The Most Common Enemy

According to the CDC, more than 25% of senior citizens fall every year, and the chances of falling again more than double after the initial incident. This is a sobering statistic, and needs to be at the forefront of every caregiver’s mind: Fall prevention. Additional statistics from the CDC are even worse: 95% of hip fractures are due to falls. Almost one million people are hospitalized each year due to a fall. Falls are the leading cause of TBI (traumatic brain injury) for seniors, as well. (https://www.cdc.gov/falls/facts.html).  

Exacerbating the problem, after falling once, some seniors become so scared of another fall that they severely limit their movement and activity. This causes a host of other problems that could lead to an early decline. 

Our Fall Prevention Origin Story

In the beginning, around age 88, Mom had a caregiver two days a week for a few hours while I worked. The other days she was at the Senior Center. Still able to get around, and in (almost!) full use of her faculties, Mom was active with her caregiver—going out shopping and to lunch every day—and used no assistive devices whatsoever.

One Tuesday, the caregiver left on time at 1:30. Mom was watching TV and having a snack. I got home, on time, at 2:15, and was met at the door by a very anxious and upset dog. Luna Belle herded me (seriously—it’s a story all by itself) physically to the den, where I found Mom on the floor. Conscious but confused. 

She broke her hip in that fall. The first fall she had ever had. That fall led to a very quick change in her dementia status, led to hospitalization followed by rehab, followed by home health, followed by hiring her caregiver full time in our home. Mom never played Bingo again after that fall, and the decline was steep. Since then, she can’t get around without her walker, and moves very slowly. 

Minimizing The Likelihood

Fall prevention is all about minimizing the likelihood of it happening.

We felt pretty confident before the fall that we had done everything in our power to minimize the risks to Mom. Most of the common risk factors weren’t an issue: She didn’t have to navigate any stairs in our home, we got rid of the throw rugs in her areas, decluttered as best we could, and tried to keep her muscles as strong as possible.

It didn’t matter. She still fell.

That is the important message this week: Do everything you can to minimize the dangers, but be aware that this common accident can happen at any time. Here are a few things you can work on right now to try to minimize your loved one’s chances:

Shoes

“Poor footwear” is specifically listed on the CDC website, and it is very important for your loved one. Mom was a fan of slip-on slippers around the house, and that might have been one of the reasons she fell. Unsupportive, slip-on footwear can move, shift or even fall off of their feet, causing them to lose their balance and fall. Make sure your loved one is always wearing supportive, closed back footwear that fits them well.  

Carpet vS hardwood

Decorate your place however you like, I don’t care. What could become a problem, however, are uneven surfaces or changes in the surface itself. In our house, the hardwood gives way to carpet when you enter a bedroom or the den, so there is definitely a little lip to navigate that could cause imbalance. The best part about the carpet, I will say, is the lack of an area rug. Tripping over the edge of a throw or area rug is a huge risk factor, and something you absolutely control. Hardwood gets the nod, however, for ease of maneuverability with the walker. It is significantly easier for Mom to navigate the hardwood floor instead of a plush carpet.  

Using the walker

Pop was a temporary walker user after the kidney cancer, so we had some experience with using one. Both of my parents used the Rollator style—with the four wheels and the seat. It was a seamless transition for Pop, but Mom really struggled to get the hang of the walker. Unfortunately, the walker itself can become a falling hazard if your loved one isn’t comfortable using it. Seems like it would be the best form of fall prevention, but not if you don’t know how to use it… Our biggest problem now, due to the severe dementia, is when Mom forgets she needs a walker and starts just trying to walk. 

Grab bars

Put these up today! My Pop was a very proactive, forward-thinking type of dude, so he installed these in our house when it was built in 2001. Neither one of them needed these for over a decade, but they got used to using them anyway, and it was definitely helpful as the years passed. Getting your loved one in the habit of using the grab bars right now, when they are merely a convenience item, could save them from very dangerous bathroom falls in the future. Put these inside and outside the shower, as well as near the toilet if possible. 

Pets (sorry, everybody)

Luna Belle is a service dog, no doubt about it. The above example isn’t my only story about her saving somebody in the house, and we couldn’t have made it without her. That being said, puppy Luna was a nightmare with my parents! She didn’t know how big she was, she was pushy to get into the middle of things, and she ran with the unwieldy gait of a newborn deer. Here is my suggestion, everybody: Get pets that are older, lower maintenance, and really, really smart. 

Minimizing The Short Walks

Don’t misunderstand my intentions! I need Mom to walk as much as possible to keep as much muscle as possible. However, she fell taking three steps from one recliner to the other in her den. 

Three steps. 

Bending down to pick something up. Just getting something from the table. Those are the biggest risk factors—those couple of steps that they aren’t completely upright, aren’t thinking clearly, don’t put on their shoes, are stepping over the dog.

Now, if Mom needs something quickly, I get it. It’s just not worth the chance. 

Maximizing The Longer Walks

We absolutely do, however, maximize longer walks for her. Not only is it extremely important to keep muscle mass, but at this point, putting her in new situations and with new scenery are the best chances we have to keep her mind active. It’s all about fall prevention in the future.

We walk down the halls of The Facility, out into the courtyard to look at the flowers, anything to get her moving and talking. 

Mind you, these walks are all of a hundred feet before we stop for a few minutes. I’m not talking about going to the mall or even The Dollar Store anymore—just getting her up and moving to keep those neurons firing and that muscle memory active.  

But, Pat, I can’t buy a new house!

I know. You’re doing the best you can with what you’ve got. Many of you have stairs to navigate, which sounds like the worst case scenario from my perspective, but you have what you have. If you are reading my blog, you’re just trying to get through each day doing the best you can for your loved one while raising your own family. You can’t just up and move, so you might need to make some tough decisions and maybe even some changes in your current living arrangement.

What rooms are “safe”

We are committed to making my parents as comfortable as possible during their later years, so we designed their bedroom and den to be accessible and safe from the very beginning. Despite the fact that her fall occurred in her den, we still maintain that the room is as safe as possible for her. There is a low-pile carpet, no throw rugs, no furniture to navigate around, no clutter on the floor and minimal furniture.   

What can you add

Loyal readers will notice I mention grab bars in the bathroom repeatedly. That’s because they work! Think of falling in your bathroom instead of your living room. There’s no room in the bathroom, making it way more likely to hit your head on something very solid leading to a TBI. Mom fell and hit nothing on the way down—I think that was the absolute best thing we could have hoped for. 

Work with what you have

Mom can’t navigate my dining room. Just impossible with the structure of our house. She can, however, get to the chair at the head of the table, so that is where she sits. My family room furniture is too large for her walker to get by, so we literally move furniture for her to come sit with us to watch TV. Those are examples of ways we make incompatible areas of our home work for her.

No Matter What…

If it’s going to happen…it’s going to happen. Fall prevention measure will only take you as far as fate will allow. We can’t prevent accidents from happening. All we can do is minimize the chances, and minimize the additional risks associated with them.

Pop was steady and sure footed until the last week of his life, but that isn’t common.

Mom fell and it changed everything and started this snowball rolling down a very steep and scary mountain.

My biggest hope is that your loved one is like Pop, but the odds are not in our favor. Do everything you can. 

THANK YOU FOR READING THIS FAR

Wow! You made it! Thank you for reading about fall prevention!

Hey, since you’re here! You may as well check out when to check your bowels, here, or read about how lucky we all are, here! Or, check out our other topics here! Either way, I appreciate you!

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