Maybe your parents are getting older and seem more fragile to you lately. Or maybe your beloved aunt wants to continue to live independently despite mounting health problems. And with the coronavirus disease 2019 (COVID-19) pandemic, you may not be able to check on them as easily.
When you love an older adult, you want them to be happy but also safe. And falls represent a major health risk for seniors. But instead of worrying and waiting for something bad to happen, ask your loved one these questions to help determine if he or she needs to talk to a doctor about fall risk. (In the meantime, there may be small steps you can take to help.)
Here’s what to ask.
1. Have you thought about falling? Are you scared to fall?
In older adults, one of the major causes of falls is a fear of falling—the anxiety makes them unsteady. That’s why people who have previously experienced a fall are more likely to suffer another. No one likes to think about it, but providers say preparing for a fall can help to limit the damage if it does happen.
“I sometimes ask people if they have thought through how they are going to fall. Most people have not, so I talk them through strategies like how to land on the softer parts of the body, around the bigger bones, so you can hopefully prevent a fracture,” says Ryan Lavalley, PhD, an occupational therapist who teaches fall prevention classes for older adults at the Orange County Department on Aging.
Lavalley works closely with Jenny Womack, a clinical associate professor of occupational therapy at the UNC School of Medicine. Together they provide services through the Orange County Department on Aging, including activity adaptations and in-home assessments, designed to help seniors make necessary adjustments to remain safe in their homes.
Both agree that if your loved one is anxious about falling, it’s time to talk to a professional.
2. You have a cane. How can I help you feel better about using it?
Of course, people who have been advised by a doctor to use a cane have been told this for a reason. If they have weakness or are unsteady on their feet, they’re more likely to fall. But social stigma can keep people from using canes.
“Some people don’t want to appear weak,” says Womack. “They don’t like to look ‘old.’ There’s a stigma around using canes and walkers. But some people have actually embraced the idea and made it fun by decorating or monogramming their cane.”
Explain to your loved one that there’s no shame in using a cane or walker. Think of it like any other prescription and follow the doctor’s orders.
3. What do you want to do that you are afraid to do?
If your loved one is limiting his or her activities in and around the home, small changes can help make things easier and safer.
“If someone isn’t cooking like they used to because things are on shelves they can’t easily reach, how can we make changes to make them more accessible? Can we move things lower?” Lavalley says. “The ultimate goal is to make people safe and successful.”
Both Lavalley and Womack say many helpful alterations can be made to a home without high costs. These include railings on stairs, increased lighting to improve visibility, and grab bars and benches to increase safety and stability while bathing.
4. Are there places in your house where you often get tired or feel uneasy?
Womack says a key aspect of the home assessment service she provides is spending time with people in their homes and watching how they move through the space. Does your dad occasionally seem wobbly when standing up from a chair? Consider placing a sturdy piece of furniture near the chair so he can use it to steady himself. Is there a lip at the entrance to the restroom you worry about your grandma tripping over? Have it removed and leveled. And you can have grab bars and other devices installed to prevent falling in the shower or bath.
Womack cautions against going into your loved one’s space and removing rugs and moving things around, despite some “fall prevention” tips you may have seen.
“Working with older adults, one of the things that we really try to think about is: What is their life experience in their homes?” Womack says. “If there’s a rug that’s been in place for 40 years, moving it might actually cause more problems. If someone is used to it being there and used to stepping a certain way and then it’s suddenly gone, that might actually increase their risk of falling.”
Womack says these conversations can be tough, but they are vital.
“Take time to listen and understand what your loved one’s priorities are. They might feel uncomfortable at first, but it’s likely something they have been thinking about. Through these conversations, you can get to the heart of what they need to make sure their home serves them well.”
After you have this conversation with your loved one, here are a few more steps you can take:
- Encourage participation in an exercise program to improve leg strength and balance.
- Help make his or her home safer by removing clutter and making sure areas such as stairwells are well-lit to reduce tripping hazards.
- Consider the medicines your loved one is taking. If they cause drowsiness or dizziness, talk to a physician or pharmacist about potential alternatives.