When Home Is a Hazard: Assessing Fall Risk in Seniors

Every 15 seconds, an older adult receives emergency room treatment for fall-related injuries, according to the National Council on Aging. In addition to broken bones, falls are a leading cause of traumatic brain injury in seniors.

To honor National Safety Month, we would like to share some of our experience in assessing home safety and fall risk for seniors.

As we age, we experience a variety of health issues that can bring about symptoms that impact our safety in our homes. Diabetic neuropathy can cause us to lose sensation in our feet, decreasing our awareness of foot placement and the information we obtain through normal sensation. Visual problems like macular degeneration and cataracts can decrease our safety without appropriate lighting and home safety modifications. In addition, we face a decline in agility, balance and strength. Medications can cause side effects such as dizziness, fatigue, nausea and frequency of urination. These factors make falling a greater hazard.

Signs that someone is at risk of falling

The Asbury Home Services team includes a certified aging in place specialist who is trained to look for indicators that a person may be experiencing health issues that require further medical assessment and home adaptations. In general, the home may appear to be cluttered, which happens when people decrease the distance they need to travel around the house or are unable to perform basic housekeeping tasks. Signs include:

• Stacks of mail, dishes and reading materials near a favorite seat; prescription bottles in various locations around the house or a days-of-the-week pill box; beds, dishes or laundry that are undone. Sometimes an individual wears the same clothes for multiple days because their balance is threatened when they try to change clothes or manage their laundry.
• A footstool by the bed indicates the person’s mattress is too high for them to easily get into bed at night. Conversely, a low mattress can be difficult for them to get up safely. Sometimes seniors move into their favorite recliner and no longer attempt to get into and out of bed for fear of falling.
• The bathroom is another risk area. A toilet paper roll holder or a towel rack that have come off the wall is an indication that someone has used it to try and help stand up because they do not have the transfer strength they need. They risked falling when it came loose and now risk falling again.
• If someone has already fallen, that is an indication the home may no longer be a safe place. Bring in a professional to observe the person in their home to see whether medication is organized and being taken correctly, if there are lighting issues, home modification needs, durable medical equipment needs for safety in activities of daily living, and whether the person can safely prepare their meals, take out the trash or get to a doctor.

Falls and isolation – negative cycle

When people begin to worry about their balance and strength or have already suffered a fall, they often curtail their activity and become more isolated. This creates a negative cycle. People don’t necessarily think of isolation as a hazard, but it has physical and emotional consequences. Being home alone for long stretches leads to reduced cognitive activity, which is linked to dementia and depression. Social interaction and having a purpose have been shown to improve mental health. On the physical side, a lack of activity hastens muscle loss.

If you notice your loved ones turning down invitations to outings that may be a sign that they are facing declines that could be impacting their safety and decision-making abilities.