The leaves are changing, there is briskness in the air – fall is here. While falling leaves are a beautiful sight to behold, there is another type of “fall” which is frightening to watch: the fall of an older parent which can cause serious injury or even death.
According to the Centers for Disease Control and Prevention (CDC), one out of 10 seniors will fall at home in their lifetime and every 29 minutes an older American dies from a fall-related injury. Falls are the leading cause of accidental death for those over age 65 and contribute to the overcrowding in hospital emergency rooms across the country where every year more than 2 million seniors are treated for non-fatal fall injuries.
September 22 is National Falls Risk Prevention Day and while we celebrate the beginning of autumn, it is a great time for the 44 million Americans who caring for someone in the autumn of their life – whether a parent or other loved one over age 50 – to pay attention to the warning signs for potential falls risk.
In fact, it is not just seniors who can suffer injuries from a fall. It is reported by AgingCare.com 52 percent of caregivers who help lift a fallen parent suffer from back pain or injury caused by improper body mechanics when lifting someone. Asking a health care professional for tips on how to safely lift a loved one is critical for a family caregiver’s own health.
Following are 12 tips gathered from sources such as the National Council on Aging Fall Prevention Awareness Week Tool Kit, the Falls and Fractures information from the National Institute on Aging and The Essentials: Falls and Fall Prevention brochure from the MetLife Mature Market Institute and National Alliance for Caregiving to help caregivers identify and solve potential falls risk problems:
1. Remove “trip factors” such as throw rugs, bath or kitchen mats, hallway obstructions and remove clutter such as piles of old newspapers or magazines which may be in pathways and can inhibit mobility particularly for a parent using a cane, walker or wheelchair.
2. Modify stairs by ensuring handrails are on both sides, ensure the tread and rise of the stair steps are differentiated and easy to see (either paint different colors or use a light/dark stain) or even consider purchasing an electronic chair lift for easier navigation of stairs (costs run from $2,700 - $9,000 depending on the track complexity and length of stairs). Also consider moving your parent’s living quarters including bedroom all to one ground floor to avoid stairs all together.
3. Be aware of weather issues – icy or slick front porch steps can be a sure hazard for aging parents. Create and alternative access to the home such as a side or garage door to avoid steps or add handrails to steps outside.
4. Get grabby – add sturdy grab bars to bathrooms and remove flimsy towel bars which will not hold the weight of someone who is falling. Ensure the bars in the bath and shower are both horizontal vertical for easy entry and exit.
5. Let there be light – often light switches are only at one end of a hallway or stairs – add switches at both ends and consider lighted switches which are easy to see in the dark.
6. Make sure home temperatures are set at 68-70 degrees year-round. In warmer summer months, add a fan in main living areas and keep your parent well hydrated with water; in winter pile on sweaters and blankets but avoid making the entire house too cold or too warm. Extremes in environmental temperature can cause dizziness and unconsciousness in seniors.
As we age, diseases such as Alzheimer’s, heart problems, Parkinson’s, diabetes and even thyroid problems, glaucoma, cataracts and osteoporosis can contribute to a higher risk for falling.
1. Vision - ensure your parent’s glasses prescription is up to date and ensure they are getting good sleep. Insomnia or lack of sleep can cause grogginess and vision problems leading to a fall.
2. Hearing – if you parent wears a hearing aid ensure they are wearing it at all times and not only when they leave the house. Also beware that inner ear disorders can cause dizziness.
3. Medications – New prescriptions are the leading cause of falls in older Americans and 40 percent of seniors are admitted to nursing homes because of persistent falls at home, often based on medications. Always ask the doctor or pharmacist about new prescription side effects such as dizziness or disorientation and review the entire list of medications your loved one is taking to ensure drug interactions will not cause a harmful fall.
4. Avoid alcohol – as we age our body’s metabolism changes and we lose lean body mass. This makes absorbing alcohol more difficult. In the past where we could drink 2-3 cocktails or glasses of wine, now our bodies have the same reaction after just one glass. Alcohol also raises blood pressure, slows reflexes, decreases concentration, impacts our ability to get to sleep and can have harmful interactions with medications – all key contributors to falls.
5. Increase Vitamin D intake – whether it is 10 minutes of sunshine a day, a change in diet or a nutritional supplement – the U.S. Preventive Services Task Force reported that increased vitamin D decreases falls risk by 17 percent. Eat more salmon and walnuts with healthful Omega 3 fatty acids and vitamin D, get outside or take 800 I.U.s of a vitamin D supplement a day to improve bone strength.
6. Balance and bone strength – Speaking of bone strength, adding some light weight lifting to an exercise routine becomes essential as we age. In fact, studies have shown increasing strength through weight bearing exercise will decrease risk of falling by 13 percent. And improving balance through exercises such as yoga or tai chi helps improve flexibility, lowers heart rates and blood pressure and releases lactic acid in muscles which cause tension. An alternative to finding a class is to try the free smartphone or tablet app called RELAX which helps with guided mediation, yoga poses and a journal on relaxation and exercise.
One program which improves balance, strength and confidence in older parents is a called Fall Stop Move Strong. Developed by a former professional Broadway dancer and an occupational therapist, the 12-week program is offered to seniors in New York City or via a DVD purchased online for seniors to follow along at home or in a local class. A current study of the program through participants at the Martha Stewart Center for Living at Mt. Sinai shows significant improvement in mobility, balance and strength in older Americans.
As we begin to celebrate fall, make falls prevention part of your caregiving plan.
This article was adapted from Sherri Snelling’s book, A Cast of Caregivers.