Preventing Harm in Your Own House

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Seniors are often one wrong step away from falling in their own homes. To reduce the chance of an accident, follow these tips.

By Richard Trubo
WebMD Feature

Reviewed By Brunilda Nazario

Rosemary Bakker still shudders when she reflects back upon the alarming phone calls she received, telling her that her mother had fallen and fractured her hip. She got two of those frightening calls in just a two-year period. Ultimately, they changed her life.

The first time that Rosemary's mother, Arlene, fell, she was 69 years old. Her feet had become tangled in an extension cord, and she tumbled to the floor. Then two years later, she slipped on a comforter that was draping off the bed. She lay helplessly on the floor with a refractured hip for at least three hours until she could slowly maneuver to a phone to call for help.

"When we finally brought my mother home from the hospital, I noticed that the ordinary architectural details of her home -- the area carpets, the low-light levels, the door sills, the extension cords -- became barriers to her safety and independent functioning," recalls Rosemary. "Her home was a time bomb waiting to go off."

Rosemary, a certified interior designer, was so unsettled by her mother's predicament that she put her own life onto a different path.

Returning to college, she earned a graduate degree in gerontology. Today, she is director of an innovative program she founded called GEM (Gerontologic Environmental Modification) at New York Weill Cornell Medical Center's Division of Geriatrics and Gerontology. Her goal: Make homes safer and more livable for senior citizens.

Fear of Falling

With their slower reflexes, brittle bones, decreased muscle strength, and poorer vision, the elderly are often just an ill-advised step or an unexpected stumble away from disaster. Each year, more than 730,000 men and women over age 65 end up in hospital emergency rooms for injuries related to the stairs, bathtub, carpeting, and furniture in their own homes. Falls are a particular concern and are the leading cause of injury-related deaths among older adults. According to the CDC, about one in three adults 65 and older will fall this year, and as a result will end up in the hospital five times more frequently than for injuries from all other causes.

"Among the elderly, there are changes in the spine that alter their center of gravity," explains Elaine Gallagher, PhD, RN, professor of nursing at the University of Victoria in British Columbia and founder of a program called STEPS (Seniors Task Force for Environments which Promote Safety). "With changes in muscle tone and changes in gait, they may be more prone to falls, particularly if they also have one or more chronic diseases such as arthritis, osteoporosis, or Parkinson's disease."

Fortunately, many accidents around the home are preventable if steps are taken to minimize the hazards. "As you get very old and very frail, some degree of falling may be inevitable, and it may be impossible to prevent all falls," says Gallagher. "But a number of them can be prevented."

Home Safety Checklist

To reduce the risk of accidents in your (or your elderly relative's) home, here are some steps worth taking:

• Make sure electrical and phone cords are positioned away from where people walk. If you decide to attach cords to walls or floors, use tape rather than nails or staples, which can cause damage and create a fire hazard. Replace frayed cords, and never place them under carpets or furniture.
• "Scatter rugs are real hazards for tripping," says Ann Burkhardt, MA, OTR/L, director of occupational therapy at the Columbia-Presbyterian Medical Center in New York. If you're going to have scatter rugs in your home, make sure that they have adequate nonskid backing so they won't skip as much, she advises. Consider applying double-faced adhesive carpet tape to make all of your rugs slip-resistant.
• "Many older people bathe holding onto towel racks and shower curtains," says Bakker. Instead, install grab bars in the shower and tub, she advises. Mount the bars onto structural supports in the wall, using heavy-duty screws. Also place non-slip strips or mats in the bathtub and shower.
• Improve the lighting throughout your home to help prevent falls. You may need brighter lights to see clearly as you age. The light switches should be located at the entrance to each room so you won't have to enter a darkened room. Keep a night light on in the bathroom.
• The height of the toilet seat should make it easy to use. "I often recommend a raised toilet seat with side bars on it, which an older person can use to push against, using his or her upper body strength, to help exit from the seat," says Bakker.
• Install smoke detectors -- at least one on every floor of your home, near the bedrooms. Place them on the ceiling or on the wall about 6 to 12 inches below the ceiling. Change the batteries twice a year.
• When reaching for items on high shelves, use a sturdy stepstool with a handrail that you can hold while climbing. Be certain that the stepstool is fully open and stable before each use.
• Make smart footwear choices. "Crepe soles on a wet kitchen floor can lead to a serious fall," cautions Burkhardt. Supportive shoes with thin, non-slip soles are a better choice.
• Review the medications you're taking with your doctor, particularly if they're causing side effects that might affect your balance or alertness. "Medications that are particularly problematic include mood-altering drugs that are used for anxiety or depression," says Gallagher. "Some sleeping pills may leave you groggy in the morning or when you get up at night to use the bathroom. Antihypertensive pills can sometimes reduce your blood pressure so much that you may feel dizzy when you get out of bed." Also make sure your medications are stored in clearly marked containers to avoid confusion.

Help on the Way

To minimize your accident risks, stay as physically fit as possible. Movements like tai chi (an ancient Chinese exercise program) improve coordination and balance, and classes are held in many senior citizen centers.

When upgrading your home or apartment with safety features, "Medicare will pay for very little of it," says Bakker. "The Medicare program considers most of these environment retrofits to be non-medical in nature, but rather as 'convenience items.'"

If you need help paying for bathtub grab bars or other improvements, contact the department of aging in your city or county, and ask if you qualify for low-cost or no-cost home-modification services. Also, some fire departments will come to your home to conduct an assessment of possible hazards.

Originally published Sept. 30, 2002.

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Last Editorial Review: 1/31/2005 4:46:01 AM