quote:

Shall we also talk about preventing falls, or should that be another thread?

Yep, MariaBee and here it is!

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Falls are a BIG DEAL! Old folks don't bounce as well as they did when they were 18! Their bones are brittle and they are typically more frail in MANY ways. A fall should ALWAYS be taken seriously, no matter HOW many times the person has fallen before and been okay nor how much they protest and say they are all right. The best thing to do is to prevent the fall and if one occurs, have the person checked out at the ER just in case... Do NOT let them talk you out of going to the ER or reporting the fall to their doctor!

Despite the absolute fact that people fall (if they haven't, trust me when I say, they will!), there ARE things we can do to reduce the risk of falling and the severity of a fall. Here's some tips and I hope that others will jump in and add to this list!

• SECURE handrails should be USED on ALL stairs, even if there is only ONE step! An insecure or weenie handrail is dangerous and should be replaced or removed! Be SURE your loved one uses them!

• Patios and decks should have at least 36" high SECURE railing (taller railings for taller people) around them if they are not level with the surrounding ground.

• remove ALL loose rugs and mats from walking areas. This includes welcome mats, bathroom mats, and bedroom throwrugs.

• wall-to-wall carpeting is a frequent problem. Although wall-to-wall carpeting sure feels great on the toesies and helps prevent drafts, it is a health hazard from an allergy & respiratory (COPD) point of view, a hygienic nightmare and a fall hazard. MANY people somehow get the toe of their shoe caught (like stumping your bare toe, except with shoes) and down they go! If there is wall to wall carpeting in a loved one's home, be SURE it is not very thick and is extremely well-stretched.

• slippery bare flooring - smooth, laminate flooring is a nightmare for falls! It is VERY slippery (how well can you walk on your countertops?). Some of the more expensive and carefully engineered laminates have a texture to them that is wonderful and is NOT a fall hazard. Smooth tile flooring - both artificial tile and natural glazed tile - is also scary to have underfoot. Waxed floors are ASKING for trouble - the shine ain't worth it! The key here is that the flooring is NOT smooth; it should be slightly rough or patterened so that feet don't slip easily. If your dog slides on it, so will your loved one.

• Water on the floor, even a small amount, can send an elderly person slippin' and slidin' in a heartbeat! ALWAYS thoroughly dry ANY wet areas, even if its only a few drops, where people walk.

• install grab bars in bathrooms, bedrooms, near stairs ANYWHERE that people may need to have an extra hand-hold. Be WISE about the site for installation - I have seen grab bars for safety that have very acute corners on them! Wooden or rounded metal grab bars are the best. If you install them IN a shower or bathtub, please locate them very carefully as they can become a hazard if someone falls!

• use gait belts for loved ones with poor ambulation or a history of falls. This should be as routine as putting on shoes. You never know WHEN someone is going to take a tumble and you can seriously injure a loved one and/or yourself by grabbing their arm, etc. to prevent a fall. Doesn't help for a fall to take out the patient AND the caregiver! Loved Ones may be resistant to wearing them, but this is something one should be very firm about. It saved my own mom MANY times...

• wear lace-up shoes or skid resistant socks/footies. Walking shoes are ideal for seniors to enhance their footing. Some sneakers and sport shoes, believe it or not, have rather slippery soles. If they are pretty smooth in the store, imagine how slick they will be on a wet surface or after some wear... Many folks have trouble with wearing lace up shoes for obvbious reasons: their feet may swell, or they may have trouble tieing their shoes (velcro solves this problem). Sometimes people have to wear slippers because of foot problems - make SURE they are non-skid soles! Slippers are a poor idea because they not only slip on, they slip OFF, too! Open-toed shoes, flip-flops, shower shoes or sandals are relatively worthless unless they are non skid and hug the foot snugly. Sandals that fit snugly with substantial straps and non-skid soles (not the "pretty" ones!) work very well.

• proper use of walking assistance devices, such as canes, gait belts, walkers, etc. are a great help, but many folks refuse to use them or use them improperly.

• learn how to "walk" a patient who has trouble ambulating. Believe it or not, there are right and wrong ways to help someone walk. If you have not received instruction (please don't assume that you know how), have a physical therapist instruct you on the proper way to SAFELY assist someone - not only for their safety, but also for your own.

• Use bright lighting 24/7 in walking areas - there may be plenty of light for YOU to see to get around, but that may not be the case for an elderly loved one. The vast majority of falls occur on the way to the bathroom...

• PAY ATTENTION when a loved one is walking whether you are walking them or not. It is simply amazing how many falls occur while we are talking with someone, or our attention is distracted while walking a patient. Your complete attention is needed! If you have not had the frightening experience of having a loved one fall (or nearly fall) while you are walking them, trust me when I say that it's an experience you do not want!

• PETS should be either restrained or trained to stay out of the way when elderly folks are walking. This is another VERY common scenario for a fall - the cat runs between their legs or the dog is dancing around underfoot! TRAIN dogs to stay a distance away from elderly folks when they are walking and to NEVER rush the door, stairs, etc. Cats are tougher to control, so it's important to pay keen attention when gramma and gramps are walking around the house that kitty is NOT going with them to the kitchen for a late night snack... If you do not know how to train your dog to respect the distance needed by elderly people when walking, please call your local AKC obedience training club for advice or the number of a trainer who will assist you with this. Please don't think this is impossible - I am a retired professional dog trainer who has trained therapy dogs, assistance dogs and hearing dogs. My 30, 85 and 110 lb. pooches NEVER got in Mom's way... even when excited, they would dance at least 3 feet away from her when she was walking. The cats were more difficult, but we also trained them to stay away from Mom while she was walking.

• Arrange furniture carefully to allow a clear path. Coffee tables are terrible offenders. Most of us who have them put them pretty close to the sofa - VERY easy to fall over! Padding on sharp corners will help prevent injuries to shins, legs, arms and heads if an object cannot be more safely relocated. When it comes to furniture, less is better.

• Objects that tip easily should be removed from an elder's walking path. Hatracks, fern stands, potted pants, pet cages, are just some of the "tippy" objects you may find in your house. Two story condos for rabbits should be relocated (wanna know how I know about that one? ). When people lose their balance (or don't have much to begin with...), they will reach out to grab ANYTHING to keep from falling. Stubborn elders will actually ambulate by creeping along hand over hand from door jamb to chair to table to (did somebody say rabbit cage?) couch, etc.

• Use bed alarms to alert a caregiver that a person is getting out of bed at night (or anytime) unassisted. Wish we had had one... Doorknob alarms or tinkly bells are also very useful to alert a caregiver that someone is moving around...

• ALWAYS assist elderly people with compromised ambulation when rising from a sitting or lying down position, especially after sleeping. This is a no-brainer as we have ALL had near misses ourselves when half-awake or tired...

• Stoves, crock pots, fireplaces, chimineas, barbecues and other hot appliances should be well secured so that people cannot fall into them. Turn pot handles IN toward the center of the stove. Keep fireplace doors closed. A fall can be compounded quickly by a fall into a hot appliance!

• Install and USE door and window locks. When people have dementia, their judgement is very impaired. Sitting in the windowsill to catch a breeze or attempting to fly like a bird may sound like stuff your loved one would NEVER do, but it HAPPENS! Locks can prevent obsessive refrigerator raids, unauthorized laundering,not to mention escapes and walkabouts!

• ASSUME NOTHING! Just because your loved one has walked around by themselves for 70 odd years that they REMEMBER or have the judgement to be careful now! Just because your mom has never tried to climb out of a 3 story window and slide down the downspout does not mean that she might not attempt it in a "senior dementia moment."
Don't assume just because your loved one has been given a cane or walker and instructed in its use that it's a done deal. Things change as their condition worsens... Mom got to where she walked holding her cane BACKWARDS until she hadda surrender it. Always monitor their use and ambulation during use. A walker accident is a nasty thing to witness, let alone go through...

Please remember:
NONE of us can ALWAYS prevent EVERY fall!
Falls HAPPEN under the most structured and safety conscious of circumstances to the most well-trained people! Elderly folks DO sneak out of bed when they are not supposed to do so; they also resist using devices to help them. They frequently do screwball things that lesser mortals would fear! All you can do is the best job of preventing falls that you can! Doesn't matter how many grab bars you install, gait belts you strap on them, pets that you train to be well-mannered, furniture that you move - if an individual does not abide by "the rules," or does something that simply flies under your radar, there is NOTHING you can do about that! Falls happen with physical therapists on both sides of a patient - all it takes is the right set of circumstances and down they'll go! People do not have to have a lot of trouble ambulating to fall, particularly when they are elderly. All it takes is missing a step - something that can happen to ANYONE. Pay attention and do your best and if a fall occurs, know how to assist them after they fall (click here!)! Don't beat yourself up if your loved one falls and is injured on YOUR watch - stuff happens. If it had not happened on THAT day, it would most likely have happened another day...

OK - Y'all please add to this list!

This message has been edited. Last edited by: Moms_Buddy,

Great post, MB!

I think we ought also remember that it's not only ambulatory folks who take spills.

Wheelchairs come to mind. When you're not rolling, the wheels should always be locked. And the chair should always be parked in a safe location---not near a ledge (edge of a deck, sidewalk, etc.), and on the most level ground you can find. Never leave your loved one in a wheelchair outside without giving them your constant, undivided, attention!

Also, I think of all those transitional moments---like getting in and out of the shower (anybody got good ideas on this?), into and out of the car, and up and down from chairs.

Mom has an electric lift chair/recliner that we can raise the seat of to meet her bum as she goes to sit down, and this is a big help. But a firm hand in the middle of the lower back will also prevent a loved one from plopping down too hard onto a chair.

This may not sound like much of a "fall", but a couple of years ago my mom suffered compression fractures in her lumbar spine from plopping down onto the toilet seat because the seat was too low and she couldn't maintain control of her dissent all of the way down. Now we have a bedside potty in the fully raised position, positioned over her toilet so she doesn't have such a long distance to travel in reaching the seat.

Okay everybody, let's hear some more! I know we all have learned some tricks along the way

Thanks for this MB. Actually there are several that are problems here, not for Mike-for ME. I have always been a clutz when it comes to staying on my feet. I am so afraid I will break something one of these days. When I walk on the rocky beach I take a stick with me, I'm actually more sure footed pushing Mike's chair. Over the years-many I have given myself some scares. I think I'm a little better than a few years ago-I sit on my Swiss ball when I am using the C. I always use one of those non skid mats in the shower or tub. I think all bathrooms should have grab bars-don't know what I would do without them now. I usually use hand rails-almost fell down the last step last week when I slipped carrying out the garbage-lost my balance, had to reaach with my left hand as I had the bag in the right it was a wake up call-I usually use the ramp if I am carrying stuff. So please be careful yourself especially if you are getting up there in years-like me (I have been accident prone since I was VERY young)Gypsy