Living with a chronic condition requires a lot of adaptations. The one thing you don’t want to cope with is the effects of an injury that could have been prevented. Falls are the second leading cause of death from accidents for people of all ages and more than 200,000 people suffer a fracture of the hip each year from falls. For some, it may be impossible to continue living alone after suffering a serious injury.
Risk Factors. People with chronic conditions often have a lower level of activity which can lead to osteoporosis. This means that falls are more likely to produce serious injuries.
Who is at risk for falling? People who have poor balance, impaired vision, decreased muscle strength or impaired sensation in their legs. Normal aging can cause these problems and chronic conditions can compound the difficulties. In addition, our reaction time and reflexes slow down as we age so it’s harder to regain our balance after sudden movements.
What can you do?
Adequate lighting is important. Use higher wattage light bulbs in your lamps; as we age, we require more light for good visibility. However, don’t use higher wattage than is recommended for the fixture. Keep in mind that too high wattage in ceiling fixtures, recessed lights, and “hooded” lamps will trap heat and may lead to fire through overheating.
Install light switches at the entrance of each room so you do not have to walk into a dark room. Place night lights along pathways you use during the night—between bed and bathroom, in the hallways, into the kitchen. Some night lights have sensors which automatically turn the lights on at night and off in the daytime. Keep a flashlight by the bed and replace existing switches with “glow switches” that can be seen in the dark.
Place light switches at the top and bottom of stairways so you can turn on the lights before using the stairway from either end.
Stairs. Handrails should be on both sides and extend several inches beyond the top and bottom of the steps.
Sufficient lighting is imperative. Place light switches at the top and bottom of stairways so you can turn on the lights before using the stairway from either end. The lighting should not produce glare or shadows along the stairway. Each step, particularly the edges, should be clearly visible.
Place fluorescent or reflecting tape on the edges of the top and bottom steps. Steps should not have open risers or an overhang which can catch a person’s foot when going up. Stair treads should be deep enough for the whole foot. Maintain carpeting on stairs in good condition.
Keep your floors safe. Arrange furniture to remove obstacles that might prevent a direct flow of traffic within each room and between rooms. Check that outlets are available for lamps and appliances without the use of extension cords. If you must use an extension cord, use tape--not staples or nails--to fasten it to the floor against a wall to prevent tripping. Be sure the cord has sufficient amp or wattage rating for the appliances being used. Remove cords from under furniture or carpeting. Cords can be damaged by the weight of furniture and cords which run under carpeting may cause a fire.
Don’t place small rugs on bare floors or on top of carpets: Even if you use rubber matting, adhesive carpet tape, or slip-resistant backing, it’s still easy to catch your foot in them.
Thresholds higher than 1/2" can create a tripping hazard. Remove the threshold or install a beveled ramp on each side of it. Clearly mark any change in floor level, even if it’s just one step.
Keep drawers closed to prevent stumbling.
Step stools. Standing on chairs, boxes, or other makeshift items to reach high shelves can result in falls with serious consequences. For people without chronic health problems I would recommend a step stool with a wide stable base and a handrail. However, I cannot recommend a step stool of any type for people with a chronic condition or disability.
If you implement my recommendations to store frequently used items within your easy reaching range and use a grab reacher for extended reaching, you should not need to use a step stool at all.
Medications. Be sure that all containers are clearly marked with the contents, doctor’s instructions, expiration date, and the patient’s name. Whether to have child-proof caps depends on your ability to open them (they’re difficult). If there are no small children around you probably don’t need them. I have small grandchildren but cannot open child-proof containers, so I have to be diligent in placing medications beyond their reach. A lightweight locking file box can serve this purpose.
Emergency exit plan. Develop two emergency exit plans in case one gets blocked when an emergency occurs. Make sure that both are accessible. Practice the plan periodically so that everyone is capable of escaping quickly and safely. Install smoke detectors and check the batteries frequently.
Outdoor safety tips. Be sure exterior steps are in good repair and have handrails which are securely fastened to fittings. The surfaces should be non-slip and the step edges visually marked to avoid tripping. All walkway surfaces should be non-slip, even in wet weather, and free of obstacles. Provide outdoor lighting for safe ambulation at night. To conserve electricity, install outside lights with motion detectors.
Uncarpeted floors in public buildings can be hazardous during wet weather. Cane and crutch tips can slip easily when walking from a wet sidewalk onto a marble or tile floor. When you first enter the building try not to put too much weight on the walking aid. Lean against a wall for support, put the crutch tip down flat and don’t put weight on it until you are sure it won’t slide out from under you.
When crossing the street during wet weather, don’t walk or place your crutch on the painted lines as they can be slippery. If sidewalks appear to be slippery, walking on the grass may give better traction.
Home Safety Guide for Older People: Check It Out/Fix It Up by Jon Pynoos and Evelyn Cohen.Serif Press, Inc., 1331 H Street NW; Washington DC 20005. (202) 737-4650.
Safety for Older Consumers. Free. Order from U.S. Consumer Product Safety Commission; Washington DC 20207. (800) - 638-2772.
Home Safety Inspection Checklist. A home safety audit covering basic fire escape, smoke detectors, carbon monoxide detectors, basic electrical safety, electrical extension cord safety, and garage door opener safety. Send your request to Underwriters Laboratory; UL Literature Dept.; 333 Pfingsten Road; Northbrook, IL 60062. Phone: (708) 272-0919, ext. 42862.
Safety & You. Written by Nancy H. Steorts, former chairman of the U.S. Consumer Product Safety Commission. A comprehensive consumer safety reference guide. : Syracuse University Press, 621 Skytop Rd., Suite 110, Syracuse NY 13244-5290. (800)-365-8929.
© 1999-2008 Grace R. Young
Courtesy of Diane Young and Sharon Lark
Tagged as: accessibility , aging , falls , pacing , weakness