Taking Steps To Prevent Falls

Question: My 86-year-old mother has fallen several times in the last month. The rest of the family is worried she might soon need nursing home placement. We don't know how to bring up the subject and what plans we should be making. Can you point us in the right direction?

Answer: Slow down! This is difficult time, but don't put the cart before the horse. Your answer may or may not be a nursing home. Although falls are the most common cause of fatal injuries in older adults and one of the biggest factors leading to eventual nursing home placement, there could be many ways to help your mother continue to live safely in her own home.

Falls and accidents seldom “just happen.” Usually there are at least several contributing factors that lead to a fall. The danger in some of these factors can be eliminated or reduced by taking simple steps to make an elder's home safer. Here is a room-by-room breakdown of some of these steps.

Bathrooms: Place a rubber mat or rubber safety strips in the tub or shower. Install sturdy grab bars in the tub/shower area to provide support. Have a night light available to use after dark and in the middle of the night.

Bedrooms: Use night lights or bedside, remote-controlled light switches. Place the telephone in an area easy to get to and keep the cord out of walking pathways. Consider a cordless telephone.

Stairs and hallways: Put light switches conveniently at both the top and bottom of stairs. Make sure carpeting is not loose or buckling and use non-skid treads on stairs. Both sides of each stairway should have sturdy handrails running their entire lengths. Avoid waxing hardwood floors that could create a slippery surface.

Living areas: Secure and place electrical/telephone cords out of walking pathways. Remove throw rugs that might slide or attach non-skid strips to rug backings. Furniture should be arranged to allow for unobstructed walkways. It is important to keep floors clear of clutter.

Older adults should also be aware of clothing and behavior that can help create a safer environment. Encourage your mother to wear well-fitted, flat, rubber-soled shoes to prevent slipping. Suggest she not walk or climb stairs with arms loaded—always leave a hand free for balance. You might remind your mother to slowly get out of bed and slowly rise from sitting to avoid dizziness. Make sure she has her vision tested regularly and keeps her glasses clean. As her caregiver, try to be aware of any medications your mother takes that could cause difficulty with balance. Most importantly, your mother should be discussing the falls with her primary care physician to see if there is a medical condition that needs attention. Taken together, these steps can reduce, although not eliminate, the likelihood of a debilitating fall.

The dangerous situation created by a fall is frequently compounded by the inability to call for help. Personal emergency response systems should be installed whenever someone appears to be at risk of falling. The systems provide 24-hour access to emergency help, giving both the elder and family members some sense of security.