Falls and Injury

The World Health Organization defines a fall as ‘an event, which results in a person coming to rest inadvertently on the ground or other lower level.’ In Canada 30,000 people fracture their hips every year. Among women who had a hip fracture, 50% will no longer be able to live independently with 19% needing long-term nursing home care. 28% of women and 37% of men will die within the first year. 1 in 3 will re-fracture within the first year and 1 in every 2 will re-fracture within 5 years. Sobering statistics. There is good reason to prevent as many falls as possible. Before you run out and buy rolls of bubble wrap to protect your loved ones, lets look at some strategies that might work for you and the seniors in your world.

First and foremost keep moving. Use it or lose it is a very real concept and while it won’t prevent falls in and of itself, it will equip the body to better withstand the effects of falls. It makes sense that a sedentary lifestyle – sitting or not being physically active for most of the day – is a factor that contributes to many conditions and diseases. Check out the normal routine of the senior in your life. Does their day consist of watching television, reading books, sitting at a computer or some other combination of things devoid of physical activity? Lack of physical activity causes muscle atrophy which in turn affects quality of life … if you don’t do it, eventually you can’t do it. Gentle exercise such as yoga, tai chi or walking with a friend are all great options. If you have taken advantage of the free membership to The Oldish, look in the Toolkit for exercises that can be done standing or sitting.

Medications are often acknowledged as the biggest risk factor for falls. There are a couple of proactive steps that can be taken to mitigate this concern. Start by working with your senior to write out a list of every medication they take. Include prescriptions, over the counter and herbal medications … yes, they count! That list should be with them at all times and reviewed with their primary care physician annually or every time a new medication is prescribed whichever comes first. Check out our Medication Checklist in the Toolkit. We developed that with input from doctors and highly recommend that you use it.

Continence issues tend to have a life of their own but can make your senior’s life very difficult affecting their confidence, socialization habits and fall risk. A discussion with a nurse specialist who works with continence issues is a good idea and, of course, the subject needs to be noted with the physicians but one thing that can be done at home is to chart the eating, drinking and toilet habits of your senior. After this has been completed for a couple of weeks, patterns start to emerge that can be altered in order to produce more desirable results. For instance, fluid intake can be reduced or stopped after a certain hour in order to eliminate one or two trips to the washroom in the middle of the night … note: check with the doctor because certain medications require fluid intake patterns that can’t be altered. Making sure that pathways to the bathroom are uncluttered is important, training oneself to turn lights on rather than walking in the dark is helpful and there are several types of incontinence products on the market ranging from small pads to full incontinence briefs that can be utilized in an effort to reduce hurried trips to the bathroom.

Environmental hazards are a huge issue but a really easy one to make changes with and see instant results. Clean out clutter; throw out the throw rugs and scatter mats; make sure that lamp and telephone cords are tucked away so that feet and clothing don’t get caught on them; install grab bars in appropriate places making sure they’re nailed into studs not just drywall; replace the existing toilet with a taller or ‘comfort height’ model; have a look at how your senior enters and exits their bed and adjust the height so that there isn’t the need to climb up into it or struggle to get out of it; review the home’s lighting in the daylight and in the evening and make sure that the things that need to be seen can actually be seen clearly; reorganize furniture and kitchen work areas so that everything is within easy reach and sight; make sure that aids such as glasses, hearing aid, canes and walkers are up to date, fitted properly and used; review the need for such items as hip protectors in order to reduce fall injuries and have a discussion to make sure they will be worn both inside and outside of the home. Once again, please consider a free membership to The Oldish and check out our Toolkit for a room by room Home Safety Checklist developed by Dr. Vicky Scott for the B.C. Injury Research and Prevention unit.

Outdoor hazards are not as easily dealt with outside of one’s own property but awareness is key in all locations. Around your senior’s own home, make sure that railings are secure, steps are well defined, clutter such as garden tools, hoses and snow shovels are out of the way. Municipal issues are a bit trickier to deal with but an effective senior’s group can petition the municipality for appropriate solutions to risk factors such as uneven or broken sidewalks, unorganized sandwich board advertising, appropriate garbage bins and planters and properly functioning cross walk lighting and signage.