Protecting the Elderly

Question: If a frail, elderly adult falls, and can’t get up, in the middle of a room and is unable to reach a phone, what happens?

Answer: They stay there.

It’s sad and shocking, but it happens – and it’s preventable. Accidents happen all the time; but an injury that would otherwise be insignificant for younger people can be catastrophic for the elderly. With a little planning and a few interventions you can help protect the elderly persons in your life. Some general inspections you can perform yourself: ensuring the house is well lit, free of tripping hazards, and has sturdy handrails. Below are some actions you can take to protect the elderly persons in your lives.

Activities of Daily Living

If you are concerned about accessibility issues or household dangers in an elderly person’s home (or your own) you can request from the person’s doctor that a social worker or nurse perform an in-house inspection. A social worker will assess the safety and accessibility of the home, as well as check their social support systems.  A nurse can also assess the person’s ability to perform activities of daily living, which may uncover potential issues that can lead to injuries. For example, if a person has difficulty bending or squatting, it will be difficult for them to sit on the toilet. A device that raises the toilet seat height may be recommended. If needed, the doctor can write a prescription for home-safety and accessibility equipment that may be covered by insurance.

Household Dangers

A common cause of home accidents are slip and falls in the bathroom due to holding onto the shower curtain or towel rack for support. Towel racks can rip out of the wall; they are designed to hold towels, not people. Even a frail person’s weight can cause the rack to dislodge from the wall. If a person has mobility, or balance issues, professionally installed handrails in the shower, bathtub and toilet area are a must. To avoid slipping, place anti-slip mats near showers and bathtubs.

Upon waking at night to go to bathroom, which can be urgent, people can be confused and not fully aware of their surroundings. Without enough light, they can trip, or they can walk into furniture and edges of walls. Having light switches near the bed is effective, but many people don’t want to turn on full lights. Wall-mounted nightlights are a good option. It’s a good idea to put night lights near staircases as well. When you inspect a person’s home you should actually turn on all the lights to see if they are working. Light bulbs that are on high ceilings might not have been replaced, which may be an embarrassing confession.

Are there trip and slip hazards in the home such as wires and extension cords extending through a room or a hallway? Are space heaters and tea kettles kept in bedrooms or living rooms? These wires and appliances are tripping and fire hazards. Is the flooring in good repair, with no peeling linoleum, frayed carpets, or slippery rugs? Is the plumbing up to date? Faulty plumbing can lead to slow leaks.

Medical Causes

Medical issues can lead to dizziness, confusion and weakness which can cause falls. New medication or not taking medications properly can cause adverse effects. Your doctor or pharmacist can do a medication reconciliation. New onset confusion, dizziness, and weakness can be a sign of infection such as a urinary tract infection or pneumonia. It can also mean a change of health status such as a recent cardiovascular or neurologic condition and must be investigated by a doctor. If the temperature in the home is not regulated it can lead to hypothermia or hyperthermia. Diarrhea and urinary or bowel incontinence causes rushing to the bathroom leading to trip and falls.

Communication and Planning

Many elderly people are holed up alone without assistance or only get sporadic visitors. These people may be in trouble and no one would know. Many lives have been saved by neighbors and family members checking up on elderly people who live alone. Even those who have elderly family living with them can better prevent serious injury.

Establish a communication protocol. Make sure the elderly people you are caring for have phones around the house and a cell phone. If falling is an issue, or if there have been prior episodes of falls consider a necklace EMS alert system, which only requires a touch of a button to summon help. Have a scheduled visit plan. Communicate with neighbors and family to develop a schedule for checking up on the elderly, especially during storms and heat waves when power can go out.

Elderly people who live alone often take pride in their level of independence. However, they may not know that their health and safety could be jeopardized. By performing these general inspections you can help them maintain their independence and dignity while possibly saving their life.

Written by: Jacob Gerlitz