Health Take-Away: Falls leading risk for losing independence


People are happiest in their own home. This is especially true as we get older. Home is where we are most comfortable and where our best memories are stored like treasures scattered throughout our rooms. Yet, older people lose their ability to live independently for a while — and maybe even permanently — because they fell at home and injured themselves so badly that they needed institutional care.

Falling at home is the leading cause of losing independence for senior citizens. Fractures of the spine, arm or leg can result in the need for nursing home care. Even more frightening, broken bones can lead to complications that are more dangerous than the original injury.

That's because older people may have other conditions, such as heart or breathing problems, which add risk to surgery. Not walking or moving around while bones and other injuries heal can cause blood clots, pneumonia and other serious conditions. Adding to the risk is the tremendous emotional toll that loss of independence takes on most people, especially if they are leaving a loved one behind.

Even though all people start losing their balance as early as the age of 22, stronger muscles keep younger people from falling more frequently. As we age, we become more sedentary and the core muscles that keep us upright and strong become weaker. This increases the risk of falling, and once an individual falls, he or she is at a greater risk of falling again.

Clearly, the goal is to keep everyone safe at home for as long as possible. There are many ways to evaluate an individual's risk of falling — or the risks in their environment that can cause a fall — and then determine how safe someone is at home.

Let's start with a self-assessment. If you or a loved one gets around the house by going from chair to table to sofa (we call this a "furniture cruise") you are at risk for falling. If you need help standing from a sitting position by pushing up from the arms of the chair, that's another risk. See your primary care physician for a more comprehensive evaluation.

Local home health agencies such as Visiting Nurse associations and Hospice will conduct a home evaluation to assess your risk for falling as part of its process for admission to services. Also, programs such as A Matter of Balance, which are sponsored by the YMCA and senior organizations, can help older people learn how to strengthen their core muscles to help avert falls.

There is a lot that individuals and families can do to increase safety at home, paying close attention to the bathroom, kitchen and bedroom where most falls occur. The following are essential tips on making a home safer:

• Keep the inside and outside of the home in good repair. Remove objects that someone is likely to trip over, inside and outside. Make sure walkways are clear

• Remove or secure scatter rugs and loose carpeting on stairs

• Keep the cellar door closed

• Place a strip of brightly colored tape at the top and bottom steps of a stairway

• Install grab bars near the toilet, tub and bed

• Install an elevated toilet seat

• Install handrails on both sides of the stairway

• Make sure night lights work and illuminate the way from bedroom to bathroom

• Consider rubber treads on stairs, or a chairlift if needed

• Attach a bag to your walker to help carry things, leaving your hands free

• Wear an emergency bracelet or necklace

Many of these tips are not expensive. While all can be valuable, a home assessment will pinpoint the exact changes an individual needs to remain safe at home.

No one thinks they are going to fall, but statistics tell a different story. By making a few important changes in your environment and lifestyle, people can stay safe in their own homes for many years to come.

Patricia Tremblay, MS, RN, is the Director of the Berkshire Visiting Nurse Association & Hospice. She has more than 37 years of home health and hospice experience as a nurse, leader, and consultant.


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