Falls Awareness & Prevention Guide

Transcription

1 HOME SAFETY IS BONE SAFETY. Falls Awareness & Prevention Guide Prepare your home or assist a loved one today by following these fall-proofing recommendations, courtesy of the American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association.

2 Falls Awareness & Prevention Guide HOME SAFETY IS BONE SAFETY. Taking a fall at home can be a frightening and life-changing experience, especially for the elderly and those living alone. But, with a few simple changes at home, you and your loved ones can protect your bones and stay safe and independent at home. Don t overlook the risks lurking in your home or the changes needed to safeguard your health. Take steps today to prevent accidents and injuries. Remember: Home Safety is Bone Safety! In this guide, the members of the American Academy of Orthopaedic Surgeons (AAOS) and The Orthopaedic Trauma Association share tips on how you or a loved one can: Recognize the medical, personal and environmental factors that increase your risk of a fall. Make modifications to your bathroom, stairways, kitchen, bedroom and living areas to help fall-proof your home. Reduce your risk of injury and contact a friend, relative or emergency service in the event of a fall. According to the Centers for Disease Control and Prevention, falls are the leading cause of both fatal and nonfatal injuries among elderly adults. In 2010, more than 2.3 million Americans were treated in emergency departments for fall-related injuries, leading to nearly $30 billion in direct medical costs. The statistics can be grim, but the solutions are simple. Learn more at orthoinfo.org/falls.

3 Are You at a High Risk of a Fall? There are a number of medical, personal and environmental factors that can make someone more susceptible to a fall-related injury. Familiarize yourself with the following risk factors to find out if you or a loved one is at a high risk of falling. HOME SAFETY IS BONE SAFETY. medical risk factors Impaired musculoskeletal function Osteoporosis Cardiac arrhythmias (irregular heartbeat) Blood pressure fluctuation Alzheimer s disease and senility Arthritis Hip weakness and imbalance Neurological conditions such as stroke, Parkinson s disease and multiple sclerosis Urinary and bladder dysfunction Vision or hearing loss Cancer that affects the bones Side effects of medications personal risk factors Inadequate footwear Not drinking enough water Excessive use of alcohol environmental risk factors Slippery or wet surfaces Poor lighting Cluttered pathways in the home Pets that create tripping hazards All throw rugs and area rugs that are not properly secured What lifestyle choices can you make to help reduce your risk of falling? There are a number of things you can do to keep your bones strong and lessen your risk of a fall-related injury, including: Maintain a healthy lifestyle and stay physically active. Have your bone density tested annually to help recognize signs of developing osteoporosis, as recommended by your physician. Get an annual eye examination. Get an annual physical that includes an evaluation for cardiac and blood pressure problems. Maintain a healthy diet with adequate dietary calcium and Vitamin D from both food and supplements. Check with your doctor(s) about any side effects of your medications; make sure all medications are clearly labeled and stored in a well-lit area and take medications on schedule with a full glass of water, unless otherwise instructed. bone loss risk factors Lack of exercise and activity Smoking Unhealthy diet More info at orthoinfo.org/falls

4 tips on fall-proofing your home Research shows that simple safety modifications at home, where most falls occur, can substantially cut the risk of falls and related injuries such as bone fractures for seniors. Prepare your home or assist a loved one today by following these fall-proofing recommendations, courtesy of the American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association. HOME SAFETY IS BONE SAFETY. Bathroom Place a slip-resistant rug or rubber mat adjacent to the bathtub for safe exit and entry. Use a rubber mat or place non-skid adhesive textured strips inside the tub. Use a sturdy, plastic seat in the bathtub if you cannot lower yourself to the floor of the tub or you are unsteady. Install grab bars on the shower walls. Replace glass shower enclosures with non-shattering material. Stabilize yourself on the toilet by using a raised seat or a toilet seat with armrests. Keep a nightlight on in the bathroom. Kitchen Immediately clean up any liquids, grease or food spilled on the floor. Store food, dishes and cooking equipment within easy reach. Do not stand on chairs or boxes to reach upper cabinets. Remove all throw rugs and hold area rugs in place with a rubber, slipresistant backing. Use non-skid floor wax. Stairways Keep stairs clear of packages, boxes or clutter. Provide enough light to clearly see each stair and the top and bottom landings. Light switches should be at both the top and bottom of stairs. Consider installing motion-detector lights that turn on automatically when you approach. Keep flashlights nearby in case of a power outage. Remove all throw rugs, and secure area rugs near the bottom and top of stairs with a rubber, slip-resistant backing. Install a contrast strip on the edge of each stair to increase their visibility. Put non-slip treads on each bare-wood step. Install handrails on both sides of the stairway. Each should be 30 inches above the stairs and extend the full length of the stairs. Repair loose stairway carpeting, wooden boards and loose handrails immediately. More info at orthoinfo.org/falls

5 tips on fall-proofing your home continued HOME SAFETY IS BONE SAFETY. Bedroom Place a lamp, telephone and flashlight near your bed. Keep clutter off the bedroom floor. Arrange clothes in your closet so that they are easy to reach. Do not stand on chairs or boxes to reach upper shelves. Install a nightlight along the route between your bedroom and the bathroom. Sleep on a bed that is easy to get into and out of. Replace satiny sheets and comforters with non-slip fabrics such as flannel. Outside Keep the path between your driveway and the front door, as well as the pathway between the mailbox and your front door well-lit and clear of debris. For cold weather locations, keep salt and a shovel near the front door so you do not have to walk on an icy sidewalk in order to reach them. Install motion-detector lights so they turn on automatically when you step outside at night. At least one covered, no-step entry with a ramp is recommended for any home. Footwear Wear properly fitting shoes with rubber, non-skid soles. Avoid wearing high heels. Tie your shoe laces and never walk in bare socks. Replace slippers that have stretched out of shape or are too loose. Living Areas Keep low-rise coffee tables, magazine racks, footrests and plants out of the path of foot traffic. Arrange furniture so that you have a clear pathway between rooms. Walk only in well-lit rooms and always turn on lights. Install easy-access light switches at room entrances so you do not have to walk into a dark room to turn on the light. Motion or sound activated lights and glow-in-the-dark switches are also helpful. Remove boxes, newspapers and all clutter from pathways, including doorways and hallways. Keep electric, appliance and telephone cords out of walkways, but do not hide cords under a rug because it creates a tripping hazard. Secure loose area rugs with a rubber, slip-resistant backing. Replace chairs or sofas that are so low they are difficult to get out of. Repair loose wooden floorboards immediately. Remove door sills higher than a half inch. Pets Place a bell on your small pets so you can locate them easily and know when they are near your feet, creating a potential tripping hazard. Train dogs to walk beside you, instead of in front of you. In the case of a larger or stronger dog, train your pet not to pull you when on a leash. More info at orthoinfo.org/falls

6 what you need to know if you fall Taking a fall at home can be very frightening, especially if you are home alone or have been injured as a result. Follow these guidelines and share them with family members to help you or your loved ones recover quickly from a fall: BEFORE YOU FALL when FALLing HOME SAFETY IS BONE SAFETY. Make the changes suggested in the home safety checklist. Make it a habit to have a relative, friend or neighbor check in with you once a day so there is someone designated to investigate in case you are unable to answer the phone or come to the door. Ensure your safety: Medical alert devices are a helpful way to help ensure your safety after an unfortunate fall or accident. In order for a medical alert device to be effective, it must be worn at all times, even when showering or sleeping. Cellphones are not an effective alternative to medical alert devices. They are not waterproof and do not remain attached to your body when undressed. Also, someone with mild cognitive impairment may not be able to use a phone properly, especially in a time of panic and distress. Do not extend your arms to break the fall. Instead, raise an arm to protect your head. Try to fall on your side or buttocks and roll over naturally. after you FALl Do not panic! If you try to get up too early or from the wrong position you could make an injury worse. Take several deep breaths, assess the situation and determine if you are hurt. If possible, slide or crawl along the floor to the nearest couch or chair and try to get up. If you are badly injured, do not try to get up. Instead, call for help from a family member or close neighbor. If you are alone, crawl slowly to the telephone and call a relative, friend or 911. More info at orthoinfo.org/falls

7 Fall Prevention Tips Everything you need to know to keep your kids safe from falls. From the moment your baby starts to crawl, the world is a magical place filled with new adventures and discoveries. From a child s perspective, everything is a potential mountain to climb (that giant bookshelf), obstacle to overcome (those pesky stairs) or mysterious place to investigate (anywhere beyond the safety gate). Little bumps will happen but we re here to help so these brave expeditions don t result in something more serious. Install Window Guards and Stops Screens are meant to keep bugs out, not children in. Properly install window guards to prevent unintentional window falls. For windows above the first floor, include an emergency release device in case of fire. Install window stops so that windows open no more than four inches. Open Windows From the Top and Close After Use If you have windows that can open from both top and bottom, make a habit of opening just the top to prevent accidental falls. Keep in mind that as kids grow, they may have enough strength, dexterity and curiosity to open the bottom. Keep windows locked and closed when they are not being used. Keep Kids From Climbing Near Windows For your crawlers and climbers, move chairs, cribs and other furniture away from windows to help prevent window falls. Never move a child who appears to be seriously injured after a fall call 911 and let trained medical personnel move the child with proper precautions. Secure Kids When Seated Keep babies and young kids strapped in when using high chairs, infant carriers, swings and strollers. If your baby is in a carrier, remember to place it on the floor, not on top of a table or other furniture. Help Babies Learn to Stand and Walk Safely There are some things to know about baby walkers: They don t come with safety features that prevent the walkers from rolling down the stairs, and it s easy for children to fall or reach higher objects that may be unsafe. So please be extra careful. Because baby walkers can be dangerous, try using a stationary activity center. These items give your baby a chance to practice standing and moving more safely. Look for one that is on a stable, non-moveable base and place it away from stairs, hot appliances or window cords. Unintentional falls are the leading cause of non-fatal injuries for children in the United States. In 2010, unintentional falls resulted in nearly 3 million injuries requiring treatment in an emergency room. For more information visit safekids.org Safe Kids Worldwide

8 Play on Soft Surfaces at Playgrounds Take your kids to playgrounds with shockabsorbing surfaces such as rubber, synthetic turf, sand, pea gravel, wood chips or mulch. If your child falls, the landing will be more cushioned than on asphalt, concrete, grass or dirt. Click for more tips on playground safety. Be Smart, Protect Your Head It s important that kids have the freedom to be creative and push their limits. That means wearing a helmet for appropriate activities such as biking or snowboarding to prevent a head injury that can ruin the fun down the road. Use Shopping Carts With Wheeled Attachments for Kids Don t leave your child alone in a shopping cart. If possible, use shopping carts that have a wheeled child carrier that is permanently attached. Some of these models look like cars or benches attached to the shopping cart, so your kids will love them. If you are placing your child in a shopping cart seat, use a harness or safety belt. If the belt is missing or broken, select another cart. We know that letting your child ride in the cart basket, under the basket, on the sides or on the front of the cart is fun. It can also be dangerous. Watch Out for the Stairs Use approved safety gates at the tops and bottoms of stairs and attach them to the wall, if possible. Remember to read the manufacturer s instructions and warning labels to make sure you have the right gate for your needs. Not all gates are safe for use at the top of stairs. Prevent Slips at Home Consider anti-slip rugs for the floors in your home, and mats or decals in the bathtub or shower to help prevent dangerous falls. Keep hallways and stairs well-lit and clear of clutter. Don t let kids play on high porches, decks, stairs or balconies. If it s unavoidable, make sure they are supervised by an adult. Show Older Kids How to Be Responsible Talk to your kids about appropriate play behaviors. We know some play can be physical, but it s important to know when and where it s appropriate. Prevent TV and Furniture Tip-Overs Secure TVs and furniture to the wall using mounts, brackets, braces, anchors or wall straps to prevent tip-overs. These kinds of accident happen more than you might think so take a few minutes, secure your TV and furniture, and then never worry about it again. Don t let children climb on furniture or use drawers or shelves as steps. Learn more about TV and furniture tip-overs. Actively supervise toddlers on stairs. Hold their hands when walking up and down stairs. For more information visit safekids.org Safe Kids Worldwide

9 What Are Ways to Prevent Falls and Fractures? Fast Facts: An Easy-to-Read Series of Publications for the Public National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center 2 AMS Circle Bethesda, MD Phone: Toll free: BONE TTY: Fax: NIHBoneInfo@ mail.nih.gov Website: The NIH Osteoporosis and Related Bone Diseases National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from the National Institute on Aging, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the NIH Office of Research on Women s Health, and the HHS Office on Women s Health. The National Institutes of Health (NIH) is a component of the U.S. Department of Health and Human Services (HHS). Falls are serious at any age, but especially for older people who are more likely to break a bone when they fall. If you have a disease called osteoporosis, you are more likely to break a bone if you fall. Osteoporosis is called the "silent disease" because bones become weak with no symptoms. You may not know that you have it until a strain, bump, or fall causes a bone to break. Falls are especially dangerous for people with osteoporosis. If you break a bone, you might need a long time to recover. Learning how to prevent falls can help you avoid broken bones and the problems they can cause. Why Do People Fall? Some of the reasons people fall are: Tripping or slipping due to loss of footing or traction. Slow reflexes, which make it hard to keep your balance or move out of the way of a hazard. Balance problems. Reduced muscle strength. Poor vision. Illness. Taking medicines. Drinking alcohol. Illness and some medicines can make you feel dizzy, confused, or slow. Medicines that may increase the risk of falls are: Blood pressure pills. Heart medicines. Diuretics (water pills). Muscle relaxants Sleeping pills. Drinking alcohol can lead to a fall because it can: Slow your reflexes. Cause you to feel dizzy or sleepy. Alter your balance. Cause you to take risks that can lead to falls. November

10 What Are Ways to Prevent Falls and Fractures? Fast Facts: An Easy-to-Read Series of Publications for the Public How Can I Prevent Falling? At any age, people can make changes to lower their risk of falling. Some tips to help prevent falls outdoors are: Use a cane or walker. Wear rubber-soled shoes so you don't slip. Walk on grass when sidewalks are slick. Put salt or kitty litter on icy sidewalks. Some ways to help prevent falls indoors are: Keep rooms free of clutter, especially on floors. Use plastic or carpet runners. Wear low-heeled shoes. Do not walk in socks, stockings, or slippers. Be sure rugs have skid-proof backs or are tacked to the floor. Be sure stairs are well lit and have rails on both sides. Put grab bars on bathroom walls near tub, shower, and toilet. Use a nonskid bath mat in the shower or tub. Keep a flashlight next to your bed. Use a sturdy stepstool with a handrail and wide steps. Add more lights in rooms. Buy a cordless phone so that you don't have to rush to the phone when it rings and so that you can call for help if you fall. You can also do exercises to improve your balance. While holding the back of a chair, sink, or counter: Stand on one leg at a time for a minute and then slowly increase the time. Try to balance with your eyes closed or without holding on. Stand on your toes for a count of 10, and then rock back on your heels for a count of 10. Make a big circle to the left with your hips, and then to the right. Do not move your shoulders or feet. Repeat five times. How Can I Prevent Broken Bones if I Fall? Sometimes you cannot prevent a fall. If you do fall, you can try to prevent breaking a bone. Try to fall forwards or backwards (on your buttocks), because if you fall to the side you may break your hip. You can also use your hands or grab things around you to break a fall. Some people wear extra clothes to pad their hips or use special hip pads. 2

11 What Are Ways to Prevent Falls and Fractures? Fast Facts: An Easy-to-Read Series of Publications for the Public How Can I Keep My Bones Healthy? Some ways to protect your bones are: Get enough calcium and vitamin D each day. Walk, climb stairs, lift weights, or dance each day. Talk with your doctor about having a bone mineral density (BMD) test. Talk with your doctor about taking medicine to make your bones stronger. Recommended Calcium and Vitamin D Intakes Calcium Life-stage group (m/day) Vitamin D (IU/day) Infants 0 to 6 months Infants 6 to 12 months to 3 years old to 8 years old 1, to 13 years old 1, to 18 years old 1, to 30 years old 1, to 50 years old 1, to 70-year-old males 1, to 70-year-old females 1, >70 years old 1, to 18 years old, 1, pregnant/lactating 19 to 50 years old, pregnant/lactating 1, Definitions: mg = milligrams; IU = International Units Source: Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, For More Information About Osteoporosis and Other Related Conditions: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD Phone: Toll free: BONE ( ) TTY: Fax: NIAMSBoneInfo@mail.nih.gov Website: 3

12 National Institute on Aging (NIA) For the NIA publication on fall prevention, go to: Website: American Geriatrics Society Website: What Are Ways to Prevent Falls and Fractures? Fast Facts: An Easy-to-Read Series of Publications for the Public The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center acknowledges the assistance of the National Osteoporosis Foundation in the preparation of this publication. For Your Information This publication may contain information about medications used to treat the health condition discussed here. When this publication was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released. For updates and for any questions about any medications you are taking, please contact the U.S. Food and Drug Administration (FDA) toll free at 888 INFO FDA ( ) or visit its website at For additional information on specific medications, visit Drugs@FDA at is a searchable catalog of FDA-approved drug products. 4