Environmental and Personal Safety Measures Important to Prevent Fall-Related Injuries
Each year, one in three people over age 65 falls, causing many seniors to lose their independence and possibly require a change in living arrangements. Upcoming winter weather conditions only add to the likelihood of falls. However, with proper planning, falls can be prevented.
According to the American Academy of Orthopaedic Surgeons (AAOS), just over half of falls occur in the home, followed by falls that occur in the community, and a remaining 10 percent that occur in institutions such as nursing homes. The National Center for Injury Prevention and Control (NCIPC) states that most fractures as a result of falls occur in the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
The following groups of people are at increased risk for falls according to the AAOS:
• Older women
• Seniors unable to stand on one leg for more than five seconds
• Users of multiple prescriptions and over-the-counter drugs
• Elderly people who live alone
Despite the increased likelihood of falls as a person ages, falls are preventable. Local orthopaedic surgeon John Leupold, M.D. said there are several steps to take to reduce the incidence of falls.
Exercise makes the body stronger and more able to withstand the impact of falls. Leupold said exercises that improve balance and coordination as well as strength are the most helpful. He said, “Exercises like running, walking, and lifting weights are great for balance and strength training. Tai chi is a relatively new exercise in our country, and is great at improving balance and coordination. Before you start any kind of exercise program, though, you should check with your family physician about the best type of exercise program for you.”
As people age, the way medicines work in the body change also. Some medicines, or combinations of medicines, can cause sleepiness or dizziness, which can lead to falls.
According to the AAOS, people should routinely have their vision checked. Conditions like glaucoma or cataracts that limit vision increase chances of falling.
Safety-Proof the Environment
There are several things that can be done in the home or while outdoors to prevent falls. Leupold recommends the following steps be taken:
• Remove things that can be tripped over, such as papers, books, clothes, and shoes from stairs and walkways.
• Keep frequently used items in cabinets that can be reached easily without using a step stool.
• Use good lighting by putting light switches at the top and bottom of every staircase and putting nightlights in bedrooms, hallways, and bathrooms.
• Use grip bars in the bathtub, shower, and toilet areas. Never grab a towel rack, shampoo holder, or soap tray for support in the shower, as they do not hold a person’s weight.
• Use a normal height bed so it is easy to get in and out of.
• Secure throw rugs with double-faced tape or slip-resistant backing or better yet, don’t use throw rugs at all.
• Clean spills on floors immediately.
• Be aware of pets, as they can be moving tripping hazards or jump up, causing falls to occur.
• Use a cane or walker if needed. Promptly replace worn rubber tips of the devices.
• Let soap suds go down the drain before moving around in the shower.
• Do not lock the bathroom door. Leupold said, “Locking the door may delay help from reaching you.”
• Never carry any package that obstructs the view of the next step on the staircase.
• Install handrails on both sides of a staircase and keep at least one hand on a staircase’s handrail.
• Wear glasses if needed, but remove reading glasses before walking.
• Consider carrying a cordless phone or cell phone.
• Close cabinet drawers to prevent stumbling over them.
• Upon awaking in the morning or at night, sit on the edge of the bed to prevent dizziness before standing.
• Eat breakfast every morning to prevent getting dizzy.
• Wear clothes that fit properly to avoid tripping on a coat, pair of pants, or bathrobe that is too long.
• Wear shoes both inside and outside the house. Shoes that properly fit and have nonskid soles are best. Also avoid going barefoot or wearing slippers. Leupold said, “You should avoid wearing dress shoes in winter weather because they make it difficult to keep your balance, especially on ice and snow. Instead, wear winter boots or wear treads on your shoes.”
• Put salt down where needed on sidewalks, patios, and driveways.
• Shovel as soon as possible. Leupold said, “If snow isn’t shoveled immediately after it falls, a dangerous layer of ice can form on top. If you don’t want to shovel yourself, set up a service now to handle shoveling for you this winter.”
• Don’t go outside unless it’s necessary. Leupold said, “The less you are out in the dangerous weather, the less likely you are to fall in it. When you do go out, try to get as much accomplished as you can at one time to reduce the number of trips you must take outside.”
• Use the buddy system. Leupold said, “Have someone go with you or at least let someone know where you are going when you venture outdoors.”
• Provide leverage by grabbing onto a railing, putting more weight on a walker, or holding onto a friend more tightly.
• Avoid broken sidewalks or areas under construction if at all possible.
• Keep front entrances well-lit.
• Park where it is clear of snow and ice and keep driving to daylight hours to be able to see patches of ice on the streets and in parking lots.
• Keep a bag of non-clumping kitty litter in the car to create traction if the car gets stuck. Make a scoop by cutting off the bottom of a milk or orange juice container.
Despite preventable measures taken, a fall may at times be unavoidable, but steps can still be taken to minimize injury. Leupold said, “If you know you are going to fall, try to fall on your side or buttocks. From there, it is important to get up in a way that does not make any possible injury worse. You should first take several deep breaths, assess the situation, and determine if you are hurt. If you believe you are injured, do not attempt to get up and instead try to call for help from a family member or by using a cell phone if possible. If you do feel strong enough to get up, roll over naturally, turning your head in the direction of the roll. If you can, crawl to a strong, stable furniture like a chair and pull yourself up by putting both hands on the seat of the chair. Slowly begin to rise and bend whichever knee is stronger, keeping the other knee on the ground.”
According to the NCIPC, many people who fall, even those who are not injured, develop a fear of falling. This fear may cause them to limit their activities, leading to reduced mobility and physical fitness, and increasing their actual risk of falling.
Anyone with questions can contact Dr. Leupold at 712-336-8708. He said, “Falls are a pretty common occurrence, especially in the wintertime, but by being physically active, being aware of your surroundings, and taking proper safety measures, falls can definitely be prevented.”