Dear Ally,
I recently received a call that my 87-year-old mother fell and was being transported to the hospital. My mother broke her hip. She refuses to use a mobility aide such as walker or cane. I’d like her to get a fall alert pendant, but she says she will not use. HELP- I am frustrated. What steps can I take to ensure my mother’s safety and prevent future falls?
Sincerely,
Frustrated Son
Dear Frustrated Son,
Thank you for your question. Many other adult children are concerned about preventing falls for their parents.
As a Geriatric Care Manager, I have an up-coming visit scheduled to do a home safety check. Come look over my shoulder and see what changes your mom might consider if she wants to increase her safety and minimize the chances of future falls.
The couple I am visiting are determined to stay in their own home and are fearful of ending up in a nursing home. The number one reason older adults end up living the rest of their lives in a nursing home is falls. Knowing this might motivate your mother to make necessary changes.
The first thing I notice is the steep stairs leading to the entrance of the house. There is only one railing on the left side of the stairway. To maximize safety, there should be a railing on both sides of a stairway both inside and outside of the house.
When the door opens, I immediately see an area rug right at the entry way. This is the first of three area rugs, one with curling edges and wrinkles across its hand-woven surface. To maximize safety, remove all area rugs. They are a tripping hazard. I pay attention to the transitions from one room to another, from the wooden floor in the dining room to the tile floor in the kitchen. Floors should be level. Luckily, this is not a problem here.
The house faces north, and though there are multiple lights all over the house, they are all turned low, and the house is dark. Nightlights during the night, and good lighting during the day all contribute to safety. Nightlights are particularly important in bedrooms and in the bathroom.
Grab bars by the toilet and in the shower make a bathroom safer for older adults. As I check each room, I am looking for clear passageways. Dog beds and extension cords can be tripping hazards, particularly if they are in the middle of the room. These are all the environmental factors that contribute to safety and make falls less likely.
Now we sit down and look at the personal factors that can contribute to falls. As we age our balance naturally changes due to changes in vision, bone mass, restricted mobility, muscle strength and endurance, and increased likelihood of chronic diseases. These all can increase our likelihood of falling.
A proactive step that your mother can take is to exercise. We need to work on strength, balance, flexibility as well as endurance. Not unexpectedly, they tell me that they walk every day-their only exercise. They don’t like hearing that walking isn’t enough. Exercise programs such as Tai Chi, Water Aerobics, Yoga, dance and Pilates are all types of exercise that help us be more confident in our ability not to fall. I recommended that they consider working with the senior personal trainer on my team to assess their fitness levels, make recommendations for maintaining leg and core strength, and finding exercise programs they can enjoy. The personal trainer can also come into the home for personalized 1:1 session for balance training. As I mentioned during the home safety check and consultation: “If you don’t use it, you lose it.” More and more research points to the importance of a comprehensive exercise program to prevent falls.
Change is hard. Those older adults who actively make the changes they need to make (such as using mobility aids like canes and walkers) or wearing a PERS (personal emergency response system such as a pendant) or making modifications to the home and EXERCISING are the ones who are more likely to avoid unnecessary falls. No one can “be careful” all the time. I hope you can share some of this information with your mother, and when she returns home, she will be more receptive.
Regards,
Ally
Written by Malka Young, LICSW, CCM and Laila Vehvilainen, MS, MPH, NASM-CPT, CDP – Your Geriatric Care Managers at Allies in Aging
Caregiving demands kindness and radical empathy… Try to imagine that you have dementia, and in your confusion, you don’t know where you are. The familiar house you have lived in for decades appears strange to you, and you want to go home. You are panicked. Only your long-term memory is intact, and you long for your old room in the house you grew up in. As caregivers, our natural impulse is to say, “Honey, we are home. This is our house that we have lived in since 1986! This is not convincing to a person with dementia. If you came upon a stranger who told you they were lost, and wanted to go home, how would you react? Kindly, with reassurance. You might put your arm around them and tell them that you will help them get home or you might say that you will stay with them and not leave them alone. To respond with kindness and patience each time you are asked “When are we going to go home?” as if this is the first time you are hearing this question.
