Fall. When I hear that word this time of year, I think of gorgeous autumn colors, football, chilly days, pumpkins, and children gearing up for Halloween. But the word fall has many different meanings (52, in fact I looked it up). As a physical therapist working in home health care, the word fall is not as beautiful as our lovely Upper Peninsula autumn weather. Falls are a very common problem for elderly people in the home, frequently leading to serious injury. Six out of every 10 falls occur in the home, where we are familiar and comfortable with our surroundings. The good news: they are preventable.
I'd like to take this opportunity to review some things everyone can do to improve safety and prevent falls at home. Making minor modifications to your home can significantly improve safety and reduce the risk of falling. It's important to make the changes BEFORE a fall or other accident occurs, but convincing people to make preventative changes is sometimes difficult. Patients who have fallen almost always tell me they wish they would have improved the safety in their home before it was too late. You can learn from their experiences.
One of the most common hazards I find in homes are throw rugs. It's rare for me to find a home without them. If they are not secured, the rug can slide under foot and cause a person to lose their balance. Throw rugs can also be flipped up by shuffling feet or the posts of a walker, causing a tripping hazard. The best solution is to remove all throw rugs completely, but using professional-grade, double-stick tape to completely secure the edges can improve safety. Very thin mats with a rubber backing are acceptable, but people must still take care when walking over these with walkers. One area in the home where a rubber-backed rug is helpful is in front of a sink. A secure rug is much more safe than a wet, slippery floor. And of course, a bath mat is always recommended in front of the tub or shower.
We live in an area with beautiful, historic homes. I love the character, but our ancestors did not wire these homes for safety (or for today's electronics). Stairwells and hallways are often poorly lit, which will likely require professional electrical upgrades. Often, there is one small light fixture for an entire room, which is not enough to adequately illuminate the space. Lamps are helpful, but often the outlets in older homes are not exactly where you want them. Be careful not to stretch extension cords across walkways you will address one safety problem while creating another. If you must have an extension cord across a walkway, use duct tape or another strong tape to completely cover the cord. Be sure to replace the tape as soon as it starts to come loose. It is important to have good lighting in bathrooms and bedrooms, and night lights are essential to prevent falls during nighttime trips to the bathroom. Don't forget to have flashlights available in the bedroom, bathroom, kitchen and living room for unexpected power outages.
Speaking of the bathroom, this is a room that often needs attention when it comes to safety. Grab bars near the toilet and shower are helpful to improve safety with transfers. Patients will often tell me they don't need grab bars because they hold onto the sink or use the towel bar when getting in and out of the shower. Yikes! Towel bars are meant to hold the weight of a wet towel, not a person! Sinks are often not stable enough for the added pressure, especially pedestal sinks. A properly installed grab bar is the only object safe enough to support your weight with these transfers.
Clutter comes in many forms, but we often don't think of furniture as clutter. When arranging furniture in a room, ensure the walkways are wide enough to move freely, with or without a cane or walker. Less may very well be more. "Stuff" clutter also presents a fall risk in many ways. Things that become obstacles to walk over or around lead to loss of balance and falls. Also, if your things are disorganized, they are hard to get to. When you have to bend, lean or step up to reach things, you can become unsteady. Place often-used items in easy to reach places, and store less-often-used items out of the way. Always ask for help when it comes time to access items stored in harder to reach places like upper cabinets and attics. (It won't be long, and we will need to get out those holiday decorations.)
This is not an exhaustive list of possible home modifications to improve your safety, but it's a very good start. Don't wait until it's too late. Making these changes today will help to ensure the leaves (and snowflakes!) are the only things falling this autumn. For more information, contact your health care provider, or call 337-5700.
Editor's note: Caroline Gwaltney is a Physical Therapist and Board Certified Wound Specialist at Aspirus Keweenaw Home Health and Hospice.