Fall Prevention at Home

For aging adults, falls are a leading cause of major injuries such as hip fractures, head trauma, and accidental death. Anything we can do to mitigate the risk is something worth doing.

At least 25 million Americans are currently taking care of elderly parents, and that number will continue to grow as the baby boomer generation reaches senior status (Nightingale, Yancy, 2016). Over the next 20 years, the number of people over the age of 65 in the U.S. is expected to grow to 78 million outpacing the number of young people for the first time (Older People Expected to Outnumber Children, 2018).

According to the National Council on Aging, staying in their current home is one of the top ten desires of senior adults (Saltzman, 2017). Almost 60 percent of seniors have lived in the same home for twenty years and want to continue living in their current home for the rest of their lives. They want to live in a comfortable and familiar home rather than moving to a nursing home or assisted living facility. When seniors stay in the same home as they age, it’s called aging in place or active aging. The problem is most homes aren’t designed for aging in place safely.

Falls are common in older adults

A major fear of both seniors and their caregivers is the danger of a fall in the home which could cause serious injury or even death. Close to one-third of older people who live at home will fall at least once. Falls are a leading cause of major injuries such as hip fractures, head trauma, and accidental death. (CDC.Gov, n.d.)

Even more disturbing is that if a person has fallen once, they’re more likely to fall again. The senior develops a fear of falling and reduces their activity level. Reduced activity weakens their muscles and stiffens their joints and makes them even more susceptible to falling.

Why Seniors Fall

Susceptibility to falling can be caused by reasons such as medications, poor vision, and lower body weakness. Safety hazards in the home can also contribute to falls. Most falls occur during transitions such as going from sitting in a chair to standing up, getting out of bed, going to the toilet or going up and down stairs. Falls in the home can be caused by improper lighting, obstacles on the floor or a house that wasn’t designed for people with limited mobility.

Falls can cause major physical and financial impacts

Falls can require a trip to the emergency room and a hospital stay. A fall can seriously impact a senior’s independence making them more likely to be admitted to a long-term care facility. Common injuries include a broken hip or head injury. The Agency for Healthcare Research and Quality (ahrq.gov) ranks hip surgery among the twenty most expensive medical conditions. (Torio, Moore, 2016)

Direct medical costs include hospital and rehabilitation fees, nursing home care, doctor and physical therapy services, medical equipment fees and prescription drugs.

Long-term effects of these injuries can be disability, dependence on others, inability to do household chores and reduced quality of life.

Caregivers can take action to reduce the possibility of falls

Planning is crucial. Many falls can be prevented by taking charge of health issues and making modifications to the home. There are several things you can do to ensure the senior’s health doesn’t contribute to a fall. These include:

  • Getting a health evaluation for the senior from their doctor or healthcare provider. Have the doctor review medications which may cause the person to get dizzy or sleepy. Find out if you can switch to medications that don’t have those side effects.
  • Consider adding strength and balance exercises to the senior’s daily routine
  • Have their eyes checked and ensure prescriptions are up to date if they wear glasses.

For other ideas, visit The Centers for Disease Control (CDC). They have developed the STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative which includes educational materials and tools to improve fall prevention. (CDC.Gov, n.d.)

Call in professionals to analyze home remodeling needs

After you’ve addressed any health issues which can contribute to falls, focus on making the home environment safe and secure. Create a comfortable environment for aging in place. Special accommodations may be needed immediately as well as for future use of equipment such as a wheelchair or walker.

The right modifications will make the home work more efficiently and give the senior the ability to move around comfortably without fear of falling. To respond to the need for special design and remodeling standards, the National Association of Home Builders (NAHB), along with AARP has developed an Aging-in-Place Specialist certification. A list of Certified Aging in Place Specialists can be found on the "Find a Certified Aging-in-Place Specialist" page at nahb.org. A home remodeler or occupational therapist can achieve the certification by successfully completing an educational program. (AARP.Org, 2014).  

Aging in Place Occupational Therapists will look at a senior’s daily routines and identify any barriers that might prevent them from completing their activities. They will make recommendations for current needs as well as future needs which may eliminate or reduce future remodeling expenses.

An Aging-in-Place Remodeling Specialist will be knowledgeable about building codes and will be able to estimate the cost and time of any remodeling projects. You may be able to get help paying for home modifications. Check with your local Area Agency on Aging, State housing finance agency, welfare department, community development groups or the Federal Government.

Conduct a home hazard self-assessment

Before calling in a professional, conduct a self- assessment of the home. A self-assessment will give you an idea of the changes that need to be made and will facilitate a more meaningful conversation with the occupational therapist or home remodeler. An assessment will raise your awareness of home hazards that can be easy to overlook and will give you the opportunity to keep the home safer before and after any renovations have been completed. Some common home hazards are:

  • Obstacles or clutter in hallways and walkways
  • Throw rugs without non-slip backing
  • Carpets with folds, ragged edges, or holes
  • Exposed electrical cords that could be tripped over
  • Loose rocks or gravel in driveways and walkways
  • No grab bars in bathrooms
  • Insufficient lighting
  • Doorways that don’t accommodate a wheelchair or walker

After you complete a hazard assessment, make a list of remodeling projects needed. Use our Fall Prevention Home Renovation Checklist to help get organized to complete the work. Creating a safe environment with needed modifications and renovations to the home will ensure your aging parent can live in their current home for as long as they want.

  • Nightingale, Yancy (2016). Caring for Elderly Parents. Retrieved from https://blog.dol.gov/2016/08/18/caring-for-elderly-parents
  • Older People Expected to Outnumber Children (2018). Retrieved from https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html
  • Saltzman (2017) Aging in Place Tech Helps Seniors. Retrieved from https://www.usatoday.com/story/tech/columnist/saltzman/2017/06/24/aging-place-tech-helps-seniors-live-their-home-longer/103113570/
  • CDC.Gov( n.d.) Important Facts About Falls. Retrieved from https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
  • Torio, Moore (2016). National Inpatient Hospital Costs. Retrieved from https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.jsp
  • CDC.Gov (n.d.). STEADI Materials for Your Older Adult Patients. Retrieved from https://www.cdc.gov/steadi/patient.html
  • AARP.Org (2014). How an OT or CAPS can Make a Home a Good Fit. Retrieved from https://www.aarp.org/livable-communities/info-2014/using-an-OT-or-CAPS.html
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