Fall Could Be Prevented By a Healthy Lifestyle and a 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. The guideline tells us that fall prevention is possible if we change certain habits and lifestyles and reduce risk hazards in the living environment.

The National Institute for Health and Care Excellence (NICE, UK) has also published specific fall prevention guidelines for health professionals, caregivers, and people over 65 and their families to raise awareness. 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 make some effort.

1. Adopt a healthy lifestyle.

Healthy ageing is the best preparation for preventing falls and all other age-related illnesses.

• First, stop smoking, avoid excessive alcohol consumption, and maintain body weight within normal limits.
• A balanced 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 an exercise program that aids agility, strength, balance, and coordination. You can find out if such a 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 quality of life.

2. Review medications with your doctors.

Some medications can increase the risk of falling because of their direct effects (e.g., lowering blood pressure, sedation) and/or side effects (e.g., fatigue, drowsiness, confusion, dizziness). The greatest risk occurs if you are on multiple 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 your medications and check it regularly with all the doctors you consult. Do not forget any over-the-counter drugs or herbs that you also use.
• Check with your doctors or pharmacist about the effects, side effects or any possible interactions of your medications.

3. Do you have foot problems? Is your footwear appropriate?

• Consult your doctor and get appropriate treatment for serious foot problems such as a bunion, toe deformity or infection.
• Check all your shoes, including formal wear, walking shoes, and slippers. Are they safe to walk 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.

4. Have eye tests annually.

• Apart from getting a proper prescription for spectacles, the ophthalmic optician can detect early signs of glaucoma, cataracts, and diabetic retinopathy by examining the eyes.
• It is recommended that elderly people should not wear multi-focal lenses while walking, especially on stairs.

5. Consult your doctor if you have hearing problems, such as a 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 outdoors so that you can hear traffic approaching.

6. Avoid standing on chairs or boxes to reach or get things. If you must, use a sturdy step or ladder, preferably when someone is around.

Make the home environment safe

Research shows that most falls happen at home while the elderly engage in daily activities. Removing the known hazards and improving safety at home can substantially cut the risk of falls and related injuries.

General planning

• 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 entrances. Light switches should be installed at the entrance and are easily reached, so 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 appliances, telephone cords, and extension cables must be tidied up so that they are not trailing all over the floor and not in the traffic pathway. However, ensure they are not hidden under the carpet or rugs.
• Mats or rugs without slip-resistant backing must be secured with double-faced tape or tacks.
• Avoid clutters. Keep boxes, stools, umbrellas, remote control, toys, newspapers, magazines, walking sticks etc. in their proper places and away from walking paths.
• Do not store boxes or bicycles near doorways or in hallways.

Bathroom

• 

  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 the 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 beside the toilet seat. Alternatively, use the raised seat or a special toilet seat with armrests.
• If you are unsteady, climbing in and out of the bathtub is unsafe. A walk-in shower is a better solution.

Bedroom

• 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 carpets or rugs.

Kitchen

• Use non-slip floor tiles.
• Keep the floor dry. Clean any liquids, grease, or food spilt on the floor immediately.
• Store food, dishes, and cooking equipment within easy reach.
• Do not stand on chairs or boxes to reach upper cabinets. Ask for help instead.

Living room

• Arrange furniture so that you have a clear pathway when moving around.

  

• Keep coffee tables, magazine racks, footrests, and potted plants out of the traffic path.
• If you keep pets, ensure you don’t trip over a nearby dog or cat.
• If there are children at home, take extra care of toys lying about.
• Do not sit in a chair or on a sofa that is so low that it is difficult to stand up.

Stairs

• 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 must be secured immediately.
• Light switches at the top and bottom of stairs 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, beware of uneven or broken pavement and garden paths covered with moss or mud when out walking.