Fall Prevention

Strategies That Can Be Used At Home To Prevent Falls.

Some of the most common predictive risk factors for whether a person can successfully stay in their desired home or dwelling include:

Today I want to write about fall prevention as it’s one of the leading risk factors that prevents older adults from staying in their desired location (aging in place) and can decrease health and quality of life.

I have personally experienced the pain and suffering caused by falling. Right after I graduated with my Doctorate in Occupational Therapy, I fell and broke my right wrist (which is my dominant hand).

Guess what my doctoral project was on? Aging in Place & Fall Prevention…. I wish I was making this up.

The culprit of my fall was a beautiful, albeit evil (in my opinion) throw rug my Grandmother bought in Turkey in the 70s. I tripped on that rug on my way back into her apartment after taking out her trash. Grandma was 95 at the time and I was 33 and had just graduated OT school near Portland, Oregon. I was staying with Grandma because it was the night before I had an interview for my “dream job” at a prestigious hospital in Seattle.

I didn’t make the interview.

Even though I broke my wrist, my Grandmother refused to move that rug for another 3 years! She only agreed to move it after she tripped on it several times, had a fall in another part of her house and wound up in the hospital. Her hospital stay was enough to make her reconsider moving the rug. My Grandma, like many of my patients, had to come to terms with her fall risk on her own terms, and only then was she willing to make changes to her environment. I had even suggested we hang the rug on the wall. She responded by saying, “You can move the rug….when I die,” while sipping her martini.

Grandma eventually came around and continues to inspire me to share knowledge. As part of my effort to help people and families support one another with “aging in place” and maintaining quality of life, I’m going to review fall statistics and give a few pointers for strategies that can be used at home to prevent falls.

One in five falls leads to serious injury including broken bones (fractures), and head injuries (Alexander, Rivara, Wolf, 1992; Sterling, O’Connor, Bonadies, 2001). More than 800,000 patients are hospitalized every year due to a fall injury, with head injuries or hip fractures as the most common injuries (CDC, 2016). Falling once doubles a person’s chances of falling again (O’Loughlin J et al., 1993).

Now let’s review some of the areas where falls occur and how we can try and minimize risk.

Stairs are a big culprit for falls as the likelihood for a person aged 65+ to fall increases in homes with stairs.

Strategies:

Bathrooms are easy to modify, however, falls frequently occur when people are in a rush to get to the bathroom.

Strategies:

Gardens are one of the most frequent places falls occur near homes.

Strategies:

Living Rooms are the source of close to 1/3 of falls for older adults that live in homes without stairs.

Strategies:

Driveways & Sidewalks Around the House are particularly dangerous due to the high risk of injury from landing on pavement.

Strategies:

Bedrooms are the place where nearly 1/3 of falls occur for adults living in homes without stairs.

Strategies:

Although a few strategies around the home can decrease risk for falls and injuries, I always recommend people ask their doctor what their fall risk is, and how they can decrease their risk while increasing their strength and mobility. I’ve also found in my work experience that patients respond better to peers than they do clinicians or family members. If you’re caring for a family member, incorporate fall prevention conversations with your family member’s friends. Statistics show that falls are common among older adults. Suggestions can sound less dogmatic coming from a friend than a family member or clinician, and ultimately helping people feel empowered is the best way to promote quality of life.

Sources

Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall–related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 5, 2016.

O’Loughlin J et al. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. American journal of epidemiology, 1993, 137:342-54.

Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism.
Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9