Visiting older relatives? Help spot and fix fall risks
The pandemic may have increased risk or fear of falling; take time during the holidays to help reduce it.
A lot of families have plans for big holiday gatherings this year, bringing the generations together especially now that children over age five can get vaccinated against COVID-19 and all adults can get a booster dose to give them additional protection.
This means many adults will travel back to their parents’ or grandparents’ homes for the first time in a while, especially if they don’t live nearby. Or maybe they’ll go see a favorite aunt or uncle, or a treasured older neighbor who lives alone.
All this reuniting and celebrating together can also bring chances to spot and fix household hazards that could raise an older person’s risk of suffering a fall this winter and beyond. It’s also a great time to shop for holiday gifts of practical items that can prevent falls.
As a recent University of Michigan poll shows, older adults’ risk of falling may have increased during the pandemic due to less physical activity, less mobility and more isolation. Their fear of falling, which can actually lead to increased risk of falling, also increased.
In fact, a new study based on the poll data shows, older people whose mobility got worse during the first part of the pandemic were 70% more likely to say they’d had a fall in that time, and twice as likely to fear falling.
“Even if an older adult has gotten more active since getting vaccinated, their risk of falling could still be higher than it would have been if the pandemic hadn’t increased their inactivity or isolation,” said Geoffrey Hoffman, Ph.D., a fall researcher and assistant professor in the U-M School of Nursing who performed the study with the team from U-M’s National Poll on Healthy Aging. “Taking steps now to reduce fall risk in their homes could prevent catastrophic injury and hospitalization.”
He and poll director Preeti Malani, M.D., who has training in geriatrics, recommend gently but firmly providing older relatives and friends with tips to maintain their independence, including addressing fall hazards, while you’re with them. “Fallproofing” older peoples’ homes can prevent common causes of falls and help them avoid injury.
Key things to look for and address:
Take it to the mat
If an older person has small throw rugs and mats around their house, these can present a major fall risk.
Get a roll of non-skid material, cut pieces to fit each item, and place it underneath. If they have non-skid material under rugs already, check to see if it’s still gripping the floor and rug – the “stickiness” can wear off over time. Throw rugs and mats shouldn’t be placed on top of carpeting, just bare floors.
Bath mats should have rubber backing that’s in good condition. If it’s cracked or worn away, it’s time to get a new bath mat. Perhaps you can even splurge on a really good one as a holiday gift.
Scour the bathroom
Water on hard floors make bathrooms fall-prone areas for many people. If an older person has a tub/shower combination for bathing, stepping up and over the tub wall to get into and out of it requires special care.
A grab-rail, either permanently installed or one that uses strong suction cups to stick to the walls of the tub stall, can help greatly. So can a rubber mat with suction cups on the tub floor. Just like bath mats outside the tub, these mats should be replaced when they’re not gripping well anymore.
For people who have trouble balancing on one foot, or standing for any length of time, a stool with non-skid feet in the tub can be helpful. (It can also give anyone who shaves their legs a more secure place to put their foot while shaving.)
If there’s a possibility of renovating the home to remove a tub and install a walk-in shower stall, this is a great time to discuss it and start calling potential contractors. Shower stalls and walk-in tubs with doors reduce fall risk – though they still have thresholds that can trip an older person up.
Taking action now may be a key factor in helping an older person, especially one with balance or mobility issues, remain in their home as they age.
Shed some light
Dark hallways, stairways, closets with high shelves and outdoor steps can all be fall-risk areas.
Take time to install brighter light bulbs – including long-lived LED bulbs that won’t need replacing for years – or even to put in new fixtures that take multiple bulbs. Add motion sensors so lights come on automatically when someone enters the area or approaches the door, in case it’s dark or they’re carrying something and don’t want to have to reach for the switch.
‘Smart home’ systems, which are becoming more common and less expensive, can control many home functions from a smartphone app – for instance, to turn on lights before a person comes home at night, or goes up or down the stairs.
Nightlights that light up automatically when it gets dark, or have a motion sensor, can help light the way to the bathroom at night.
Step it up – or bring it down
Ask the older person how they reach things on high shelves, or climb up to change a lightbulb, a clock or the smoke alarm batteries. If they say they usually drag over a chair or a small stool and stand on it to reach above their head, this is much less safe than a folding step stool with multiple steps and a high rail that to hold while climbing.
Work with them to reorganize their storage to bring items lower on shelves, even if they’re only used a couple of times a year. Give the gift of time to help someone reorganize, declutter and put heavy items in lower drawers and shelves – it can be a great chance to talk and catch up.
Give a gift of double safety: a smoke detector and carbon monoxide detector with built-in batteries that last 10 years, so there’s no yearly climb up a ladder to change the battery.
Check railings along stairways and porch steps, to make sure they’re securely fastened to the wall or posts. If the steps themselves are slippery, add friction with stick-on traction strips.
If an older person stores holiday decorations in an attic, basement or upstairs room, offer to help bring them to the main floor. Offer to help put up outdoor holiday lights together, reducing the chance of a fall from a ladder.
Put winter hazards on ice
Slips and falls during the winter months can be especially hazardous, even if the older person doesn’t live in a cold climate.
Make sure they have an ample supply of de-icer or sand to use on their steps, walkway and driveway. For people who can’t easily lift a heavy jug, transfer the de-icer or sand to a container with a lid and add a scoop so they can scatter it more easily.
Make sure the snowblower is in good working order and that snow shovels and car scrapers and brushes are close at hand, and in good shape so they will be most effective. Get a new shovel with a back-saving handle to provide more stability when shoveling and prevent muscle strains that can reduce mobility.
For anyone planning to go for walks in the winter weather, boots with good treads or removable rubber-and-metal gripper devices can add traction.
Make sure outdoor lights work and have automatic sensors that come on when a car pulls in the driveway or garage. Check doormats to make sure they won’t slip. Clean out gutters above entranceways so melting snow doesn’t collect on steps and form ice.
Clear the clutter
Tripping on small furniture or decorations, or items left on stairs or floors, is a common cause of falls, especially if someone is carrying a laundry basket or other large item and can’t see the trip hazard.
During a holiday visit, offer to help an older person move things around to clear wider paths to walk, free from obstructions. Set up a basket for capturing “as you go” items at the bottom and top of stairs so they aren’t left lying on a step or landing.
Put their best foot forward
Slippers and shoes to wear around the house with good treads, not slippery bottoms, make great holiday gifts. Wearing shoes or slippers with grip inside the home, rather than socks or bare feet, is a great way to reduce fall risk.
Also, make sure there’s a chair or bench inside the entrance that’s used most often, giving a place to sit to remove outdoor shoes and put on slippers or indoor shoes.
Keep pets from being a trip hazard
Past U-M polls found that older adults get a lot of enjoyment and companionship from having pets, and that 1 in 10 people over 50 have gotten pandemic pets. But pets can also bring trip and fall hazards.
Check to see that pets’ water and food bowls and beds, and cats’ litter boxes, don’t get in the way on the floor.
For dog owners, retractable leashes can give more flexibility in case the eager pet wants to get out the door and their owner gets tangled in the leash. Put bells on cats’ collars so their owners can hear when they are nearby.
Paper cited: “Changes in activity levels, physical functioning, and fall risk during the COVID-19 pandemic,” Journal of the American Geriatrics Society. DOI: 10.1111/jgs.17477