By Nicole Levison

When you are a kid, falling down is part of many adventures, and even when you get hurt, you heal quickly.

As you get older, a tumble is not only terrifying, but often leads to further serious injuries.

Falls are the main cause of death from injury for folks over 65—a truly frightening statistic that does not have to be because most falls are preventable. Many of the risks can be alleviated by just knowing what they are and making a few modifications.

The hazards can be divided into three areas, Environmental, Medical, and Physical.

• Environmental. This refers to indoor and outdoor threats to safety. Using nightlights, installing handrails and non-slip strips/mats around the tub and toilet, rearranging furniture, and removing obstacles like clutter and throw rugs can reduce environmental risks. Bad weather and uneven ground are also major culprits, so make sure you have solid footing and test a surface before moving quickly. Be aware of your surroundings.
• Medical. Some medicines cause dizziness and reduce mental alertness. The more medications you take, the more you are at risk for taking a spill. Talk to your doctor about any side affects, as well as evaluating the possibility of changing medications or lowering doses.
• Physical. Changes in vision, hearing, balance, and mental status can be dangerous. Performing simple maintenance like changing hearing aid batteries and keeping the aids clean and free of wax, and employing the right eyeglasses, shoes, and assistive devices (like a cane) can make a difference. Osteoporosis, diabetes, heart, muscular and circulation issues can adversely affect your coordination.

Fall Prevention Checklist

Floors

Be sure all floors are clear of toys, books, objects, food, unnecessary furniture, throw rugs, loose carpet, or uneven floorboards. Avoid using floor waxes that build up and cause slickness. Make sure appliance cords are kept out of pathways. As a caregiver, you may be too busy and tired to clean your house, and you may want to consider hiring an outside helper, or asking a friend or neighbor, to help you pick up a few days a week. While you may be able to maneuver around objects on the floor, your loved one may trip and fall.

Stairs

Install hand rails on both sides of staircases, and make sure that steps are free of dirt and dust which may cause slipperiness. If your stairs have carpet, ensure that the carpet is appropriately nailed down and has no bumps or lumps that could cause your loved one to trip. If the floors are wood, be sure that no floorboards have popped up.

General Home Safety Precautions

• Clear the paths. Rearrange furniture so that there are always clear paths. Keep furnishings such as coffee tables, coat and magazine racks, footrests, and planters out of highly traveled areas. Put items within easy reach so that your loved one doesn’t have to strain or use a chair or step stool.
• Light it up. Make sure your home is well-lit. Keep flashlights in convenient places in case of a power outage or burned-out bulb.
• Keep it Safe. Use a raised toilet seat or install armrests around the toilet. Use chairs, couches, and beds that are easy to get out of. Don’t drink excessive amounts of alcohol. Always get up slowly, and if you feel faint make sure the temperatures aren’t too drastic and that you’re well-hydrated.

Outdoors

Make every attempt to assist your loved one, such as holding his/her arm when walking. See that your loved one is dressed in appropriate, properly fitted footwear and that laces are tied well. Slippers, stockings alone, high heels, and sneakers with deep treads may be difficult to walk in, but are particularly dangerous for an elderly loved one.

Be sure to sand or salt any icy outdoor sidewalk and walk carefully on icy or wet surfaces. Avoid uneven ground and clear walkways of any debris. Have your loved one use a cane or walking stick when possible.

Practical Tips for Improving Health

Exercise, especially activities that are weight-bearing such as walking, can increase bone strength and prevent osteoporosis. Weight-bearing exercise has also been shown to limit some of the symptoms for those who already suffer from osteoporosis.

Simple, low or no-cost exercises such as Pilates (home videos are a great starting point),stretching, Yoga, and breathing exercises can help increase range of motion, flexibility, and balance—which will greatly reduce the chances of falling.

If Your Loved One Falls Down

• Don’t panic! If you panic, your loved one will panic.
• Ask your loved one to slowly try to get up if he or she is not seriously hurt. Ask him or her about any pain or dizziness. If you suspect an injury you may consider contacting a doctor of healthcare professional before moving your loved one (or asking him or her to move). If the fall was not serious and your loved one seems to be okay, ask him or her to move slowly, with your help or with the help of stable furniture. Be careful not to use your back—and instead use your legs, for stability.
• If your loved one is unable to get up and you are unable to help him/her, cover them with a blanket and keep them warm until help arrives. If your loved one falls when you are not around—be sure they know to keep themselves warm by rubbing their muscles and moving on the ground before help comes.  
• If your loved one falls when you are not around—be sure they know that the first priority is to get attention via the telephone, an alarm, a nearby door or window, or by making a loud noise.

The good news is that the majority of falls do not result in serious injury. But the psychological impact often causes people to unnecessarily restrict their activities because of fear. So if you can avoid the trauma of fear by heading it off, you improve your and your loved ones’ health ahead of time.