition, resistant and safe.

  • There are several cordless phones available, each marked with glow-in-the-dark markers, and ensuring they can be audibly located (i.e. they have a phone locator feature)

  • No loose tiles or pallets

  • Appropriately placed nightlights throughout the house

  • Infrared sensor lights in certain areas where a brighter light is required at night

Technological considerations

  • Install carbon monoxide detectors outside appropriate

  • Install smoke detectors outside appropriate

  • If necessary, based on level of independence, arrange for a medical alert device/subscription

  • Install detectors that also have emergency lighting and/or install motion detection lighting where appropriate.

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