Services for Elders and Their Families
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An Ounce of Prevention

We have all heard the saying “An ounce of prevention is worth a pound of cure”. This often true phrase has many applications. I have written previously about how an older adult and their family members can make decisions about the appropriateness of various living situations, and how to evaluate them. As a Geriatric Care Manager, I often assist older adults in obtaining services that enable them to remain in their own home. Part of this assistance includes an evaluation and education regarding the safety of the elders home and living environment.

No environment can be completely safe and secure, the sterile and risk free environment is seldom obtainable. It should be the caregivers and elders goal to critically evaluate the surroundings, making changes adaptations where appropriate. The purpose of this article is to address some common areas of concern regarding safety of living spaces.

Guarding against the risk of falls.
Make a conscious decision to not place yourself at risk. Thought this may sound common place, many younger and older adults, do not adapt their thinking as their body changes. For example, an “I can do it all myself attitude” may have been an asset all of an older adults life. But as the body ages, it is wise and prudent to consider pertinent risks in lieu of normal physiological changes.

Because of the normal changes that occur in the muscular skeletal systems of the body as one ages, some daily tasks may become more difficult to perform. An older adult may compensate for these changes while performing every day tasks. For example, to accommodate, an elder may use a chair or stool for a ladder to reach for items, placing themselves at risk for a fall.

Falls are especially dangerous because research shows that falls, and the complications from falls, often leads to death. Apart from death, a fall can drastically effect the quality of life that a senior can experience; leading to long-term disability. Research shows that up to 30 percent of older adults in the community experience a fall in a given year.

Think ahead about items that you may use regularly, and rearrange your kitchen and living areas; keeping items easily accessible. Make it your decision that if you cannot reach an item with ease, you will wait for assistance. A fall can also occur as a result of loss of balance due to drop in blood pressure, (postural hypertension) resulting from rising from a sitting or laying position to quickly. Other risk factors for fall include inactivity, visual impairment, medications and uneasy gait.

Remove any loose or frayed rugs, no matter how attractive they may be. Be practical. If an area rug has frayed edges, or curled corners, it may be time to remove that rug. If you want to keep the carpet, you may want to have the carpet tacked down, or use two sided carpet tape.

Look critically around the rooms in your elders home for potential hazards; things that he could trip or fall over. Stacks of magazines or books, lamp cords that block walkways, any thing that could cause a hazard. Sometimes it can be helpful to have someone else assist. Sometimes we get so accustomed to our environment, that we no longer see the obvious.

Carefully check electrical appliances and cords.

Many older adults, due to normal changes in the body, may not be able to detect the tell tale signs of electrical shortages such as smoke and heat odors. Be sure to have all electrical cords and appliances checked to be sure that they are in good condition. Try to avoid using extension cords, but if you must, assure that they are in good condition and not over taxed.

Install Smoke Detectors.
You will want to install and check your smoke detectors at regular intervals. Often smoke detectors have a shrill tone that lets homeowners know that the battery is running low. It is important to also have another method of checking; perhaps by placing a notice 6 months ahead on your yearly calendar. In addition, you should check to be sure that you are able to hear the alarm while laying in bed.

The most potentially dangerous room in the house?
It may sound peculiar, but many accidents happen in the bathroom. This is due to both wet surfaces and removal of clothing. It is important to have mechanisms in place to steady ones self in the rest room. You may want to have balance bars installed around the tub, shower, and commode. In addition, you will want to have any slick surfaces, such as the tub floor, treated with a non-stick material. If you prefer taking showers, you will want to purchase a shower chair and sprayer nozzle for your bath.

You may also want to install a night light in the bathroom to guide you in the nighttime hours. Some elders, who need to use the bathroom frequently during the night, may find it easier and safer to purchase a bedside commode.

Keep your physical health at optimal functioning.
Women should consult with their physicians about osteoporosis, and the risk of injury. Osteoporosis is a disease that many women experience, as a result of hormonal changes during menopause. This is treated in a variety of ways, with the most successful being Hormone Replacement Therapy. In addition to hormone replacement therapy for women, there is recent research that shows that flexibility and strength training, at any age, can result in less falls, less serious injury, and a quicker recovery for older adults.

If you are in need of strength training and flexibility training, especially if it the result of previous illness, speak with your physician about an appropriate plan to regain strength muscle tone. There are outpatient Physical Therapy Centers called Comprehensive Outpatient Rehabilitation Facilities, (CORF) that allow you to refer yourself for treatment. You will need to have Medicare Parts A & B, and there may a co-payment depending on the facility. You may want to call your local Information and Referral line or ask your physician to inquire about locations.

Medication Management.
Sometimes medications can cause dizziness or balance problems. You should be wary of mixing medications, including over the counter drugs. It is important that you take medications as prescribed. Be sure to discuss any possible side effects with your physician or pharmacist. When you go to see your physician, take your present medications, in their original containers, with you in a bag. You will want to be sure that the physician knows all medications that you are taking.

Pill boxes are lovely, but they are not very practical. If possible, always keep medications in their original containers. It is not uncommon for someone to confuse medications by accident, especially late at night. You should discard old medications; especially old prescription drugs. These drugs not only will lose potency over time, but keeping old medications can be dangerous.

If you have trouble keeping medications organized, or remembering if you have taken medications, you may want to purchase a seven day, multi-dosage pill organizer. If you are able to have someone assist you in filling the week, this can relieve the stress of keeping medications organized.

Emergency response
Many older adults report being fearful about becoming ill or falling at night, and not being able to reach anyone. There are many variations of the Emergency Response Units that seniors can wear or carry with them. There are some that only call 911, and there are those that call a noted friend or relative. Many elders are afraid to push the button, except when they are extremely ill, mostly because they do not want the trouble and charges that may accompany. This can be especially dangerous if the person is having a stroke or heart attack, where symptoms can be masked in early stages. I prefer the assistance buttons that notify someone or allow conversation with someone without calling 911.

Most home owner/renter insurance companies will conduct free safety assessments of a policy holders home. You may want to call and schedule an assessment of your home. The key is to get all of the information that is available, and then act on it. Remember, especially when it comes to your safety, “An ounce of prevention is worth a pound of cure”.

Some of the expertise is derived from Paul E. Riel. Among other things, he teaches ‘Self defense and safety for women’ at Jacksonville University, and Yes, he also my husband.


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