Fall Could Be Prevented By Healthy Lifestyle and Risk Free Environment
“The Guideline for the Prevention of Falls in Older Persons” is a joint effort of the American Geriatrics Society, the British Geriatrics Society, and the American Academy of Orthopaedic Surgeons. It was published in 2001 and revised in 2010. Essentially, the guideline tells us that most falls could be prevented if we change certain habits and lifestyle, and reduce risk hazards in the living environment.
To raise awareness, the National Institute for Health and Care Excellence (NICE, UK) has also published specific guidelines on falls prevention for health professionals and carers, and for people over the age of 65 and their families. All these guidelines and information are freely accessible.
This article will focus on some of the recommendations that could be carried out quite easily if we just make a bit of effort.
- Adopt a healthy lifestyle.
Healthy ageing is the best preparation for preventing falls and all other age-related illnesses.
- To start with, stop smoking, avoid excessive alcohol consumption, and maintain body weight within normal limits.
- A balance diet with all the necessary nutritional factors especially calcium and Vitamin D is essential for muscle strength and slowing down age-related problems such as osteoporosis. It is important to take adequate fluids as well.
- Take up exercise program that aids agility, strength, balance, and coordination. You can find out if such program is available in your community from the physiotherapist or doctor clinics. In addition, activities such as climbing stairs, cycling, jogging, hiking, dancing, weight training and gardening are all helpful in improving strength and health.
- Social and leisure activities, hobbies, reading, learning new skills and any brain stimulating games are great for brain health and life quality.
- Review medications with your doctors.
Some medications can increase risk of falling because of their direct effects (e.g., lowering of blood pressure, sedation) and/or side effects (e.g., fatigue, drowsiness, confusion, dizziness). The greatest risk occurs if you are on multiple number of drugs (polypharmacy), especially sedatives, antidepressants, anti-convulsions, and medicines for treating blood pressure, heart rhythms and diabetes. The guidelines recommend simplification and reduction of medications where appropriate. Therefore,
- Keep an up-to-date list of all your medications and check it regularly with all the doctors whom you consult. Do not forget any over-the-counter drugs or herbs that you also use.
- Check with your doctors or your pharmacist, about the effects, side effects or any possible interactions of your medications.
- Do you have foot problems? Are your footwear appropriate?
- Consult your doctor and get appropriate treatment if you have serious foot problem such as bunion, toe deformity or infection.
- Check all your shoes, including formal wear, walking shoes, and slippers. Are they safe for walking in? Are they laced or buckled? Ask for advice if you are not sure.
- Avoid high heels, badly fitting shoes and shoes with worn out soles.
- Have eye test annually.
- Apart from getting proper prescription for spectacles, the ophthalmic optician can detect early sign of diseases such as glaucoma, cataracts, diabetic retinopathy from examining the eyes.
- It is recommended that elderly people should not wear multi-focal lens while walking, especially on stairs.
- Consult your doctor if you have hearing problems such as ringing sound in the ears (tinnitus). It is prudent to get hearing aids if you have partial or complete hearing loss. It is especially important when you are outdoor so that you can hear traffic approaching.
- Avoid standing on chair or boxes to reach or get things. If you have to, use a sturdy step or ladder, preferably when someone is around.
Improvement of home environment
Research shows that most falls happen at home while the elderly going on daily activities. Removing the known hazards and improving safety at home can substantially cut the risk of falls and related injuries.
- Ideally all rooms should be on one level especially the bathroom and bedroom. Keep clear pathways between rooms.
- Adequate lighting in all rooms, halls, stairs and door entrance. Light switches should be installed at the entrance and are easily reached so that you don’t have to walk into a dark room to turn on the light. Glow-in-the-dark switches may be helpful.
- Repair uneven or broken floorboards. Remove door sills higher than a half inch.
- Electric appliance and telephone cords, and extension cables must be tidied up so that they are not trailing all over the floor, and definitely not in the pathway of traffic. However, make sure they are not hidden under the carpet or rugs as well.
- Mats or rugs without slip-resistant backing must be secured in place with double-faced tape or tacks.
- Avoid clutters. Keep boxes, stools, umbrella, remote control, toys, newspapers, magazines, walking sticks etc. in their proper places and away from walking paths.
- Do not store boxes or bicycle near doorways or in hallways.
Use non-slip floor tiles and keep the floor dry.
- Install grab bars for support and balance in the shower or bathtub.
- Apply anti-slip surfacing in bathtub or shower.
- Place a slip-resistant rug adjacent to the bathtub for safe exit and entry.
- Install a nightlight between the bedroom and bathroom. A light with movement detection is also a good idea.
- Install grab bars besides the toilet seat. Alternatively, use raised seat or special toilet seat with armrests.
- If you are unsteady, climbing in and out of bathtub is not safe. A walk-in shower is a better solution.
- A bedside table with a lamp and a torch on it, and keep the telephone handy in case you need to call for help.
- Is the bed easy to get into and out of?
- Keep clutter such as clothes off the bedroom floor.
- Avoid deep-pile carpet or rugs.
- Use non-slip floor tiles.
- Keep the floor dry. Clean up immediately any liquids, grease or food spilled on the floor.
- Store food, dishes, and cooking equipment within easy reach.
- Do not stand on chairs or boxes to reach upper cabinets. Ask for help instead.
- Arrange furniture so that you have a clear pathway when moving around.
- Keep coffee tables, magazine racks, footrests, and potted plants out of the path of traffic.
- If you keep pets, take care so that you don’t trip over a dog or cat which lies nearby.
- If there are children at home, take extra care of toys which are lying about.
- Do not sit in a chair or on a sofa that is so low that it is difficult to stand up.
- Install handrails on both sides of the stairs.
- Repair broken steps immediately. Put anti-slip surfacing if the steps are not carpeted.
- Use light solid colour carpeting for stairs so that the edges of the steps can be seen clearly. The carpet must be fitting and any loose area is secured immediately.
- Light switches at top and bottom of stairs and are easy to reach. Installing motion-detector lights is a good idea. Keep a torch nearby in case of power failure.
- Keep stairs clear of packages, boxes, or clutter.
Lastly, when you are out walking, beware of pavement which is uneven or broken, and garden path which is covered with moss or mud.