Fall Prevention GuideEverything to know about preventing falls
Table of Contents
You Are Not Alone
Making Your Home Safe
What You Need To Purchase
Work With You Doctor
This guide was written for you. If you have fallen or fear a fall than you need to know there is hope, falls are preventable. Inside the pages of this guide is a step by step guide specifically designed to help you avoid falls and maintain your independence.
Falls are extremely common in seniors, and it’s important to know that there is usually more than one reason that a person may fall. Therefore, you need more than one solution to help you avoid falls. The important thing to remember is that you must take action on many fronts. Use this article as a guide and follow up on all of the helpful steps.
Imagine your life in the future. Are you living on your own, are you in a wheelchair or are you confined to a hospital bed? The choice to prevent falls might be in your hands. However, you have to take action now by following the steps in this guide.
The fact that falls are preventable is the most important takeaway that you can have in this guide. By using a broad range of strategies, you will be able to reverse the chance of falling and live a full, vibrant, and independent life. Let’s get started.
You Are Not Alone
Falls are a very serious problem in the senior Canadian population. Among seniors who live independently over 30% will have at least one fall per year. Those who are in assisted living situations or other institutions, this number rises to well over 50% having at least one fall per year. Many seniors have more than one fall each year.
Falls often result in a trip to the hospital. Seniors represent over 1/3 of all accidents that report to our hospitals, and they represent almost 60% of all admissions. Also, their stay in the hospital is much longer. The average stay is 14.3 days compared to 7.5 for all other medical issues.
Falls are very serious. They represent over 90% of hip and wrist injuries and 60% of all head injuries in seniors. Over half of these injuries result in the individual never returning to full mobility.
These are alarming statistics. However, the problem of falls in the senior population is indeed much larger than these statistics describe. Most falls in seniors go unreported. It is impossible to estimate the actual number of falls that take place, but we can assume it’s much higher.
Simon Fraser University did a lengthy study on the cause of most senior’s falls, and the results were alarming. Through the use of video monitoring, they observed falls in real time. The most prevalent cause of falls (41%) was merely the inability to transfer one’s weight from one foot to the other. Transferring your weight can cause the center of gravity to shift too far, causing the fall. The second highest (25%) was catching their foot on a chair leg, a carpet, a ledge or the leg of a table. Slips and stumbles accounted for (21%).
Most falls take place in the home; in fact, statistics show that well over 50% of all falls take place in the home highlighting the importance of being safe from falls in your own home. We will show you how you can dramatically improve the safety of your home environment.
The most serious falls often involve breaking a hip. Many seniors have osteoporosis, and this makes their bones vulnerable during a fall. The sad reality is that 1 in 5 people who break their hip die due to complications within one year of their fall. Moreover, after the most serious falls, the person never returns to their home. These are serious and sobering facts, and it means if you are vulnerable to a fall you must act immediately.
We know falls are a serious problem and they can rob seniors of a high quality of life. We also know that they are all too common and a very serious problem for individuals and our healthcare system. However, they are prevented if we act soon. You need to focus on a few things that will help you live a safer and more productive life. The first task is the most obvious and in many ways, the easiest to accomplish. You need to create an environment in and around your home that is safe. This guide provides a checklist of things to help you avoid the situations that cause most falls. As you read through the steps, you will notice that they are common sense steps. Most of them cost little to no money. Once the potential dangers in your home environment have been taken care of it is time to look at products that will help you prevent from falling in the future. Whether it is a product or service for your home, aids to get around or advise regarding clothing options, we have provided an extensive list of the latest items that we are recommending. Finally, it’s time to deal with your body as this is the most exciting part of the guide. We show you that no matter what age you are you can strengthen your body, take better care of it, improve your balance and retrain yourself to walk with more confidence. Let’s start the journey.
Making Your Home Safe
We know that falls often involve the most mundane of everyday tasks. Tripping over a carpet or a table leg is much more common than a slippery patch of ice. By making some small changes to your home environment, you can greatly improve your chances of avoiding falls. Whether you live in a house or an apartment making small changes to your home can go a long way to staying safe and injury free. Some of these tasks might be too difficult for you to perform by yourself. Make sure you get some help for those tasks: a family member, a friend, building maintenance staff or outside help. A safe home is the most important thing you can do so don’t be afraid to ask for help.
- Pick up all of the clutter that has accumulated on the floor
- Store shoes, umbrellas, hats and other items in a closet or drawer
- Remove all throw rugs
- Secure remaining rugs with double-sided tape
- Repair loose floorboards
- Make sure that everything you need is easily accessible at your comfortable reaching height
- Once again make sure all of your commonly used items are easily accessible
- Keep all chairs in the kitchen and dining room tucked under the table
- Immediately clean up all spills to avoid slippery floors
- Remove all items on the stairs
- Keep the stairs well lit
- Make sure that there are handrails on both sides and they are installed securely
- Immediately clean up any spills on the bathroom floor
- Make sure there is a good non-slip bath mat
- Make sure the bathroom is well lit
- Install a nightlight in the bathroom
- Professionally install grab bars by the toilet and bathtub
- Have a light that is easily reachable in the middle of the night
- Make sure that the path to the washroom is clear
- Install a nightlight
- Leave your walking aid (if you need this: walker/cane) by the bedside
- Consider removing the coffee table for a clear path
- Clear paths by eliminating all unnecessary furniture
- Place all lamps and other items away from natural walkways
- Make sure each piece of furniture is secure and stable
- Remove all electrical cords and other items that are on the floor
- Consider seating options where your hips are above knee level for easier sit to stand
- Make sure halls and walkways are free of clutter
- Ensure there is bright lighting
- Install nightlights
- Place a bench or chair near the entrance for changing footwear
Entrance and driveway:
- Make sure that the entrance is well lit
- Have de-icing salt placed on the entrance and driveway
- Remove items that are in the pathway of the entrance
Outside the house:
- Always have the garden hose put away
- Place all rakes, shovels and other tools away
- Make sure that all outdoor furniture is secure and safe
- Remove all unnecessary items on the ground
- Watch for wet leaves, have leaves removed
- Stay off the wet grass
When leaving home:
- Always plan and carefully prepare what you will need
- Take your walking aid with you
- Make sure you are wearing the proper footwear
- Only go out when it is clear, bright and dry
Final thoughts on preparing your home:
- It’s difficult to let go of things we love, but they might be the very item that causes a fall
- You love your pets and your grandkids, but they too can be a source of an accidental fall. Make sure you know where they are at all times.
- Don’t walk a pet on a leash, when you know that they are not calm and stable or have a habit of chasing a bird or a squirrel.
- Check your home and analyze what could get you in trouble that would cause a fall.
- Take your time; you’ve earned it in your life.
- Plan ahead, think about what you need before you go out.
What You Need to Purchase
Once you have made sure that your home is secure from the most obvious dangers you need to focus on what you might purchase to assist you in staying safe and upright. These strategies range from very small items that cost little money to more expensive items that will have a greater impact on your safety. Always keep in mind, that the ultimate goal is to keep you safe and free from potential falls. You might not need all of the items below, however, consider each one as a potential savior.
- Install grab bars in the tub, shower and toilet areas of the bathroom
- Consider handrails in the hall
- Place Reflective tape on all door sills
- Secure non-slip treads on wood stairs and flooring
- Install a stairlift to eliminate the dangers of falling on your stairs
- Install light switches on both the top and bottom of all stairs
- Install motion sensitive lighting that eliminates the need to find a switch at night
- Make sure you have furniture, chairs, sofas, and beds that you can easily get on and off (when you sit with your feet on the ground, your hips should be slightly above knee level)
- Your physiotherapist will help you to adjust all of your furniture for the proper height
What you wear can make a big difference to your safety. Follow these suggestions to help reduce your risk of falls.
- Avoid loose slippers; they do not give you the grip you need on the floor
- Wear nonslip footwear both inside and outside of the house. It’s a good idea to start the day in a comfortable pair of shoes that provide good grip and leave them on for the day
- Avoid heels that are greater than 1 inch
- Consider shoes with ankle support (snug heel and wide forefoot)
- Consider footwear without laces. Laces can become undone and pose a tripping risk. Loose laces are also a falling risk, particularly when you need to tie them from a standing position when out in the community.
- Velcro fasteners are a great idea
- Try and find footwear that is easy and comfortable to take on and off
- Avoid loose-fitting clothing that can get caught on objects
Your Vision is Important to Prevent Falls
We all know that vision decreases with age. However, did you know that poor vision is one of the leading causes of falls in seniors? Vision issues are also one of the most easily overlooked areas in a Fall Prevention plan. The reason is, that eyesight deteriorates slowly over time, and one is usually not aware of just how their vision has changed. Very few seniors have their vision checked as often as they should have. Follow these steps to help to ensure that your vision is not the cause of a future fall.
- Get your vision tested on a regular basis
- Follow all of the recommendations from your eye doctor
- Do not wear your reading glasses while walking as this can distort your visual field
- Make sure your home is well lit during the daytime
- Ensure that your bedroom, the hallway, and the bathroom are equipped with a nightlight and that the light switches are always within reach
Medication and Falls
For most seniors taking one or more drugs is simply a daily routine. While these medications were prescribed with your health in mind their interactions and effects on your body can have dire consequences. Adverse drug reactions are serious and can be deadly. They can also increase your risk of falling as you run the real risk of losing your balance due to the interactions of one or more of these drugs. As we age, our body may change the way we metabolize certain medications. It is very important that you talk to your doctor to see if you can work with them to ensure your medication is safe, working well together and in the proper dosage for your well being. If at all possible, ask your doctor if a reduction or an elimination of one or more of your medications is a possibility.
Your Diet is Important
The majority of seniors do not get enough protein and calories to help prevent muscle loss. Also, they lack sufficient intake of key vitamins and minerals. The lack of vitamins could be a result of living alone, difficulty getting to the grocery store, a lack of appetite or any number of other factors. ‘You are what you eat,’ and if you are not getting the sufficient amount of protein and calories on a daily basis, you are zapping your muscles of much-needed strength.
Compounding the problem of insufficient protein intake, seniors face the fact that the natural aging process robs us of muscle strength. After the age of 70, we begin to lose 15% muscle, mass per decade. Muscle loss increases dramatically with inactivity. The loss of muscle mass is called sarcopenia, and it has a dramatic effect on one’s ability to remain stable on our feet. Studies have shown that there is little correlation between body weight and falling. There is, however, a direct correlation with a loss of muscle mass and an increased risk of falling. Follow these tips to make sure that you are consuming a diet that will help to increase your strength and improve your balance.
- You need to make sure that you are consuming 20-30 grams or 3-4 ounces of protein as a minimum at each meal
- Stay clear of a high carb and low protein diet
- Make sure your overall calorie intake is adequate
- Stay hydrated, drink lots of water throughout the day
- Understand that alcohol can be a major risk factor for falls
- Consider supplementing your diet with Vitamin D which can help reduce muscle loss
- In addition to Vitamin D, Calcium has been proven to be beneficial to seniors
- Weigh yourself regularly and take note if you develop sudden weight loss
- Consult a dietician or nutritionist
Work With Your Doctor
Your doctor plays an important role in your fall prevention program. Regular check-ups with your physician can help to keep your physician up to date on issues that affect your health. It must begin with a frank discussion during your doctor’s visit. Let your doctor know that you are concerned about falling and that you are willing to work on fall prevention. If you let your doctor know that you have a plan to stay independent, it will encourage him/her to do everything possible to assist you in your plan. Changes in weight, blood pressure or other vital measurements can alert your doctor to facilitate a course of action. Honest discussions in regards to your medications and other medical concerns should be ongoing. Your doctor is a key team member in your overall health plan, and it is important to keep him/her informed of any changes in your well being.
We have already outlined some of the things you can purchase that will help prevent falls. Let’s take a closer look at the most important items that have your safety and security in mind.
One of the most important considerations is a medical alert system. You might be tempted to stay with your cell phone or portable landline phone. Don’t make this mistake. It is quite possible that you may not always have one of these items close to you at all times. Your phone may need to be charged; it could be left on a table or in another room. It is imperative that you have a wearable medical alert system. An alert system will give you and your loved ones the peace of mind that no matter what happens your device will be activated and you will get the proper help you need.
The first thing to consider is, whether you need a portable system or one that works only in the home. The decision comes down to whether you are an active senior or whether your mobility keeps you confined to one location. For those Seniors who are active and leave their home, the portable system based on cellular service is highly recommended. For those homebound seniors, a system that works only in their home is all that they would require.
The second consideration is whether to have the chosen device monitored by a 24/7 monitoring service. An alternative option is, to have the device call a designated family member or friend. There is a greater cost of having a monitoring service. However, it is essential that you choose this option. Relying on a family member, neighbour or friend has its obvious limitations.
Your device should have built-in GPS capability. GPS tracking can help the authorities if you ever get lost. More importantly, it will aid the emergency response team to your exact location in case you can’t speak or don’t know where you are at that moment.
Finally, you should consider adding Fall Detection on your device. Fall Detection will alert the monitoring system that a fall has taken place. Naturally, this will result in an additional monthly charge, but may well be worth the extra cost, this is recommended if you are at high risk of falling.
In addition to a medical alert device here are some other products that have shown to be highly effective in either helping to prevent falls or cushioning the fall.
Bedside fall mat: If you run the risk of falling out of bed through the night then this product might be helpful. Most of these mats have a non-slip bottom and enough foam to cushion the fall from a bed. Also, consider an electrical bed system that can be lowered to the ground during the night.
Comfortable non-slip shoes. These should be easy to both put on and put back off.
Fall Management Socks. These are warm and comfortable socks that provide the wearer with a slip-resistant bottom.
Grab bars in the washroom. They should be installed wherever there is a need for balance: in the shower, toilet area and along the wall.
Raised toilet with bars. Raised toilet seats provide an easy way to get on and off the toilet, and the bars provide an extra level of safety.
Shower chair. Showers are inherently dangerous. The combination of wet surfaces and unsure footing can lead to a fall. A proper non-slip mat on the floor can help to mitigate a fall. The addition of a shower chair is a perfect addition to the bathroom. Sitting down for a shower provides stability and safety.
Transfer bench. If you have a bathtub, this is a product you should consider. It allows for the transfer over the side of the tub by merely sitting on the bench and scooting over. The act of stepping over the side of a bathtub is one of the most dangerous things a senior faces. A transfer bench can help to alleviate this danger and can also double as a shower chair.
Non-slip mats and tape. If your floors are slippery, then consider placing non-slip mats or non-slip tape that will give you a better grip on the floors.
Having a reacher or grabber available in a room that has items that are not easily within reach. Using stepladders or chairs to reach an item should be avoided completely.
Remote controls for lighting, television or other electric and electronic devices. Consider installing the clapper, motion sensitive lighting or have a home assistant device like Amazon Echo, Google Home or Apple Alexa. The less stress to turn on or off televisions, radios, and lights the less risk one undertakes.
If you are at risk of falling it is most likely that you will need some assistance in getting around. Several products that can help you to improve your mobility. Canes and walkers not only provide support and assistance in getting around they can help build a sense of confidence and security. Proper research is important so that you not only purchase the right product but that it fits your body and you operate it correctly. Your physiotherapist will guide you in setting up the height and proper use of the aid.
In most cases you will be purchasing more than one walking aid, a cane and a rollator, or a stairlift and a scooter. Each has their function, and none of them can answer all of your needs. A remarkable number of seniors who have fallen did so while not using their device. If you need a walking aid, then you also need to get in the habit of using it when appropriate. Here is a guide to help you pick the right product for your needs. A final decision on a cane, walker or another device should be made in consultation with your physiotherapist. They will provide training in the proper way of using the walking aid.
Walking cane. Canes the simplest and cheapest option that you can purchase. Walking canes are suitable for balance issues and can help to provide stability for those who need just a small amount of assistance. Canes can come with a single, wide and narrow tip bottom or a quad tipped bottom. Single tips are the most common canes. The tip at the end of your cane provides traction so make sure your cane is equipped with a really good rubber tip. For the winter you might consider ‘ice picks.’ Your physiotherapist can help you to select the cane that is right for you. The hand grip should be comfortable in your hand. You may have arthritis in your fingers causing pain while managing the cane. Try different grips until you find the one that you are most comfortable using. The cane must be fitted properly. Otherwise, it might compromise your balance. Measure your cane height in standing: your arm should hang at the side of your body. The cane’s handle should come to the top of your wrist. A cane that is too short will cause you to lean too far to one side; if it is too long, you will have to work extra hard to push down on it. You will benefit from a physiotherapist’s instruction on how to properly move around with your cane. In general, you will put the cane in the opposite hand to your weaker side. The cane should move in unison with the weaker side.
Walkers and rollators. Contrary to popular belief a walker is not a rollator nor is a rollator a walker. Walkers have either two or four fixed legs, and they need to be lifted as you move forward. Rollators have wheels on all four legs. Walkers provide more stability and increased balance. Rollators provide ease of movement, usually have a basket to carry items and a seat to rest. If you know that you need more stability than what a simple cane provides, then you should consider a walker or rollator. You should consult with your physiotherapist to decide which product is right for you. Here are some things to consider before you make your purchase. Walkers provide the most stability, and if you have difficulty walking short distances without assistance, then a walker might be the right choice. However, walkers need a certain amount of upper body strength. If you struggle to lift items, then a walker might not be the right for you. Rollators are perfect for those seniors who can walk short distances but would like the comfort of some assistance. They maneuver easily and come equipped with hand breaks. The seats and carrying basket are very convenient. The decision on what product is right for you should be made in consultation with your physiotherapist. If you plan to place the rollator or walker in a vehicle, please ask your physiotherapist to demonstrate the best ways to complete this task.
Stairlift. A stairlift is a mechanical device that assists you in getting up and down stairs. Negotiating stairs for those who have balance or stability concerns pose a grave concern to many seniors. Stairlifts can help provide safety and peace of mind. They can also eliminate one of the biggest dangers seniors encounter while climbing up and down a set of stairs. If it is your desire to live at home and your home comes equipped with stairs, then a stairlift should be seriously considered. Here are some things to consider before having a stairlift installed in your home. Make sure the seat is right for you and that the load capacity is appropriate to handle your weight. Consider having a seat that swivels around at both the top and the bottom so that you are facing away from the stairs when getting on and off. A stairlift can save you from falling on the stairs and provide you with much-needed peace of mind.
The Importance of Staying Active
If you are a senior who has fallen or you are unsteady on your feet, you might assume that things will only get worse from this point forward. You must understand that with proper guidance, you will be able to regain some or all of the strength, power, and flexibility that you used to possess. The benefits of working with a certified physiotherapist will help to transform you from being fearful of falling to feeling strong and confident.
Your first physiotherapy session will involve an initial assessment. It’s during this session that your physiotherapist will analyze your current abilities, strengths, and weaknesses. They will test your balance, strength, and mobility with standardized tests. A trained physiotherapist will explore your mobility goals (i.e., walk to the car, pick up items from a low shelf, walk a further distance to visit a friend, etc.). They will come up with a treatment plan that is uniquely catered to you and your requirements.
A home visit by your physiotherapist is the ideal scenario as this will allow them to assess you in your home environment. They can help spot any potential dangers, observe you moving around your home and tailor their exercise program so that it will benefit you in your home environment.
Seniors frequently have weak muscles that are unable to support their body when suddenly jostled. Their muscles might not be able to fire as rapidly as required. physiotherapists are trained to carefully assess both the strength and firepower within your abilities. They can prescribe, demonstrate and monitor exercises able to increase strength.
Balance is essential to remaining upright and avoiding falls. Most people assume that balance is simply the ability of your legs to stay underneath you. To maintain balance, you should be able to keep your body weight and momentum supported by your lower half. However, balance is much more complicated than simply your lower body supporting your upper body. Balance involves your eyes, vestibular system, and your muscles, all working in a fine and coordinated sequence. In later years these connections between your various systems can become impaired. Physiotherapists can work with you to retrain your connections and improve your balance. Physiotherapists have a range of tests and are trained to assess your balance. Your balance ability can direct your physiotherapist to customize a program, that is uniquely suited for your needs. Through a comprehensive assessment by a physiotherapist, you will achieve restoration of your balance.
Your physiotherapist is an important and vital component to your comprehensive Fall Prevention Program. The majority of the steps outlined in this guide merely treat the symptoms. Physiotherapists can treat the root causes of falls and impaired balance. Getting to the core source of your mobility difficulties is how you can restore your functional abilities.
It may be difficult for an individual to believe that they can improve their balance, strength, coordination, and mobility, however, there is hope. No matter how old you are, your muscles can be strengthened, balance can be improved, and your mobility can be restored. You owe it to yourself and your loved ones to take this step. Do the work and reap the rewards. A long and worthwhile lifestyle awaits.
This article by the Bergin Motion team was intended as a guideline with one mission in mind. To help you avoid falls. It’s quite possible that you might seem overwhelmed by everything that has been outlined. This guide has dealt with making your home safe, dealing with your diet, vision and activity level. We want you to know that you can do this, that you can avoid falls and you can live independently. The important thing is you need to act, and you need to do it now. Your happiness and independence are at stake. Pick up the phone and give us a call. We can help you as we have helped many other seniors stay in their home, avoid falls and remain happy and proud of THEIR independence. An old expression says that you have two choices: “either you can get busy living, or you can get busy dying” so let us help you get busy living. You owe it to yourself, your friends and your family. Let’s make it happen together.