Archive for September, 2012

FALLS PREVENTION

Monday, September 24th, 2012 by admin

Fall prevention is an enormous topic that, as an Occupational Therapist, I get asked about all the time.  No one wants to or anticipates falling in their home, but it happens.  People always want to know how to not fall while at home.  If you work in healthcare in any way, you are aware of the prevalence of falls across the country.  Being able to advise clients and family members in proper home modifications is vital.  Keep in mind that you cannot prevent falls all together, but with the proper home modifications you can prevent falls as much as possible. 

According to The National Safety Council and Centers for Disease Control (CDC) in 2007, more than 21,700 Americans died as a result of falls; more than 7.9 million people were injured by a fall; and over 1.8 million older adults that had a fall-related injury resulted in an emergency room visit.  Falls are the leading cause of injury-related deaths among older adults 73 and older and the second leading cause of death from ages 60-72 (http://www.nsc.org/safety_home/Resources/Pages/Falls.aspx).”  In addition, a new CDC study published in the Morbidity and Mortality Weekly Report (MMWR), “ an estimated 234,000 people ages 15 and older were treated in U.S. emergency departments (ED) in 2008 for injuries that occurred in bathrooms.  Four out of 5 of these injuries were caused by falls” (http://www.cdc.gov/Features/Fallrisks/).

When I recommend home modifications, I do my best to keep it simple and save costs as much as possible.  This is usually a very overwhelming time for the people I am working with and by sticking to a few basic principles and recommendations I feel that I am generally able to accomplish what I need.  Here are my basic recommendations to decrease the risk of falls and increase safety throughout the home:

1)      To enter the home, be sure that there are handrails on both sides of the stairs.  Ideally, there should be a landing so that the door can swing open all the way to allow for easy entry.  Also be sure to provide/have proper assistance just in case.

2)      Upon entering the home one of the first things I look at is the type of flooring used.  I look for smooth transitions between rooms.  This allows for easy maneuverability of wheels (either on a walker or wheelchair) and reduces a trip hazard of having to step over a threshold.

3)      There should be no throw rugs.  If there are throw rugs that cannot be parted with, use of a non-skid mat under the rug is essential to reduce the possibility of wrinkling and sliding.  Another common suggestion is to tape the edges of the throw rug down to avoid the edge rolling up or getting caught.  Of course always use extra caution when rolling over the edges (of rugs/ thresholds) to avoid a trip hazard.

4)      Keep walkways free of clutter to avoid the need to step over or move things with your feet or equipment while ambulating.  Most standard/basic walkers are ~18” wide so keep this in mind for clearance.  This can be especially difficult in smaller homes with narrow halls and doorways.  If this is the case for you, do the best you can and if possible ask for or get assistance. 

5)      In the bathroom install a grab bar in the shower to assist with standing tasks.  In the instance of a tub/shower combo use a tub transfer bench for easier and safer transfers.   In the instance of a shower stall use a shower chair.  In either case I always err on the side of caution in the case that balance could be an issue.   This way there is a place to sit if needed in a pinch.   Non-skid matting or stickers on the floor can be used to decrease slippage on wet tile.  For ease of toilet transfers, at the very least use a raised toilet seat either with armrests attached or a grab bar on the wall depending on the space available. 

6)      If there are stairs present in/out of the home be sure to use contrast as a marker for the edge of each step.  This can be done simply with electric tape or paint.  People with visual impairments can have difficulty judging where the edge of the step is without contrast.   

7)      In the kitchen be sure that commonly used items are kept within easy reach.  This means to use the bottom shelf of the upper cabinets and the top shelf of lower cabinets as much as possible.   One other tip I love to give is to keep dishes used daily in the dish rack.  This way they are literally within arm’s reach at a moment’s notice.

8)      In the bedroom, as in the kitchen, use top drawers or the easy to reach middle portion of the closet to make clothes retrieval easier.  This way there will be minimal bending and over- reaching for needed items.  Be sure to keep bed linens off the floor to avoid getting feet/walker caught and tangled causing a trip hazard.  

9)      Lighting is key!  Be sure that lighting is kept natural whenever possible.  Avoid glare off shiny objects such as the television or floor.   To achieve this you may only need to change your bulbs to a different wattage or change the position of a lamp to provide less direct light. 

I always remind clients that safety is key!  Each person and each home is different, but with the right foundation you can easily build or change these recommendations to suit your needs. 

Contributed by

Elizabeth R.K. Tomoso, OTR
Occupational Therapist
Independent Life Solutions
(808)280-5176
etomoso@yahoo.com