Building Healthy Communities through Medical-Religious Partnerships

15. Accidents and Falls

15 Accidents and Falls Accidents and falls frequently are overlooked as major health problems associated with aging. However, both the incidence and the severity of falls increase with age, and accidents are among the ten leading causes of death among older adults. Almost one-third of adults aged 65 or older who live at home experience falls each year. Approximately one in forty of these falls results in hospitalization. Many factors increase the risk of falls among older adults. Some of these, including changes in postural control and gait, are associated with the aging process. Other factors are associated with medical disorders (e.g., diabetes or stroke) that occur more frequently in old age. Such disorders can cause muscle weakness, sensory deficits, or balance problems that can lead to instability. In addition, adverse reactions to many commonly prescribed medications can result in inattention, drowsiness, dizziness, or weakness and can directly cause a fall. Finally, many falls are the result of environmental factors that could be prevented if proper home inspections and modifications are made. The Risks of Ignoring Information on Accidents and Falls Complications of falls include fractures and neurological injuries that frequently result in serious functional limitations. People who have fallen and suffered injuries may experience permanent problems with mobility. In addition, the fear of falling that often follows a major injury may result in curtailment of activities, leading to muscle weakening and, paradoxi- accidents and falls 151 cally, possibly further increasing the risk of future falls. People who fall likely will experience a loss of independence and are at greater risk of being institutionalized. What Can Be Done to Reduce the Risk of Accidents and Falls? Fortunately, patients, their families, and caregivers can make a number of changes in the living environments of older adults to reduce the risk of accidents and falls, such as: Removing throw rugs Tacking down large rugs and carpeting completely Removing furniture that is low to the ground or likely to move Keeping objects off the floor Using nonslip polish on floors Installing handrails along both sides of stairs Providing good lighting on steps, landings, and any other particularly dark areas Placing light switches in easily accessible locations near doors and room entrances Using nightlights in bedrooms, bathrooms, and hallways Using nonskid rubber mats in showers or baths Installing handrails for baths and toilets Keeping water off the floors Using adaptive equipment for baths or showers (e.g., seats or benches) Installing raised toilet seats or using a bedside commode Keeping food and other necessary items on low, easy-to-reach shelves People also can reduce the risk of accidents and falls by using assistive devices such as canes or walkers. Medical professionals and therapists need to encourage people who would benefit from such devices to use the most appropriate and effective ones, and to emphasize how they can help to prevent falls and serious, even life-threatening, injuries. 152 suggested topics for congregational programs Suggestions for Congregational Programs Sponsor a program on home safety, mobility, and assistive devices. A physical therapist could be one of your featured speakers, along with representatives from several companies that provide in-home medical supplies and equipment. Recruit and train a group of volunteers who would be willing to conduct home safety checks for members of the congregation. Social workers from the local hospital or a home health agency can assist in their training. Recruit and train a group of volunteers who are willing to use their knowledge and skills to make minor modifications based on home safety checks (e.g., install grab bars and handrails). Recruit and train a group of volunteers who are willing to deliver meals or provide basic home services (e.g., cleaning, laundry, etc.) to people with physical limitations. This service could help some individuals avoid or delay placement in a nursing home or other long-term care facility. Organize a group of volunteers who are willing to provide basic house and yard maintenance for people who are physically incapacitated. This could be done on a short- or long-term basis, depending on the congregation’s needs and resources. Seasonal activities such as lawn mowing, leaf raking, snow shoveling, or spring gardening help might be organized. Use congregational bulletins and mailings to provide members with helpful suggestions and reminders about home safety. Home health agencies, companies that provide in-home medical supplies and equipment, or advocacy organizations (e.g., National...