Steps at home can prevent falls

If, as the adage says, "Old age ain't for sissies," the first challenge in the privacy of one's home may well be standing one's ground to avoid a fall.

Each year in the United States, according to the Centers for Disease Control, 1 out of every 3 people over 65 falls. Among older adults, falls are the leading cause of injury deaths, according to the National Association for Home Care and Hospice.

What starts as a simple misstep may cause many seniors to lose their health, their independence and even their lives.

What's more, feeling the pinch of the economic downturn, growing numbers of seniors nowadays may be unable to sell their homes - and therefore need to make them safer, says Dr. Marion Somers, a geriatric care manager in Brooklyn, N.Y.

"That's what is making people look at their own place, or a family member's house if they are living with them, and evaluate, how can we make this senior-friendly and safer?" says Somers, who wrote "Elder Care Made Easier" (Addicus Books, 2006). "With this economy, (many) seniors and their families are not able to afford the cost of nursing homes and assisted living facilities."

Geriatric care managers like Somers help caretakers and aging family members create a plan of care, which may include home safety. Resources that can be found on the Internet include the National Association of Professional Geriatric Care Managers and the National Aging in Place Council. Some private businesses will come evaluate your home.

It may seem surprising that so many people fall in their own bedroom, kitchen or bathroom, when home is supposed to be a sanctuary. Yet "some of the seemingly most innocent rooms in the home can actually be the most dangerous," says Somers. "It's important to look at your own home as if you are seeing it for the first time, and evaluate it with a fresh set of eyes."

For instance, in the bathroom, "a 1/2-inch rise in the floor may seem like nothing to us, but for someone who has trouble lifting their feet and shuffles around, this could cause them to trip," she says.

"Elderly falls at home have long been the silent epidemic that leads to injuries and often results in nursing home placement," says Dr. Cheryl Phillips, incoming president of the American Geriatrics Society, which represents health care professionals who serve seniors.

The most dangerous room for falls, she says, is the bathroom, because of maneuvering between the bathtub, shower and toilet. "Lots of risk factors come into play, and medications that cause dizziness or weakness are the biggest single factor," she says. "And falls often accompany getting up in the night."

Some safety solutions may surprise you. Think a rug always provides protection against a slippery marble or tile floor? Think again.

"The single most important thing to remove is throw rugs, even if they have been in place for years," says Jonna Borgdorff, a physical therapist in Oak Park, Ill., and national rehabilitation director for Interim HealthCare, a company that provides home care for the elderly.

Skip loose rugs that aren't clearly slip-resistant, and choose uniform flooring, rather than uneven walkways, she says.

"It is ideal to have one consistent surface throughout the home to help avoid tripping."

Borgdorff's organization offers these tips to prevent falls:

• If you have wall-to-wall carpeting, make sure it is secure and flat, without bunched-up wrinkles or raised areas.

• Fix poor lighting and add nightlights for trips to the bathroom.

• In the bathroom, non-skid adhesive textured strips in the tub or shower floor can help prevent falls, while a plastic shower chair can help ease access in and out of the tub. Likewise, a raised toilet seat with armrests may provide balance both for sitting down and getting up.

• Add handrails on steps and grab bars on bathroom walls. Handrails placed near the toilet, bathtub or shower, can help someone stay balanced when sitting or standing.

• In the kitchen, forgo slippery floor wax. To avoid falls, keep kitchen items in cabinets that are easily accessible, at waist-high level.

• On stairs, pay particular attention to the top and bottom, where you may miss a step. Consider adding stair treads and handrails on both sides. Be particularly cautious when walking between a carpeted room and a slippery floor. If walking on stairs is perilous, consider adding a stair chair that electrically glides up and down the steps.

Some pitfalls are less obvious: Don't be blind to high thresholds in doorways, says John O'Callaghan, president of the Metro Louisville (Ky.) Aging in Place Council. His company, Evalusafe, offers home safety evaluations for seniors.

Speaking of the floor, clear any clutter there, which is particularly hazardous for nighttime trips from bedroom to bathroom, he says.