Falls and home safety

Description
Falls can occur at any age, but the risk of falling and injury from falling increases with age. For older adults, falls are a major health issue that can lead to disability and loss of independence.
One-third of all older adults report falling each, but the number of falls may actually be higher because many people do not report them due to embarrassment. In fact, falls are the most common cause of injury and hospitalization for trauma among older adults. Seniors who are hospitalized for a fall may never regain the level of independence they had before the incident.


Causes/associated factors
Falls among seniors may be related to various factors.
Age
Changes associated with the normal aging process -- such as changes in vision, hearing, balance and the manner of walking, as well as slowed reaction time and increased frequency of urination -- can predispose a person to falls. A sedentary lifestyle also leads to weakness and increased falls.

Medications
Medications may cause dizziness, drowsiness, loss of urinary control or increased frequency of urination. Medications that may increase the risk of falls include those given for anxiety, sleep, depression, high blood pressure, heart conditions, arthritis and pain.

Illnesses
Illness often aggravates the physical changes related to aging and medications. Illness may also lead to nighttime urination, weakness, fatigue, paralysis, confusion, and foot deformity or pain. Illnesses that may increase the risk of falls include Parkinson's disease and other movement disorders, Alzheimer's disease and other forms of dementia, diabetes, stroke, arthritis, Ménière's disease, cataracts, glaucoma, alcoholism and depression. Falls can also be the sign of a sudden illness, such as a urinary tract infection, pneumonia, stroke or heart attack.

Environment
Environmental factors that increase the risk of falls include:

poor lighting
slick or irregular floor surfaces (raised thresholds, for example)
clutter, cords or throw rugs in main traffic areas
furniture that is too low, high or soft
unsafe stairways
restrooms without grab bars
restrooms with fixtures that are too low or high
new or unfamiliar living environment
Most falls occur indoors, especially in the bathroom, bedroom and kitchen. Outdoors, curbs and steps are the most hazardous areas. Stairs are a frequent site of falls both indoors and out. The most dangerous steps are the first and last.


Treatment
After a fall, look for any signs of injury. Even if you're not hurt, it's best to consult your doctor. The fall may indicate a developing illness. The doctor will evaluate the cause of the fall and suggest measures you should take to prevent future falls. If necessary, a family member, visiting nurse or physical or occupational therapist may help you evaluate your environment for fall risks. Finally, physical therapy may be useful for a gait and balance evaluation. The physical therapist may recommend an assistance device, such as a cane.

Prevention
Correcting safety hazards, addressing any health concerns, and modifying certain habits can help decrease your risk of falling. Here are some tips for home safety.
Use adequate nonglare lighting throughout the house, including the stairways. Install switches at the top and bottom of each flight of stairs. Place night-lights in the bedroom, hallway and bathroom.

Install handrails on both sides of each stairway. Mark the top and bottom steps, and place nonslip adhesive strips on step edges. Keep stairs in good repair and free of clutter.

Keep walkways free of throw rugs, cords and clutter.

Correct any uneven walking surfaces, such as raised thresholds.

Avoid highly waxed floors and thick pile carpets.

Avoid chairs that are too low, high or soft. To help you get up, use chairs with armrests.

In bathrooms, install grab bars near the tub, shower and toilet. Use nonskid mats in the tub and shower. Consider using a tub or shower chair and an elevated toilet seat.

To avoid bending and reaching, try to use shelves that are between hip and eye level. If necessary, use handheld reaching devices for other shelves.

Use a portable telephone.

When outdoors, avoid uneven surfaces such as holes, rocks or cracks in the pavement. Also, avoid surfaces covered with ice, water or wet leaves.
The following self-care tips can also help prevent falls.

Have your vision and hearing checked at least once a year.
Consult your doctor if you experience foot problems, foot pain or any side effects with a new medication.
Consult your doctor if you experience dizziness when you stand after lying down or sitting.
Wear properly fitting, low-heeled shoes with nonskid soles.
Stand up slowly after lying or sitting.
Avoid alcohol.
Use a cane or walker for stability if your doctor recommends it.
Exercise regularly to maintain muscle strength and coordination.
If you are at risk for falls, you may want to wear an alarm or medical alert bracelet you can activate if you need help.


Considerations
Even without physical injury, falls may contribute to social isolation. The fear of another fall may lead you to restrict activities such as traveling, shopping, and attending religious and social functions. Daily activities such as bathing, dressing and moving around the house may also be limited by the same fear.