Preventing falls at home

Why this matters more than it sounds

A fall in an older adult is rarely just a fall. A hip fracture starts a sequence — surgery, immobility, deconditioning, sometimes pneumonia, sometimes a move to a facility — that is very hard to reverse. Preventing one fall can change the whole trajectory.

The equipment that prevents falls is the cheapest in the catalog and the most under-ordered.

The bathroom

This is where falls happen. Hard surfaces, water, low seating, high tub walls, and nothing safe to hold onto.

• Grab bars screwed into studs or proper backing — by the toilet and in the shower. Suction bars are not weight-bearing and fail without warning.
• A shower chair or tub transfer bench, so standing on a wet surface is not required.
• A raised toilet seat or toilet safety frame, so getting up does not require a deep squat.
• A handheld shower head, so washing can be done seated.
• Non-slip mats inside and outside the tub.

The rest of the house

• Remove throw rugs. All of them. They are the most common trip hazard in the home and no amount of tape fixes them.
• Light the route to the bathroom. Night lights, or motion-sensor lights, on the path taken at 3am.
• Clear the walking routes of cables, boxes and pet bowls.
• Both stair rails, secure, running the full length.
• Chairs with arms, at a height that can be risen from.
• Shoes, not slippers. Backless slippers cause falls.

The part that is not equipment

• Ask about medications. Several common drug classes cause dizziness or postural drops in blood pressure. A pharmacist review is free and effective.
• Get vision checked. Including whether varifocals are contributing on stairs.
• Strength and balance. The evidence for balance exercise in fall prevention is strong. Ask about physical therapy.
• Use the walking aid you were given. Set to the right height, indoors as well as out. The aid left by the door helps nobody.
• Check the feet. Pain, numbness and poor footwear all contribute.

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