An Honest Conversation Could Prevent Accidental Falls

By Katecey Harrell
Limestone Medical Center, Emergency Management Services, responds to accidental falls involving the elderly almost every week, director Shelton Chapman said.
“Tripping hazards at a younger age aren’t a problem, but as you get older, it can be,”
Chapman said. “We may get three in one day and then go two weeks without one, but it’s frequent.”
As people age, their fall risk increases. Accidental falls are the leading cause of injury for people over 65, according to the Centers for Disease Control and
Prevention. Fall risk increases during the cold winter months, when people are more sedentary, said Jennifer Brown, regional therapy director for AccentCare.
Illness and medical flareups, like arthritis, can affect mobility, Brown said.
“Anytime a patient is sick and not feeling well, you’re going to see fall risk increase,” she said.
Falls can happen indoors or outdoors, Chapman said. “It depends on the severity of their injuries. We protect patients and bandage them if they’re bleeding and often have a fracture, and we mobilize andget them to a hospital,” he said. He said people could slip on a loose rug, miss an unlevel step, or trip over shifting concrete. Brown said that making sure pathways are clear is perhaps the most crucial step to prevent accidental falls. Brown noted that people tend to shuffle their feet a little more as they age. “It’s important to assess for trip hazards, such as rugs that aren’t properly attached to the floor or that a corner may be turned up that their foot may catch on,” she said. “Is there a change in flooring? Does it go from carpet to wood without a proper transition piece?”

Chapman said to keep debris out of indoor and outdoor pathways. “Try to remove anything that’s a tripping hazard inside and outside their home. Anything to keep a good walk space,” he said. “Anything you can do in their normal pattern of life to help keep it clean and clear.”
Pets can get entangled around people’s feet and be a hazard for the elderly, Brown said. “We often think it’s a great idea to get our loved one, who
might be a little lonely, a pet, but a young, rowdy pet may not be the best choice for them,” she said.
Proper footwear with a sturdy back, sole and laces or velcro straps to secure people’s feet can also reduce shuffling and fall hazards, Brown said. Wearing shoes at home, even though people tend to take them off, is important as we age. Side effects from different medications can also increase a person’s fall risk. She said that vision changes are one of the most common factors for falls.
“When it’s dark in your home, or there’s not proper lighting, it’s going to be a lot more difficult to see objects in your pathway,” she said.
Sensation also changes as we age, she said. Patients with diabetes may have neuropathy that significantly affects the feeling in their feet.
“Your ability to have proprioception, which is your sensation, and your bearing in your environment,” she said. “That changes, and it gets worse as we age.”
Brown said it becomes more challenging to combat obstacles in the home environment. “We suggest putting night lights in places, especially a
pathway to the bathroom, so that loved ones can see to get up in the middle of the night,” Brown said.
She said people must ensure their loved ones have an appropriately lit pathway to the restroom at night. Brown said the most common location where at-risk age groups are susceptible to a fall is in the bathtub or shower.
“A wet slippery surface is always going to put that patient at increased risk,” she said.
Families can do things at home to prevent this, like installing handrails or using a shower or tub chair. Brown said that physical therapists often see patients in the home health setting because of an injury resulting from a
fall. Home health services assess safety hazards and where a patient may have weaknesses at home. “We see patients with broken bones or limbs. Maybe a patient that just had to stay in the hospital because of a bad fall has had a head injury, and they became very weak,” Brown said. “One of the jobs we do in home health is to make sure those patients are safe at home and that we can
keep them out of the hospital.”

Brown said older people have an increased risk, but a fall can happen to anyone. Many of the tips she recommends can be beneficial when implemented in the homes of anyone at any age. It can be challenging to make aging adults understand the concerns of their loved ones, Brown said. Having honest conversations about avoiding injury and hospitalization is necessary.
Brown said one of the scariest things about aging is the fear of losing independence.
“Supporting them and knowing that you are making these changes to their home and suggesting these changes so that they can stay home and stay
safe and independent can be impactful,” Brown said.

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