As we transition from summer to fall and then into the colder months of winter, it's not just the leaves that change—our bodies experience shifts in sleep cycles, mood, metabolism, and brain activity.
The increased darkness especially impacts our loved ones with dementia and may lead to more at-home injuries, falls, and worsening mental status changes like confusion, disorientation, anxiety, or agitation. We often see more roaming around the home, not sure "what to do," wandering outdoors, and not being dressed for the cool of the season.
Falls happen every day.
Anyone is at risk, especially older adults. Combine the increased darkness that accompanies this time of year with simple aging issues like decreased vision or hearing and medical issues like high blood pressure, arthritis, joint replacement, diabetes, or any cognitive deficit (you see where this is going), and the risk of falling increases dramatically.
While it is true that you can’t put your elders in bubble wrap, there are practical ways to identify risk factors, implement a safety plan, and reduce the opportunities for falls. Start by taking a realistic look at your loved one’s health. Do they have any conditions that could raise their risk of falling? As compassionately as I can say this: if your answer was “no,” you aren't being honest with yourself.
Some of the most common risk factors include:
•Fear of falling, which can lead to inactivity, weakened muscles, and impaired balance.
•Failure to use assistive devices such as a cane or walker.
•Hazards in the home, such as slippery walking surfaces, uneven ground, clutter, or poor lighting.
•Pets: on the move and underfoot.
•Transporting items like laundry, food, and mail.
•Dropping things and trying to pick them up.
•Multi-tasking, lack of focus, or rushing.
•Any use of stairs, a stepstool, a ladder, or a chair.
Falls are more likely to occur in certain areas of the home.
Often referred to as the “heart of the home,” the kitchen is a busy room where distractions, sharp objects, and hot surfaces are common…as are opportunities for injury. Additionally, the bathroom presents a significant hazard with its slippery floors, soapy surfaces, and steamy conditions.
While a fall can happen anywhere at any time, the activities that have the highest incidents of falls are usually transitions and moving from one place to the next. Getting in and out of bed, the shower, cars, up and down from chairs, and climbing and descending stairs all present a recipe for disaster. Changes in flooring, such as going from a wood floor to carpet, and thresholds also cause concern.
How can we reduce the risk of an injury this season?
Start with some straightforward adjustments in the home:
•Improve the lighting to help ease the experience of moving from daylight to evening. Consider installing timer-controlled outdoor lighting at all entrances and pathways and indoor lighting that automatically activates in the late afternoon.
•Install grab bars in the bathroom, near toilets, and inside shower areas.
•Add anti-skid surfaces on exterior steps and inside tubs and showers.
•Install railings along staircases, ensuring they’re effectively placed and sturdy.
Not sure where to begin? Consult your local Council on Aging or your loved one's primary care provider for a home safety evaluation. A professional assessment of the risks in and around the home can lead to a practical plan that, quite honestly, could be a lifesaver.
We’ve only touched on this critically important topic, but we hope to have generated some ideas for you to consider as you try to prevent injury in your loved one's life. Together, let’s have a fall-free Fall!
Joanne MacInnis, RN, is the founder and president of Aberdeen Home Care, Inc., of Danvers, a concierge private duty home care agency in business since 2001. With 35 years of nursing practice, management and administration experience focused on home care and hospice, Joanne and her team specialize in advising and supporting families addressing the elders in their lives retain dignity and quality of life.
