The most common location for serious falls in older adults is in the home.
Going through your home with a checklist of hazards, or even having it evaluated by a physical therapist, can go a long way to reducing the risks.
Fred Barnard, 80, is a retired volunteer Troy firefighter. In his years of fighting fires, he never broke a bone, but recently after being awakened by his dog Max in the middle of the night, he fell.
“I fell sideways and fell on my arm, and I broke my arm,” said Barnard.
Fortunately, he recovered, but even though this was the first time he had broken a bone, it was not the first time he’s fallen.
“I fell in the bathroom,” Barnard said. “I fell in the bedroom several times. It’s kind of scary when you fall.”
To help identify risks in his home, Sara Arena, a Henry Ford Health physical therapist, and I paid a visit to his home to go through it room by room, looking for correctable problems.
“The physical therapist can then be in the home and give a very individualized approach to hopefully prevent the fall from even occurring,” said Arena.
The first area we looked at was Barnard’s garage, where he enters his house.
Arena thinks entering through the garage can be a good idea.
“(Fred) enters and exits through their garage, which is a really safe place if it’s available because ice and snow don’t accumulate in those areas, so usually those floors aren’t as slippery,” Arena said.
Her suggestions for the garage included tape or paint highlighting the step from the garage floor to the entry level and a grab bar to help steady himself on the steps into the entry door.
Onto Barnard’s living room, her first concern was his rug.
“This is a rug that if you’re in the middle of it, you might not have an issue,” Arena said.
Arena thought the pile was thick and the edges could catch someone’s foot. She suggests removing the rug, choosing a thinner one with less pile, or carpet wall to wall.
Arena also identified that removing any clutter or trip hazards where people might walk is essential. In this case, that’s Max’s bed. Also, don’t forget pet toys and even pets themselves.
“Pets are actually a very big concern,” Arena said. “There is actually some data to show pets are a cause of falls among older adults.”
Ideally, pets should be trained to stay beside you, not in front or behind you.
“The recommendation is 75-watt bulbs or higher to have appropriate lighting with our eyes as we age,” Arena said.
Moving into the bathroom, the considerations are different.
“My first thought as I walk into this bathroom is going to be the rugs on the floor, so thinking about the test where you put your foot right on here and move it, this rug, as you can see, doesn’t move, so this is actually a fairly safe rug,” Arena said.
Rugs, in general, can pose a trip or slip hazard, but they can be very important and useful in areas that become wet and slippery, like the bathroom or near the kitchen sink. Just make sure the rubber backing is good.
In the bathroom, tubs and showers are naturally slippery, so in addition to installing an anti-skid surface, grab bars are important.
Statistically, the bedroom is where most falls in the home occur.
“In the bedroom, one of the key recommendations is either having a lamp near the bed that’s reachable so that you can turn on the light or potentially something like a clapper, and those are pretty reasonable cost,” Arena said.
Another thing to keep in mind, pay attention to your path to the bathroom.
“You want to make sure that it’s clear of clutter before you go to bed at night because, during the night, when you’re tired and groggy, you don’t want to be worried about stepping over things that maybe aren’t well-lit,” Arena said.
Stairs are another fall hazard zone.
“If your stairwell will allow for it to have a railing on both sides, and you want to make sure at both the top and the bottom of the stairs you have a way to turn on a light,” Arena said.
Speaking of steps, Arena cautions that step stools aren’t generally a good idea.
“The recommendation is no more than one step and to have a rail in front of you or on the side that you can hold onto,” Arena said.
Finally, acknowledging that falls do happen, she emphasizes the importance of having a plan, whether it’s a life alert type button, a smartwatch, a cellphone, or even a smart device like an Alexa that can send a message. Being able to get help is a must for everyone.