By Denise Pott, LCSW, Assistance Home Care
When considering in home safety for older adults, prevention is key. Taking measures to avoid accidents and injuries is one of the most important steps in promoting senior health and independence. Be proactive!
The first step is to assess the mobility and needs of the older adult. Good supportive footwear is important; avoid loose scuffs or slippers. Is a cane or walker needed and if so, is it being used properly? A walker basket may be helpful for carrying items. For sitting, a sturdy chair with an elevated seat and padded arms is best. Avoid rockers, swivel chairs, or chairs with wheels. Avoid low, soft seating; if necessary a seat cushion may be used to raise seat height.
Next, walk through the home to assess fall risks. Look at the entrance; are there steps? Are they in good repair? Is there a handrail available? A railing on both sides is best. Inside the home, is there a clear pathway for mobility and exercise? Are there obstacles such as throw rugs or extension cords that could cause a fall? If so, remove them.
Check to see if the lighting is adequate. Are brighter bulbs needed? Are the light switches accessible? Is there a bedside lamp? Nightlights are a good idea for safety as many seniors are up at night to use the bathroom or because of sleep disturbances. Are there flashlights for emergency use, and are they kept in a place that can be accessed easily?
If there are stairs in the home, are they well lit? Are the handrails secure? Consider adding a contrasting color or reflective strips to the edge of the steps to enhance safety. If the laundry facilities are on a lower level, try to find a way to move them to the first floor or consider having someone else do the laundry as stairs are a major cause of falls.
The bathroom is an area where many falls occur. Check to see if grab bars are available, and consider installing them. A tub or shower seat may be helpful. An elevated toilet seat with rails can be helpful for many seniors. Is a bedside commode needed at night?
You may need to consider more expensive bathroom modifications for safety, such as adding a walk in shower if stepping over the edge of the tub is problematic. Consider having someone on hand to assist when the older adult is bathing.
Although you may not think of it, a factor that often leads to falls is incontinence. The individual may be rushing to the bathroom and not follow normal safety precautions, or may slip in urine and be injured, especially in the bathroom where there are hard surfaces if a fall occurs. A medical evaluation of the problem is needed; protective undergarments may help to avoid problems.
Assessing medication safety is another important component of overall in-home safety.
Is the older adult competent in managing their medications, or do they require assistance?
Are medications being taken as directed? Medication boxes can be helpful in organizing medication and promoting correct use. It is important to periodically review medications with a physician, nurse, or pharmacist to ensure correct dosage, frequency, and type.
When starting a new medication additional monitoring is helpful to identify problems or side effects. Remember, some medications can cause drowsiness or unsteadiness that can lead to a fall.
Finally, think about emergency situations. Is there a telephone within reach? Having a telephone on the nightstand makes good sense. Lanyards are available for cellphones so that they can be worn around the neck and kept accessible throughout the day. Consider installing a lifeline system to summon help in an emergency. Be sure that the house number is visible on the front of the house. Many communities have a system for making critical information readily available to first responders in an emergency. Your local fire department or EMS should be able to provide information on the system in your community.
Having an in-home caregiver is more affordable than you may think, and can provide peace of mind for you and your loved ones.
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