Ask a Geriatrician: Tips to trip-proof your home

From Dr. Marlene Bluestein, TMC internal medicine / geriatric specialist:

You can’t believe how easily towel racks and shower bars can be pulled down.

When I used to do house calls, my patients often insisted the racks were a fine substitute for grab bars.

Unfortunately, most shower curtains hang on tension rods that aren’t secured into a wall – and many times, towel racks aren’t attached to wall studs, because they are only meant to hold the weight of a towel.  I can’t say I was apologetic about the result of giving those bars one good pull, because falls can be a matter of life and death for older adults.

Dr. Marlene Bluestein

Dr. Marlene Bluestein

Hip fractures, which are almost always caused by a fall, can adversely impact independence, with the Centers for Disease Control and Prevention estimating one in three adults will remain in a nursing home for at least a year after a hip fracture.

Even more disturbing, the CDC reports one of every five hip fracture patients dies within a year of their injury. And it’s not just hips: A fall can also lead to traumatic brain injury, which can impact your cognitive status as well as your physical health.

There are steps you can take now.

Exercises can improve leg strength and balance. See your doctor if your medicines are making you dizzy or drowsy. Keep up with your annual vision checkups.

 

Here are some areas of special attention when giving your home a good once-over:

Rugs: If you must have a rug, a smooth wall-to-wall fit is the best option. Smaller rugs too often can slide out from under you, or catch your shoe. In the bathroom, however, a rug is preferable to stepping out of the bathtub or shower directly onto a slick, wet floor. Take it from me: I tore a hamstring doing just that and it took months to heal. Don’t just throw a towel down. Look for a high quality, rubber-matted rug with good traction.

Shower/tub: Consider eliminating the lip on the shower so you don’t have to step over, and can roll a wheelchair in, if need be. If you have limited mobility, another option is a sliding transfer bench that straddles your tub and allows you to sit while lifting your legs over the edge. A handheld shower wand is helpful, as is a shower chair or bench. Don’t forget grab bars and non-slip treads in the tub.

Toilet: Consider installing a bidet, which is a huge convenience for older people who become incontinent and find it a hassle to get into the shower with much frequency. A bidet can help accomplish a good deal of personal hygiene with little fuss. Also, a raised toilet is easier on knees and hips.

Lighting: Falls often happen on the way to the bathroom from the bedroom, so install nightlights or a lighting system that you can turn on from bed. At a minimum, keep a flashlight or cellphone nearby. Falls also happen when folks get a little dizzy when first standing up. Even if you are feeling some urgency to use the bathroom, try to sit for a minute before standing up.

Kitchen: A stove with controls along the side or front – instead of along the back – reduces burn risk. Retrofitting cabinets with pullout shelving means you won’t have to reach so far back or so high. Having a low step stool in a convenient place will leave you less tempted to stand on a chair – never a good idea, regardless of mobility issues.

Transition areas: As people age, they may not lift their feet as high when walking. Make sure stairs are in good condition with adequate handrails – or replace them with ramps.  Sunken living rooms can really be hazardous, so reflective tape or strips can serve as a signal to guests and a reminder to yourself. On the patio, flagstone can be slippery and bricks can be a problem if they constantly shift and lift. A better option: stained concrete. Don’t forget lighting!

Finally, be very cautious if you have a furry companion, particularly one that likes to be by your feet all the time. And when the grandchildren visit, make a pass through the house after they’re tucked in bed to pick up any toys lingering about.

You don’t have to make changes all at once and there is help available if you need assistance. The DIRECT Center for Independence, for example, assists with adaptations, such as ramps and bathroom modifications and can provide in-home assessments. Reach them at 624-6452 or www.directilc.org. The Pima Council on Aging also has assistance programs. Reach them at 790-7262 or www.pcoa.org

 

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Tucson Medical Center | 5301 E. Grant Rd. | Tucson, AZ 85712 | (520) 327-5461
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