No one likes falling down and this is especially true for the elderly. It is their biggest nightmare and fear in life. This nightmare and fear is also scientifically supported by a study published in New England Journal of Medicine which states that up to 75% of the elderly would have had at least 2 falls within a year and the risk of morbidity and mortality due to these falls increase with age. This piece of information just enough to make fall prevention the number 1 priority for the caregivers of the elderly.
S.T.O.P = Stop, Think, Observe and Prevent
S.T.O.P is an easy to follow fall prevention program, recommended by the Gateway Geriatric Education Centre, which can assist any caregiver in preventing falls in the elderly. In this program, a caregiver has to stop and look at the environment which the elderly is in, think of how to make it fall safe, observe the elderly and their movement and prevent a potential accident from happening.
The first thing that you, as a caregiver, should do is to identify all the possible locations that accidents can take place as the elderly moves around at home ( this also applies to nursing homes)
The Common Locations
- Use safe turnover techniques
In the morning, when the elderly wakes up, please turn them slowly to their sides, in order to avoid them from falling down from the bed.
- Set a proactive toileting schedule
It is good to check on the elderly every 2-3 hours to see if they need to use the toilet. Having a schedule will help a great deal especially at night. In any case, have a bell, alarm or a baby monitor handy on the bedside table, so that the elderly person can use it to call you , should they want to go to the toilet.
- Adjust proper bed height
If you have a hospital bed at home, you can lower the bed height in order to reduce the incidence of a fall at home. If you don’t have a hospital bed, please ensure that the bed is not to high up from the floor. Please purchase a bed which is low and a firm mattress so that it can assist the elderly in slowly maneuvering themselves out from the bed.
- Assist with standing from bed
Always assist an elderly with standing from the bed. Most falls happen when they stand up from the bed. This is due to the varying blood pressure when they stand up. This phenomenon is known as hypotension. As less blood gushes into their brains, they will feel dizzy and tend to fall down. A hypotension may be caused due to a cocktail of medications that they are on and is not something to be alarmed about.
- Ensure proper use of walking aids
Please ensure all walking aids are placed near the bed and is used properly by the elderly person. For example, when using the wheelchair, please ensure that the locks are in place before the elderly person sits on it. This will ensure that they don’t fall down from the wheelchair.
- Keep floors dry
This is an absolute MUST. Always pat or mop the floors dry. Always ensure that there are no spillages on the floor at any time.
- Use non-slip mats
Please avoid using regular mats. Regular mats tend to be slippery and this brings about untoward incidences for the elderly. Use non-slip mats especially near the shower, toilet and at the entry into the bathroom.
- Check toilet height.
- Promote the use of handrails especially at the toilet area and in the shower.
- De-clutter pathways
Please get rid of anything that would pose as a hazard for the elderly. Ideally, it should be a clear pathway for them to move around in without knocking into anything.
- Minimise glare
- Maintain proper lighting along the corridors
- Remind residents to wear their eyeglasses so that they can see where they are going
- Keep their eyeglasses clean
- Watch for steps and curbs.
Please assist them when walking them on staircases or in the curbs. It is very common for the elderly to miss a step and fall.
- Look for uneven surfaces in order to prevent them from tripping
- Pay attention to shadows and dark areas within parks or in the garden.
Their eyesight may not be so good to notice shrubs or tree roots within the shadows and this can cause a bad fall for the elderly.
- Beware of cracked and broken pavement along their pathway.
- Require shoes everywhere
It is a MUST to wear shoes everywhere
- Ensure proper fit
Please ensure that the shoes fit properly. As blood circulation in the feet is important, the shoes cannot be too tight or too lose. Ensure that the laces are tied up properly. For those who can’t wear closed shoes, sandals would be a good pick. Please ensure that it is not too lose and it fits their feet (please refer to the picture above).
- Promote healthy foot care
Feet tend to sweat and is a great place for bacteria to grow. The elderly are especially susceptible to this. Always, keep their feet dry. For those who have diabetic foot, please do not use socks on them. Always ensure that the feet is dry and there’s no scratches or cuts on their feet.
- Maintain locking mechanisms
- Use locks to stabilize the wheelchair
- Report equipment problems
In any case, if there is a fall or an accident:
1. Relax. Don’t panic. Access the situation first to ensure the seriousness of the fall.
- Is the elderly conscious?
- Are there any fractures ?
- Is an ambulance required?
These are among the few questions that should run in your head as you access the fall. If it is nothing serious, please assist them by slowly helping them up on their feet.
2. Stay warm and hydrated. Keep them warm and give them a glass of water. Remember, the incidence of the fall, would have given a shock and a sense of fear within the elderly person. Stay beside them and be a comfort to them. It will keep them at ease.
3. If the elderly has fallen down and urinated on the floor, try to move him or her away from the wet floor. Grab something that can absorb the urine and pat the floor dry to prevent another fall.
Generally, in most incidences, use common sense in handling each incident as it occurs.
Falls can be minimized and prevented easily as long as preventive measures are in place and implemented by the caregiver.