Home Safety, Accessibility, And Fall Prevention

These unprecedented times have impacted us in more ways than we realize. For some individuals, their parents, grandparents, and loved ones who are at-risk have been living in more social isolation than ever to avoid exposure to the virus. The result is fear and uncertainty because we are unable to physically check-in with loved ones to see if they are doing OK in their homes. Although the country is beginning to reopen, this article will educate you on how to make sure you and your loved ones are safe as they continue to remain home as a means of social distancing.

How Bad Are Falls?

Falling, slipping, and tripping at home are one of the most frequent causes of injury to older adults. At least one out of every three adults over age 65 sustain a fall each year that may result in decreased independence, traumatic brain injuries, fractures, increased risk of death, or a need for long-term care support. As of 2015, falls accounted for $30.9 billion nationally in medical costs and remained the leading cause of injury and death in older adults.

Causes and Risk Factors

Falls are NOT a natural part of the aging process. But why does it happen? Falls are the result of the interaction between personal, environmental, and activity-based factors.

  •  Personal factors: Lower extremity weakness, impaired balance, cognitive impairment, urinary incontinence, sensory impairment, fear of falling, medication side-effects, illness
  • Environmental factors: Throw rugs, loose carpets, pets, clutter, uneven flooring, thresholds, lack of handrails, improper footwear, lack of mobility devices if needed
  • Activity-based factors: Reaching into high cabinet, rushing to bathroom, rushing to answer doorbell, transferring into bathtub or shower

If you were to combine impaired balance, uneven flooring, and rushing to answer a doorbell, the result is the perfect storm for a fall. Even a history of prior falls is a huge predictor of future falls.

Prevention

While falls can be serious, they are easy to prevent. Here are some tips to reduce fall risk.

  1. Always turn on the lights in dim environments, and open window shades to illuminate dark rooms
  2. Remove clutter and excess furniture to improve walkability in the home
  3. Remove or secure throw rugs. Use non-slip mats with grippy bottoms if needed.
  4. Wear proper footwear with good traction (avoid flip flops)
  5. Install grab bars/grab rails as needed (such as in the bathtub)
  6. Acquire durable medical equipment as needed (such as bedside commodes or raised toilet seats)
  7. Place frequently used items in easier to reach areas
  8. Secure chargers and electrical cords away from walkways
  9. Use furniture raisers to securely raise beds and sofas to safer heights
  10. Purchase adaptive equipment such as long-handled sponges and reachers
  11.  Replace stationary showerheads with height-adjustable shower heads

Additional Safety and Accessibility Tips

  1. Keep at least one fire extinguisher in an accessible location in the home for emergencies
  2. Keep a list of emergency phone numbers and a list of medications on refrigerator doors for easy reference
  3. Opt for cordless phones
  4. Opt for D-shaped cabinet handles and lever-style door handles over traditional round knobs to open doors
  5. Opt for rocker-style light switches vs. traditional light switches
  6. Have smoke alarms, fire detectors, and carbon monoxide detectors inspected
  7. Keep oven mitts close to ovens for easy access

Medical Alert Systems

Medical alert systems are devices designed to contact emergency services in the event of an accident. If you’ve ever heard the slogan “I’ve fallen and I can’t get up”, that is a very popular medical alert system.  While these systems are effective, there are several things to consider:

  1. Prices vary–from monthly costs, to equipment costs, to cancellation fees
  2. Some alert systems require the press of a button. Others can autodetect falls
  3. Battery life varies
  4. Some systems have GPS while others will only function in a small radius near the home
  5. Languages offered may also vary

Here is a link differentiating between different medical alert systems.

Alternative Smart Devices

If medical alert systems aren’t appropriate, it might be worth considering smart technologies and wearables. Smart devices don’t necessarily require monthly subscriptions, meaning they are less expensive in the long run, but they do lack specifically designed features that you find on medical alert systems.

  • Apple Watch 4 : A lesser known feature of the newer models of the Apple Watch includes a fall detection sensor. When a person wearing the watch falls, the watch pings the wearer and indicates that it detected a fall. The device then proceeds to ask if the wearer would like to dial 911. This requires a response from the wearer.
  • Smart Home Speakers : Smart speakers react to voice commands and are slowly becoming more popular in homes. Usually used to manage lights or to answer various questions, a user who has fallen can use voice commands to have the device make phone calls to friends and family who may dial 911 for them.  However, note that the devices are not able to dial 911 at this time (as of August 2020).
  • Ring cameras for remote surveillance : Ring is the brand of porch cameras that was originally used to deter package snatchers by catching them in the act. However, the company has since expanded their product line into the home, which allows you to survey all events wherever cameras are placed. While this may seem invasive, it might be a good alternative to other medical alert systems if you would like to personally monitor your loved ones who are at risk by placing the cameras in the living room or kitchen, especially with their consent.

Cynergy Is Now Providing Remote Home Assessments

Cynergy is proud to announce that our Occupational Therapists are currently providing client-centered home evaluations through virtual telehealth sessions at this time. Our practitioners will work with clients and their caregivers in assessing the home for possible hazards and to evaluate individuals’ personal factors that may cause or contribute to falling. Our practitioners will then formulate an intervention plan and provide safety recommendations to allow clients to perform daily tasks safely. This may include modifying the home, changing activity patterns, and altering unsafe behaviors. If you or someone you know has safety concerns in the home, contact us for a home evaluation today.

In good health,
Raymond Nguyen, MS, OTR/L
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