It’s winter. Sidewalks are often snow and ice-covered, creating an increased risk of slips and falls.
But one of the most common places for falls, especially for seniors, is the one place where people feel the safest.
“It’s the home,” said Linda Ind, Program Co-ordinator of Caregiver Support & Community Outreach at CHATS (Community & Home Assistance to Seniors).
Ind was speaking at a Fall Prevention seminar for seniors, held at the Bradford library on Thursday afternoon, and at least two of the people in attendance admitted to recently experiencing a fall – at home.
“One in three adults fall every year,” said Ind, quoting national statistics. The number jumps to 60 percent when it comes to older adults. “Every 12 seconds, somebody in Canada falls.”
For seniors in particular, the fear of falling can be greater than the fear of being robbed – and fear itself can contribute to falls. Older residents may become less active as a result, which can lead to reduced strength and balance.
There is a real reason for the fear.
Citing the statistics, Ind noted that 30 percent of falls result in strains or sprains, 35 percent in broken bones.
“Falls are the leading cause of accidental or unintentional injury or death,” she said.
Seniors who do fall and experience injuries tend to spend 10 days longer in hospital than seniors admitted for any other reason. The average stay for older Canadians was 12 days; for seniors who experienced a fall, it was 22 days.
Ind identified a number of risk factors that can contribute to slips and falls, and provided advice and some simple solutions, to avoid falling:
. Inappropriate footwear (loose slippers, shoes with poor treads). “Wear sensible shoes,” Ind advised. Avoid wearing loose slippers, especially on stairs, and skip the high heels if you have balance problems, or will be walking on uneven or slippery surfaces.
. Chronic health conditions, including heart disease, diabetes, arthritis, and COPD. Alzheimer’s Disease and dementia can increase the risk of falling by 54 percent due to physical weakness, change in gait and poor balance. Those with Asthma or COPD face an increased risk of 42 percent; Diabetes, 30 percent - not only because of neuropathy (death of nerves) that reduces feeling in the feet, but because of the risk of low sugar episodes producing dizziness - and heart disease, 29 percent.
. Sensory deficits – poor hearing, poor vision, lack of feeling in the feet or hands increase the risk.
. Pain.
. Poor lighting, both indoors and outside.
. Poor sense of balance.
. Poor nutrition. Missing meals can lead to weakness and light-headedness, contributing to falls.
Ind created a “tower of risk,” using building blocks to represent the risks – with the tower becoming more and more unstable, with the addition of each block.
At the base, Block 1, were balance problems. Solutions included taking one’s time when standing up, bending over, or even getting out of bed; being aware of one's surroundings, especially uneven ground surfaces – and when shopping, insisting that groceries are evenly divided by weight between two bags, instead of trying to carry one overly-heavy bag.
Mobility issues were Block 2. A common cause of falls for seniors is using a walker or cane set at an inappropriate height, becoming a danger instead of an assistive device.
Always have walkers properly adjusted by an expert, Ind said. “There’s always people to do that.”
Block 3: Multiple medications. Some drugs have side effects that may include light-headedness, dizziness or drowsiness, and some drugs should not be taken together..
Always check medications with a pharmacist and, said Ind, “If they say take your medication with food, they say that for a reason.”
It’s all too easy to feel “not 100 percent,” and experience side effects if dealing with multiple prescriptions. “Blood thinners alone will make you wonky,” she warned. “Just be conscious of your body.”
Block 4: Low blood pressure, resulting in sudden dizziness, fainting, and falls.
Block 5: Sensory deficits. Hearing loss, neuropathy association with diabetes, vision loss, can all lead to instability when walking, resulting in falls.
The final block in the tower, Block 6, referred to household hazards – and it’s here that seniors can have the largest impact on their own safety.
Ind urged seniors to make themselves aware of the tripping hazards that may be lurking in their own homes – the scatter rugs that can bunch up or slide underfoot, the extension cords that pose a tripping risk, the loving pets that lie on steps or twine underfoot, the medicines left open and unsecured, the obstacles set on the stairs or in doorways, the floppy slippers that can contribute to falls, the places where slips are most likely to occur.
“The number one place for falls is the bathroom,” she noted – also a location most likely to maximize the embarrassment of those who do slip and fall.
Simple remedies, like removing loose rugs, installing handrails, raised toilet seats and grab bars in showers and tubs, can cut the risk.
In the kitchen, seniors should realize their limitations, and place the most-used items on shelves that can be easily reached without bending over or standing on a stool. Never stand on a kitchen chair or climb a counter to reach items on higher shelves; instead, use a proper step stool, and make sure it doesn’t become an obstacle itself.
Ensure that hallways and rooms are well-lighted. Placing nightlights in halls and keeping a flashlight on hand can prevent falls.
Ind also urged seniors to keep active. Even gentle exercise can improve balance.
“It doesn’t mean join the gym and lift weights,” she said – just stretch in the morning before getting out of bed, take walks, and participate in low-impact exercise regimes to build strength balance and improve co-ordination.
She even provided advice for walking on icy surfaces this winter: slow down and “walk like a penguin.”
Wear proper footwear with sufficient tread, then step flat-footed on the ice and take short steps, only shifting your weight to a foot when it feels securely placed, she said. Step “down and not out” from curbs, use your arms for balance - and take your time.
It may look funny, but slow is safe.
Ind handed out information on the Philips Lifeline with fall-detect – providing a measure of security for seniors at risk of falling, a list of gentle exercises that help build balance and body strength, and a checklist, to help identify and remove hazards in the home.
“The longer you’re home and you’re safe, the longer you can stay in your own home,” she said. No-one wants to end up in hospital because of a fall.
