Jake and Eleanor loved their home, a collection of their 45 years together and the four children that they raised there. Their home was filled with not only their own treasures, but also those of their parents. They were willing to live with the outdated bathrooms, narrow halls and assorted clutter, as they couldn't bring themselves to update the house for fear of losing any of the memories. However, over the last few years they noticed that the house seemed dark and they would occasionally trip or have a "close call" on one of the many extension cords. One cool spring night, Jake tripped and fell in an unlit hallway while on his way to the kitchen to get something to drink. An hour later, he found himself in the local emergency room, waiting to have his broken hip repaired.
Life is an Obstacle Course
Take a moment to think about all the close calls you have experienced -- the ones where you narrowly avoided falling. Our environment is filled with obstacles waiting to trip us up. Rocks and uneven surfaces fill our lawns. Homes provide a collection of loose throw rugs, misplaced furniture, poorly lighted paths to the bathroom and critical objects placed on shelves that are either too low or just out of reach.
As we age, our bodies change in ways that put us at an increased risk for a fall.
• Did you ever wonder why that, as we age, it is more difficult to read the menu in a dimly lighted restaurant? The lens in our eye starts to cloud up and it takes more light for the image to reach our retina. Over time this may progress to a cataract that needs surgery.
• As our hearing fails we may not be warned by sounds in our environment. For example, you may not hear the "meow" of your favorite cat moving slowly between your feet.
• As we stand still or walk the nerves in our feet send messages to our brain to help us maintain our balance. Numbness and loss of sensation in our feet are common as we age, which makes it more difficult to automatically know where we are or to regain our balance quickly.
• Many people take medicines that can lower their blood pressure. When they stand up quickly, their blood vessels respond more slowly and their blood drains from their head, causing dizziness that can lead to falls.
• When we are young and agile, our flexible joints allow us to respond to loss of balance on a rock in the lawn or an ill placed table in our path. But, with age comes arthritis and painful stiff joints that prevent us from responding quickly to life's obstacle courses.
5 Things You Can Do
1.Light the Way: Just like a pilot wouldn't land an airplane on a runway that was not properly illuminated, you shouldn't walk around in a dark house. I tell my patients to stock up on night lights and place one in every room and hallway. You never know where you might decide to go in the middle of the night. A touch or hand clap light switch next to the bed can make middle-of-the-night trips much safer.
While you probably need to improve the lighting in all parts of your home, you may not need to replace all your fixtures and lamps. Frequently, light switches and fixtures can be rewired to accept a stronger bulb. Call your electrician to see what can be done in your house. A final "light tip" is to keep a small, high-powered flashlight in the side pocket of my car for those times when I need to walk to the door in the dark. I now have a clear view of the obstacle course that awaits me.
2. Clear the Way: It is time to do a survey of your own personal obstacle course. Your throw rugs and runners may need to go. Some people recommend using rubber mats or doubled sided tape, but the edges can still roll up and catch your toe. Ask yourself if you have a clear path from room to room or if you have to navigate around furniture and lamps. All of the extension cords and loose wires need to be removed or placed against the walls. They are like trip wires waiting to cause a fractured hip or brain injury. Do you have stacks of the last 10 years of National Geographic magazines or boxes of clothes you keep meaning to take to the Goodwill store? Stairs are difficult enough without storing loose objects on them -- and don't forget you need a railing on both sides unless you plan to go only up or down.
3. Look at Your Medicines: Blood pressure medicines are designed to lower your blood pressure and reduce your chances of having a heart attack or stroke. Your blood pressure reading on the machine at your pharmacy may look perfect, but what happens when you stand up? Do you ever feel dizzy and wobbly when you get up from sitting or after spending the night in a nice warm bed? Your blood pressure may be dropping too low, putting you at risk for a nasty fall. Other medications can also cause dizziness or a weak feeling. If you are having these problems, review your list of medications with your physician or pharmacist. It may be time to make some adjustments.
4. The Most Dangerous Room in the House: That's right -- your bathroom. It is a danger zone in any house, occupied by hard floors, unforgiving porcelain surfaces, slippery tubs and shower floors, and spilled liquids. We also seem to perform an inordinate amount of those one-legged poses while drying off. It may be time to put up grab bars in the shower and next to the toilet. Is your shower or tub floor a non-slip surface? There are times when you have to ignore your pride and put a shower stool in your bathtub or shower. Another stool outside the shower to sit down on while you dry off is a good idea. I also keep a stool in my closet so I can sit down and avoid those unsafe, crazy one-legged positions I get into while trying to put on my socks.
5. Time to Organize Your Shelves: Are you standing on an unsteady chair or step stool to get your Fall sweaters off the top shelf when you feel that first cold day or when you need the good dishes out for a holiday dinner? It's time to move all the items in your house to lower shelves -- think waist level. Before you climb up on that ladder or stool, ask yourself if what you're doing is really safe.
There are many other things you can do to reduce your risk of falling, including exercise, vision checks and proper shoes. The Centers for Disease Control has an excellent brochure you can access online.
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