Preventing Falls: Making You Safe at Home and Outside Home

A fall is the most common cause of injury.
Some people, especially those who have experienced a serious fall, can worry so much about falling they restrict their activity.
They gradually do less activity, which can actually increase their risk of falling.
Do not give in to it. The more you do, the more you can do!

What is a fall?

A fall is when you slip, trip or fall suddenly onto the ground or floor. You could even bump against a wall or land on the stairs. The fall may or may not cause an injury.

• Falls can happen anywhere. You can fall in your home, in the community or in a hospital.
• People fall for many reasons. These are called risk factors. They include health conditions and choices we make, such as the shoes we wear. Know your risk factors so you can take the necessary precautions.

Why do falls happen?

Physical Factors

Usually as a result of changes due to ageing or a medical condition.

• Muscle weakness or pain
• Slow reaction time
• Poor balance
• Reduced vision
• Poor memory or concentration
• Dizziness

The following medical conditions increase the risk for falls:

• Parkinson’s disease
• Stroke
• Dementia
• Arthritis
• Rheumatism
• Incontinence
• Diabetes

The following lifestyle choices increase the risk for falls:

• Lack of exercise
• Poor diet
• Unsuitable footwear or attire

The following environmental factors increase the risk for falls:

• Poor lighting and visibility
• Cluttered spaces, narrow walkways, physical obstacles
• Staircases, steps, steep inclines and curbs
• Slippery surfaces such as wet floors

Facts about Falls

• 20-30% of seniors (age 65 and over) have a fall every year; half of them have more than one fall
• Falls are the most common cause of injury among seniors
• More than 85% of injury related hospitalizations for seniors are the result of falls
• 50% of all falls occur at home

Drug Side Effects and Falls Risk

Medications are important in treating health problems that accompany aging. Often, older adults take many medications to treat chronic conditions such as arthritis, high blood pressure and diabetes.

However, prescription and non-prescription medications can have side effects that increase the risk of falling. When taking medications, especially four or more, older adults need to be aware of possible risks and take steps to reduce them.

Common Medications for the following health problems may increase fall risk:

• Heart and blood pressure
• Sleep, anxiety and depression
• Dementia symptoms
• Arthritis and pain
• Bladder control
• Digestive, stomach and nausea
• Blood clots
• Colds, flu and allergies

The following medication side effects can increase fall risk:

• Dizziness, lightheadedness, drop in blood pressure when standing
• Difficulties with balance, slow response to loss of balance
• Loss of concentration, decreased alertness, and drowsiness
• Blurred vision

Steps to Reduce your Fall Risk

• Know why you are taking each medication and the proper dosage for each
• Always read the label on new medications to be aware of possible side effects and interactions, especially if you take four or more
• Ask for large print labels if you need them, and ask your pharmacist for more information if necessary.
• Take medications as prescribed and follow all directions on the labels
• Keep an up-to-date medication list, including those you take on an as-needed basis and ones that caused problems in the past
• Bring all your medications (prescription and over-the-counter drugs, vitamins, herbal remedies) to your doctor or pharmacist for review - especially if you have fallen or have balance problems
• Your doctor or pharmacist can help determine if any medications or dosages could contribute to falls and whether any should be stopped or replaced with alternative medications.
• Tell your doctor right away if you notice any side effects after taking a medication (see page 1 for side effects).
• Use the same pharmacy for all prescriptions - it makes it easier to check for problems.
• Avoid drinking alcohol when taking medications - it can affect how they work, worsen side effects, and cause problems with balance.
• If you fall, write down immediately where and when you fell, how you fell, what you were doing, and how you were feeling.

How to Get Up From the Floor by Yourself

• Keep calm
• Check your body
• If you are injured, call for help and stay calm
• If you are not hurt, look for a strong piece of furniture, like a chair

1. Roll onto your side
2. Crawl over to a chair or sturdy furniture
3. From a kneeling position, put your arms up onto the seat of the chair
4. Bring one knee forward and put that foot on the floor
5. Push up with your arms and legs, lift your bottom around
6. Sit down. Rest before trying to move

How to Help Someone who has Fallen

• Check for injury. If you suspect any major injury (i.e. fracture), call 999
• When assisting someone to stand up, if possible, try to do so by only offering guidance
• Allow the person to rest and check again for injuries. Seek medical help if needed

Make your Environment Fall Free

Sixty percent of falls happen in the home. In order to continue to live safely and independently, our homes have to ‘grow’ with us. Making simple changes to our environment, especially at home, can go a long way in reducing the risk of falls.

There are two main ways to reduce fall hazards in your home:

1. Adapt your environment to increase safety
2. Increase your perception and awareness of your environment

Here is a checklist for preventing falls in your home:

Stairways

• Make sure all handrails are not broken and are securely fastened
• Both sides of the steps should have handrails

Bedroom

• Use a cordless phone to help make phone calls without getting out of bed; a cordless doorbell may be used to call for help
• Install a night light
• Consider placing a commode or urinal next to the bed at night to avoid the need to walk when tired
• Place walking aids close to the bed
• Ensure that the bed is of a correct height; you should be able to place your feet flat on the floor when you sit at the edge of the bed

Useful Fall Prevention Products

Personal alarm – help alert family members or neighbors if you fall
Anti-skid strips – place on high risk areas such as stairs, curbs and uneven flooring
Rubber matting – place in toilets, kitchen and under floor mats to reduce the risk of slipping
Shower chair – help make shower time safer
Commode chair – help make bathroom visits safer
Prayer chair – a sturdy chair with a head rest in front for elder patients who cannot bend and squat during prayer and those with balance issues
Arm chair – a sturdy chair with arm rests to help you sit comfortably and safely
Grab bar – useful hand holds to install throughout your home
Night lights – help increase safety in the night time
Walking aid – helpful for those who have had a prior injury or condition that makes walking difficult

Floors and Rugs

• Make sure all floor boards are even and rugs, including area rugs, are secured to the floor with tacks, non-skid pads or double-sided tape
• Use non-skid floor wax

Bathroom

• Be sure that you can move safely in bathroom area, and in and out of the tub or shower
• Remove soap build-up in tub or shower on a regular basis
• Place non-slip strips in bath or shower
• Install adjustable height shower heads
• Mount grab bars at the toilet, bath and shower on walls with secure reinforcements, to prevent the bars from coming loose
• Make sure that the floor is dry – no water puddles on the floor
• Secure bath mats with non-slip, double-sided rug tape

Kitchen

• Items that you use frequently, such as dishes and food items should be easy to reach
• If you have to use a step stool, make sure that it has a bar at the top to hold on to
• Reduce glare by using shades or indirect lighting; install additional lighting if needed
• Clean up spills immediately
• Store heavy items within easy to reach or lower cabinets

Lighting

• Place nightlights in hallways, bedrooms, bathrooms and stairways
• Install light switches at the top and bottom of stairs
• Place a lamp (and telephone) near your bed
• Keep lighting uniform in each room and add lighting to dark spaces