Aging In Place Directory

Creating a Safe and Independent Home with Fall Prevention Strategies

• Esther C Kane CAPS, C.D.S. • Season 1 • Episode 21

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Can your home be a safe haven as you age? On this episode of the Aging in Place podcast, host Esther Kane, a seasoned occupational therapist and certified Aging in Place specialist, promises to offer you transformative insights into fall prevention strategies for older adults and caregivers. Discover how simple home modifications, starting with decluttering and securing loose rugs, can drastically lower the risk of falls. From the importance of stable furniture to the benefits of motion-activated lighting, Esther shares invaluable tips for creating a living space that supports your independence and safety.

As we continue, Esther sheds light on how thoughtful design choices can make all the difference in a home. Learn why impact-absorbing flooring and clever use of color contrast can prevent falls, as well as why rounded-edge furniture is particularly beneficial as we age. The bathroom and kitchen can pose unique challenges, but Esther discusses practical solutions like grab bars, non-slip mats, and strategic lighting to mitigate risks. With a focus on enhancing both safety and independence, these strategies aim to transform your home into a secure and supportive environment.

But safety isn't just about the physical space. Esther emphasizes the importance of lifestyle habits that keep falls at bay. Properly fitting clothing and shoes can prevent mishaps, while personal emergency response systems offer peace of mind. Esther also highlights the significance of having emergency information readily accessible and using lockboxes for easy entry during urgent situations. Tune in to learn how these proactive measures can help you or your loved ones maintain a safe, independent lifestyle in the comfort of your own home.

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Speaker 1:

Hello everyone and welcome to the Aging in Place podcast, episode number 21. I'm Esther Kane. I am your host, retired. I am a retired occupational therapist and a certified Aging in Place specialist. Today, we're going to be talking about some fall prevention strategies. We're going to be talking about some fall prevention strategies and I'm talking to older adults, anyone who is looking to age in place in their own home or just to make it as safe as possible for themselves, and also family caregivers of aging parents or senior loved ones. These are all strategies and tips. Some of them you may have heard of already and some, I hope, are unique and that you may have not heard of before. So, before I get started on this, if you're listening of any new videos which we put out every week, and if you're listening to this on our podcast channel, you know, please subscribe as well, so that we can get this information out to as many people as possible. I personally think, with 10,000 plus people a day turning 65 until at least another 10 years, then I think this information is extremely useful and informative. So, of course, please feel free to share it with others. So I'm going to talk about these fall prevention tips in like a list format. So we're going to start off with some home modifications, some general home modifications.

Speaker 1:

One of the first things I think that people don't think about when it comes to fall prevention is decluttering. Decluttering the spaces, and that doesn't just mean getting rid of excess magazines or, you know, cords that may be from floor lamps or anything like that. It also means decluttering large pieces of furniture that may be making it difficult to move from one space to the other, from one space to the other. If you have to get up from your recliner or from a sofa and sidestep to get out of the space between where you're sitting and the coffee table, then the space, the furniture, is too big. You want to downsize that furniture as much as possible or eliminate some of it to make it easier and safer, because a lot of trips and falls that I've treated in my patients have come because of that, because the room, the area itself, is simply cluttered with either too much stuff or furniture that just simply doesn't fit the size.

Speaker 1:

You want to secure loose rugs with double-sided tape or I personally recommend to remove them entirely. If you feel that you want to have some aesthetics of rugs, then I strongly recommend using vinyl rugs, the kind that sit, you know, right on the on the ground. They're extremely thin, they come in beautiful patterns and, of course, get the ones that are non-slip. There are some vinyl rugs that do not have the non-slip underneath them. I don't understand that purpose, but you want to get non-slip vinyl rugs if you feel you need that aesthetic design. They're really quite beautiful. I have several in my own home.

Speaker 1:

You want to secure furniture and appliances simply because if the person is wobbly, if they, you know, lose their balance and try to grab onto a shelf unit or a dresser or you know anything at all that isn't fastened to something, then that's going to go down with them and possibly cause even more injury. I remember I treated a patient once that had fallen and all they had was a slight bruise on their hip, but they held on to a shelf unit that had some heavy items on it. Those heavy items fell on that person and then ended up causing a head injury to the point where they were unable to return home. If they hadn't, you know, if that shelf unit had been fastened to the wall, it wouldn't have fallen on them and all they would have suffered would have been a bruised hip. So you want to fasten those kinds of things on the wall Any staircases at all, even if it's just two steps or one step going down into the garage.

Speaker 1:

You want to have handrails on both sides make it easy to get in and out. I've done that on all my steps everywhere. You want to make sure that the stair treads have non-slip treads. You can get clear adhesives now that you can put on the treads. There's even a paint type of material that you can paint right on the wooden step or stone step to make it non-adhesive. If you wanted to do carpeting, you could do that. There's all kinds of ways that you can make stair treads non-slip as much as possible. If necessary, you want to consider using installing a stair lift or a residential elevator if you have the space for that. That will make it much easier to transport from one floor to the other.

Speaker 1:

This is especially important if you live in a two or three story home. I live here in Georgia where almost every home seems to be two or three stories, so those types of elements in the home are extremely important. As you grow older, if you plan to age in places like that, you want to make sure that all areas of the home are well lit, especially stairways, hallways, especially anywhere where you get in the bedrooms, on the way to the bathroom, on the way to the kitchen, anywhere like that and I would recommend motion activated lights to turn on in all of these areas. Of course, in addition to that, it's important to have night lights. They can also be motion activated throughout the house, everywhere, especially bathrooms, bedrooms, any place that you may be wandering at night.

Speaker 1:

You want to install light switches that have lights both on the top and the bottom, or actually, I think a lot of them just come with the light on the bottom. They automatically turn on when the room gets dark. It's just an additional light, and you always want to have light switches near where you need them. You don't want to have to walk three feet to turn on a light switch and then walk three feet back to the stairs. You want to, if possible, have them moved so that they're right there where you need them, or, at the very least, use a smart plug with a smart device like Alexa or Google Home to use your voice to turn on those types of lights. You want to keep electrical cords, of course, away from all walking paths and away from just about everything. Even if they're tucked under the sofa or under the chair, you want to make sure that they're not going to be sticking out. This can happen often. If you have a pet. They'll play with the cord push it out. So you want to make sure that it's secured so that there's no way that it can come out.

Speaker 1:

I personally would recommend removing all kinds of floor lamps and just install ceiling canned lights, because those are bright, they are the easiest to manage and there's no lights, no cords, anywhere to trip over. Anything that is at a lower shelf or a lower place where you would have to bend down to pick items up. Move those items up if you use them often. My mom-in-law, when she turned 99, she fell three times in her condo. Each time she fell was because she was bending over to pick something up from a lower shelf or on the floor. So you want to have everything up as high as possible so that you can reach it comfortably and easily. These are items, of course, that you use all the time and of course you always want to install smoke detectors and carbon monoxide. That's just general safety. But you want to install smoke detectors and carbon monoxide. That's just general safety. But you want to make sure that they're the kind that you can see, you can hear, you know to accommodate whatever it is that you may be having trouble with vision or hearing you want to think about if you're redoing a home or remodeling a home.

Speaker 1:

If you're building a home, think about installing impact absorbing flooring materials so that if you did fall it wouldn't be such a drastic, a damaging fall. It won't help a lot, depending. It just helps a little bit. It can turn a break into a bruise or, you know, keep something from getting much worse than what it really is Now. I know this can be difficult in areas like South Florida or Arizona or even Texas where a lot of flooring is tiled because of the heat. Flooring is tiled because of the heat, but you certainly want to talk to your floor company if it's something that you're changing, remodeling or anything like that.

Speaker 1:

You want to use color contrast and textured surfaces to clearly define edges of steps and level changes, because visual perceptually it's very difficult sometimes to identify the edge of a step to the next step, so it's very easy to skip that, miss that and end up falling. I know I myself am having that problem now on my staircase. So I have colored edges that I'm installing at the end of each stair tread so that I can identify where that edge is. You want to. If you're going to change your furniture, you want to choose furniture that has rounded edges to minimize injuries from bumps.

Speaker 1:

As we all get older, our skin gets thinner and it's much easier to bruise, to break, get infected. All kinds of things can happen just from a little tiny bump. It doesn't happen in your 20s, 30s, 40s or even 60s, but starting in your 70s and 80s, you're going to notice a lot of much thinner skin. You want to protect it and you can do that with rounded edge furniture. And then, of course, contrasting colors between the wall and the floor can also help to identify where things are, just visually, perceptually. If that ends up being a huge issue for you, you may not even realize it until you do install those different colors and you're like, wow, I didn't even notice that that was. You know that that was the end of the floor.

Speaker 1:

All right, the bathroom. Well, the bathroom is one of the most dangerous places, along with the kitchen, in a home for any older adults. So you want to pay special attention to that. Of course you probably know we're going to be installing grab bars in the toilets, near the bathtub, in the shower stall. My mother had a long hallway into her bathroom so we installed grab bars along that long hallway to get into her bathroom so she could use that while going in.

Speaker 1:

You want to use non-slip mats in the shower, the bathtub, of course, outside the shower. Consider a walk-in shower or tub with a low threshold or zero threshold would actually be ideal, of course. Raise toilet seat with armrests, anything that can help you to get up and get down. It's so easy to fall when you're struggling to get up or down. If necessary, use a shower chair or bench. A handheld showerhead is one of the best things that anyone can do, especially if you have the bench you're sitting there. You can install the handheld showerhead that has the remote controls right on the showerhead and you can just mount that right there next to your seat and, of course, always make sure that the floor is as non-slip as possible. So whatever tile you choose, whatever flooring you choose, try to make sure inside and outside the tub and the shower that is as non-slip as possible.

Speaker 1:

The kitchen, again, is another area where many older adults fall. My great friend of mine, her mom, just passed away a few weeks ago and what started her downhill slide was a fall in the kitchen as she was reaching for something that was just a little bit too far out of her reach. Instead of scooting closer to get to it, she just tried to reach over and fell and ended up at the hospital and was never able to return home again. So just a simple little thing that takes a second that we all do every day, as we, as we're, you know, in our daily lives, as we get older, we have to stop and think about what's the safest way to do this. I know it takes a little bit of time to get used to it, but some of the tips I have for you in the kitchen are to rearrange the frequently used items to lower shelves or to any place that you can access it quickly and easily. I just rearranged my pantry so that I have pull-out drawers now and the items that I use most frequently are right there at my height level. Nice and simple. The items I don't use that frequently are in the lower shelf or up high. Of course, I don't use them often, so I don't have to access them often.

Speaker 1:

If you have to use a step stool, I recommend strongly recommend a sturdy stepool with a handrail so that you can hold on to the handrail while you are on the stepstool. I would ask a physical occupational therapist to assess if you're safe for a stepstool. Some of you may be cringing at that thought, but it is important because step stools are not always the safest for everyone, so you want to definitely, if you have to use one, at least use one with a handrail. Pull-out shelves and lazy Susans are ideal, especially any place where you have to reach in to get anything, even in refrigerators, of course, always like the bathroom. Non-slip mats by the sink, by the stove, wherever you stand quite a bit Ensure, of course, there's good lighting. Again, canned lighting is one of the best types of lighting for any room, especially the kitchen, even adding more under-the under the counter type of lighting.

Speaker 1:

And instead of having a microwave most of us have a microwave that's up high or higher, maybe at our face level, or even higher than that. It's always safer to have something like something where you're pulling out something warm at your like neck or chest level. So if you can consider installing a wall-mounted microwave at that level, or even on the counter. That would be much, much safer for you. You wouldn't have to let go of anything in order to pull something out of the microwave you want to. In the bedroom, you want to place a lamp or a phone, of course near the bed, within easy reach of the bed, while you're laying in bed, and I would recommend a touch lamp so you don't have to mess. You know reaching for the switch to turn it on or off. A touch lamp where you can just touch it. Or, better yet, use a smart plug and use a voice activated device like Alexa to turn on and off the light.

Speaker 1:

You want to consider a bed rail for support. You can just install one that sits between the mattress and the box spring. They're very inexpensive, very easy to install and they're a wonderful support. My mom-in-law used it for many, many, many years, and you want to make sure that the bed is not too high or not too low for you, so that you can get in and out of it easily. If you're trying to get out of the bed and it's just a little too high, you could put your feet on the ground and slide right down. I've seen that happen a few times. So you want to make sure that you've got a bed, that you, when you sit on it, that your legs are at 90, your hips are at 90, and your knees are at 90 degrees, so that you can, you know, touch the ground safely and pull your push yourself up safely.

Speaker 1:

If you are caring for an older adult and they have a risk of falling out of bed or they tend to get up in the middle of the night, I would recommend a bed alarm. They have some that are on the floor so once their feet touch that mat then it sets off an alarm on your phone or a device. They also have some where you put it underneath the mattress. Again, if the person goes to get up, then it sets off the alarm and it alerts you that that person is up and about or trying to get up and about. You also might want to consider an adjustable bed where the head and the foot sides go up or down. That may make it easier to get up out of the bed and also to get back into bed for someone. And if someone does have a fall risk of, you know, falling out of bed at night, you can certainly use bed rails, but you can also, if they're a very small person or light person, you know, you can modify it with large pool noodles or large pillows that you can stuff underneath the fitted sheet and create basically like a bed boat kind of thing where they're tucked in there.

Speaker 1:

Now, if this is the, if this person tends to get up in the middle of the night, that may make it difficult for them. They may end up struggling to try to get out of that and that may end up causing a fall. So, again, you want to speak with an occupational therapist about assessing how this person gets in and out of bed and what the safest, best way is for this person to. You know work, you know how to work around their situation. All right, we can't forget about outdoor safety, but you want to always make sure that the walkways, the steps are even, that there aren't any major cracks or there aren't any you know loose stones where they could walk, especially if they're using a cane or a walker to get anywhere. You want to make sure that there's handrails on all outdoor steps, of course, that there's lighting it could be solar lighting, led lighting. You always want to make sure that there's enough lighting, use non-slip strips on all outdoor steps and you want to, of course, at the same, keep every patio, porch, driveway and yards free of clutter, so that it's easy to walk around. And also, if someone were to fall and fall onto something like you know, maybe a child's bicycle or a lawn chair, you know they may end up causing more damage to themselves than if they just fell on the grass. So you want to make sure that there's at least amount of clutter as possible and, if needed, you may need to install a ramp. Now, nowadays they have these beautiful designed ramps. You can call a landscape architect, a landscape designer, and they can create these beautiful ramps that are just, you know, that blend into the aesthetic of your home. Of course, I know it depends on the size of your yard and your community, but it's certainly worth looking into to make it safer and easier, because, at the end of the day, all of this is really about keeping your independence at home as long as possible. That's the bottom line for any aging in place tip.

Speaker 1:

All right, physical health. We can't forget the fact that if you are immobile if you are, you know you don't exercise, you don't strengthen your muscles, you don't take in the right nutrition or hydration, you're going to get weaker, and as you get weaker, it's much easier and quicker to fall for any anything, no matter how much you modify the environment. So you want to make sure to exercise to you know, improve your strength as much as possible, participate in balance exercises especially. You want to make sure that your vision and your hearing, because that does affect your balance you want to review medications that they, you know, make sure that they don't make you dizzy. If you have low blood pressure, like I do, it's often, you know, you get up from a seating and I have to, like you know, stand for a second or two just to let the dizziness, let the fog go away, let my blood pressure normalize, while I stand in the act of getting up. So you want to take it easy, take it slow and make sure that you are adhering to what your body is telling you. And, of course, speak to your doctor about all of this. Staying hydrated is one of the easiest ways to prevent, you know, getting dizzy or getting weak. And, of course, vitamins, anything like that that you know. Speak with your physician about it. I'm not a physician. I'm just giving you the general information of what I've been told by my physician on how to keep myself from falling and, you know, preventing an injury.

Speaker 1:

Another issue that's personal is your footwear and your clothing. If you tend to wear clothing with loose arms or you know that tends to be baggy, that can get caught on doorknobs or, you know, kitchen cabinet knobs or anything like that, that can also cause you to trip and fall. If you get caught and you, you know, you lose your balance a little bit. So you always want to wear properly fitting clothing, properly fitting shoes that have a back, that support you. I know I have several friends who are in their 70s and 80s who insist on walking barefoot or just wearing socks in their homes and that I do not recommend that. If you have to just wear socks, at least wear the socks with the grips on the bottom. But just make sure that you have something to support you and that can keep you, you know, balanced, especially as you get older. You know we tend to have problems with our feet and you want to support them and not, um, you know, because if one foot hurts, you're going to raise it to try to get that pain out and then you're standing on one leg and that doesn't always bode very well. All right, lifestyle habits.

Speaker 1:

As I said before, don't rush. If the phone is ringing, let it ring. Take your time to get to it. Of course nowadays it's so easy with wireless and cell phones, so, but still don't rush. Take your time. Keep pets supervised. If you're taking something out of the microwave or the oven, or just turning, you know, to get a bowl of cereal or whatever, make sure the cat or the dog are not behind you so you don't trip over them. You want to be extra cautious whenever you do anything. You want to take a second plan, it out and before you know it it'll turn into a habit. But initially it does take time and it is a little difficult at first. I admit it took me quite a while and I still at times times forget to do that myself, especially going up and down the stairs.

Speaker 1:

You want to consider if you feel you're at risk. You want to consider some type of personal emergency response system. It can be having an Alexa device in every room so you can call out for 911 or help from neighbors, friends, whoever. It could be a medical alert device, anything. It could be an Apple Watch. You know that has fall detection, whatever it is. Don't rely just on your cell phone, because a lot of people will have the cell phone in their hand and if you're going to carry a cell phone, at least have an apron or something where you put the cell phone in their hand. And if you're going to carry a cell phone, at least have an apron or something where you put the cell phone in a pocket. But even so, if you fall, that cell phone could fly out of your pocket and then you wouldn't be able to access it. So you want something that is on you, or something that you can use your voice to get to it. So consider that, that you can use your voice to get to it. So consider that you want to.

Speaker 1:

We talked about the smart home devices. I think there's a lot of wonderful ways that you can use the smart plugs to turn on your lights, to even your dishwasher, your washing machine, your oven Almost everything can be attached to a smart plug and you can control it with your phone. Having the camera outside, you know, by your door alarm door bell, your doorbell outside is wonderful. You can then talk to whomever is out there, so you don't have to hurry up to get up out of your chair, which you shouldn't hurry up anyway to get to the door. So you want to speak, you can speak to them that way and you know you may not even have to get up, especially if you get a lot of solicitors in your area, in your area. But that type of technology can greatly keep you from rushing and falling and injuring yourself for something that just takes simply one second to occur and may completely alter your life, like it did with my friend.

Speaker 1:

Think about the Vile program, where you have an item on your refrigerator it's a piece of paper actually with your medical history, so that if emergency responders were to come to your home, they have that information there. They have that information there and consider a lockbox on your entrance, either front or back, so that when emergency does come, they have the code to get into your home without having to break into your home to help you. This is especially true if you live alone. It's a great way, it's a great service to have both of those so that they can help you as quickly as possible if you need it, if you were to happen to fall. Well, I hope some of these tips were new to you. I hope that they can help you and or your loved one.

Speaker 1:

I think falling that was one of the treatments. That was one of the diagnoses that I got most often working in elder care. I worked specifically in head injury type of situations and it was almost always due to a fall and, like I said, it was just something. Some of them were silly they just tripped over you know something they didn't see, or they slipped on something, or they were rushing to the door or the phone, or they were carrying too many things. It was just something so inane and it ended up just altering their lives for the rest of their lives.

Speaker 1:

So it only takes a second. So you want to avoid that one second as much as possible and live as independently as possible for as long as possible in your home, and that's what we're all about here on this podcast. That's my goal to help you to do that and to help your loved ones to do that. So I want to thank you so much for listening, for watching Again, subscribe, whether it's on the podcast or on YouTube, and I will see you next time on the next episode of the Aging in Place Directory podcast. Thank you, bye.

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Esther C. Kane, CAPS, C.D.S.

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