Learning Objectives     1. Describe 5 strategies that an older person can adopt to prevent falls.     2. List at least 5 outdoor safety tips.     3. List at least 13 indoor safety tips for fall prevention.

Except for people living in perpetually sunny climates, most of us face winters of shorter days, cold temperatures, snow, and even ice. While inclement weather can be dangerous for anyone, it is a special concern for people whose bones are fragile from osteoporosis. For these people, falls increase their risk of fracturing bones in their wrists, spine, hips, or elsewhere.

In addition to fragile bones, older people, especially those in their 80's and 90's, gradually lose much of the muscle and body fat that has cushioned and protected their bones. Decreased stores of muscle and fat can make certain areas of the body, such as the hip, more vulnerable to a fracture if a person falls.

The good news is that falls can be prevented by learning about physical changes that occur as you age and by becoming aware of potentially dangerous situations outdoors and in the home.

Physical Changes

Interestingly, most falls occur at home in the afternoon, and most people trip while walking or slip when getting up from a sitting position. Medications, alcohol, or an existing illness may slow your reflexes, cause symptoms of confusion, dizziness, or disorientation and result in a fall.

Reflexes

Reflexes are automatic responses to stimuli in the environment. Examples include quickly slamming on your car brakes when a child runs into the street, moving out of the way quickly when something falls accidentally, or bending quickly to swat a mosquito. As you age, your reaction time slows and regaining your balance following a sudden movement may be difficult. This decreased ability to control your movements can result in a fall.

To improve body control, maintain an active lifestyle. Activity maintains muscle tone and flexibility and slows bone loss. Regular weight-bearing exercises and weight-training can build and tone muscles even in very old people. Keeping up the strength in your arms and legs can go a long way toward improving how well you move. Talk to your doctor about activities that are safe and beneficial for you, keeping in mind your individual situation.

Illnesses and Medications

If you have an illness that affects your circulation, sensation, or mobility or take medications such as blood pressure pills, heart medicine, diuretics, sleeping pills, sedatives, antidepressants, muscle relaxers, or tranquilizers, you may have symptoms of confusion, dizziness, disorientation, and slowed reflexes. Use of multiple medicines can increase your risk for falling. Ask your doctor if there is a relationship between the symptoms you are having and the medicines you are taking. Never change or skip medications without first talking with your doctor.

Hearing

Changes in hearing occur as we age. If you do not hear as well as you used to, or if you are always asking those around you to repeat themselves, it is time to have a hearing test. If you have hearing loss, wear a hearing aid. Sounds around us help orient us to where we are and when we are in danger.

Vision

Vision also changes with age. Cataracts or glaucoma can develop. Your eyes need longer to adjust to changes in light and glare. Changes in depth perception or peripheral vision can decrease your ability to judge the steepness of stairs or curbs or to avoid obstacles in your path. Have regular eye exams and wear prescription glasses or contact lenses.

The following safety tips will help you avoid potentially dangerous situations outdoors and in the home:

Outdoor Safety Tips

    •     In nasty weather, use a walker or cane for added stability.

    •     Wear warm boots with rubber soles for added traction.

    •     If sidewalks look slippery, walk on the grass for better traction.

    •     In winter, carry a small bag of rock salt, kosher salt, or kitty litter in your pocket or car. You can  then sprinkle the salt or kitty litter on sidewalks or streets that are slippery.

    •     Look carefully at floor surfaces in public buildings. Many floors are made of highly polished marble or tile that can be very slippery. When these surfaces are wet, they become slick and dangerous. When floors have plastic or carpet runners in place, stay on them whenever possible.

Indoor Safety Tips

    •     Keep all rooms free from clutter, especially on the floors.

    •     Keep floor surfaces smooth but not slippery. When enter- ing rooms, be aware of differences in floor levels and thresholds.

    •     Wear supportive, low-heeled shoes even at home. Avoid walking around in socks, stockings, or slippers.

    •     Check that all carpets or area rugs have skid-proof back- ing or are tacked to the floor, including carpeting on stairs.

    •     Be sure that all stairwells are well lit and that stairs have handrails on both sides. Consider placing fluorescent tape on edges of top and bottom steps.

    •     For optimal safety, install grab bars on bathroom walls be- side tubs, showers, and toilets. If you are unstable on your feet, consider using a plastic chair with a back and nonskid leg tips in the shower.

    •     Use a rubber bath mat in the shower or tub.

    •     Keep a flashlight with fresh batteries beside your bed. Add ceiling fixtures to rooms lit by lamps only or install lamps that can be turned on by a switch near the entry point into the room. Another option is to install voice or sound activated lamps.

    •     Use at least 100 watt bulbs in your home.

    •     If you must use a stepstool for hard to reach areas, use a sturdy one with a handrail and wide steps. Reorganize work and storage areas to minimize the need for stooping or excessive reaching.

    •     Consider purchasing a portable phone that you can take with you from room to room. This will enable you to answer the phone without rushing for it, and to call for help should an accident occur.

    •     Arrange with a family member or friend for daily contact. Be sure at least one person always knows where you are.

    •     If you live alone, you may wish to contract with a monitor- ing company that will respond to your call 24 hours a day.

Source: National Osteoporosis Foundation

Reprinted with permission