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For seniors and elderly adults, the thought of falling down can be frightening, and with good reason. The Centers for Disease Control and Prevention provides some dire statistics on falls for older adults. More than one in four older adults fall each year, and one out of every five of those falls results in serious injury, including broken bones or traumatic brain injuries. Is it any wonder that many doctors recommend mobility aids to their elderly patients?
But the unfortunate truth is that falls can occur even when you use mobility aids.
Falling from a wheelchair or with a cane or walker can be quite serious. According to a study in the Journal of Trauma Nursing, 60% of those who fell from a wheelchair were aged 65 and older and suffered a variety of injuries from the fall, including concussion, femur fractures, and traumatic brain injuries. Falls that occur while using a walker and cane are more common than you might think; the Journal of the American Geriatrics Society found that of the more than 47,000 injuries treated in emergency rooms from falls while using mobility aids, 83% of those involved a walker and 12% involved canes.
Accidental falls are a leading cause of injury-related deaths for senior adults, and that knowledge alone can increase the fear of falling. And when the fear of falling increases, you’re more likely to stay at home where you might feel safer. You might sit down more, and while sitting down is certainly fall prevention, it also keeps you inactive – which leads to less strength and flexibility, which actually increases your risk of falls even more[1].
A medical alert pendant can help boost your confidence, as can using the proper mobility aid. A walker right there in front of you, for instance, can make you more confident in rising from your chair. Using a cane can help you feel sturdier and more confident. If sitting is the appropriate option for you, the use of a wheelchair can help you continue to enjoy life. To avoid falls, make sure you’re confident and safe in whatever aid you and your doctor decide is right for you.
Staying Safe with a Walker or Cane
A few of the most common mobility aids include the walker and the cane.
Although a physical therapist might measure you for a cane, they can also easily be purchased at the pharmacy or local discount store if you want to choose one for yourself. Keep in mind, however, that the cane should fit your height to be more effective and safer. To figure this out, hang your arm loosely from your side while standing. Have someone help you in measuring the distance from your wrist to the floor. That number is the height you want in a cane[2].
To use a cane, always hold it on your stronger side. When you’re ready to take a step, move forward with your weaker leg and the cane. Support your weight on both the leg and the cane. Once you’re steady, step forward with your stronger leg. Repeat this action to walk across a room. It might seem stilted and difficult at first, but you’ll get the hang of it. Canes with multiple feet at the bottom may provide more stability than those with a single point of floor contact.
The walker has a wide variety of iterations as well, but the basics are the same; instead of using it with one hand, you use it with two hands on the device. A typical walker has four points that touch the floor. Sometimes two of those points are wheels, which can lock with the flip of a switch on each wheel. This allows the user to slightly lift the two fixed tips and scoot the walker along on the wheels. Older models of walkers have four tips, one at each corner of the walker, and no wheels. These walkers must be lifted slightly while taking each step.
As with the cane, a physical therapist will likely fit you with the proper size walker, but you can also buy one yourself. Measure from your wrist to the floor as you would with measuring for a cane. That measurement is the proper height for your walker.
To use a walker, stand behind it and hold onto it with two hands. Roll or lift the walker to move it forward about one foot. As with the cane, step forward with your weaker leg first. Rely on that leg and the walker to support you. Bring your other leg up to an even level with the weaker leg. Repeat the motion for each step.
These safety tips can help make sure you move without falling:
· Keep your back straight and look forward when using a walker. Looking down could actually lead to falls, as you aren’t aware of what’s ahead of you.
· Always take your time to establish your balance. Never rush.
· Make sure the tips of the cane or walker have non-skid covers.
· If you get very tired when using your walker, ask your physician about a walker that has a seat attached, so you can easily sit down immediately if you are too tired, faint, or dizzy.
· Use a fanny pack or backpack instead of a purse. Some walkers have small pouches to hold things, which frees up your hands to maneuver the walker safely.
· Never go up and down a flight of stairs using a walker.
· When using a cane, don’t rely on just the cane on stairs. Always use the handrail.
· Sit down to get dressed. This significantly reduces the risk of falls.
· Always wear appropriate, non-skid footwear when using a cane or walker.
Remember to never be lulled into a false sense of security. Since falls can happen at any time you’re on the move, even when properly using your walker or cane, keep a medical alert necklace or wristband handy. Specifically choose a fall detection device for seniors to help ensure assistance can get to you, even if you are unable to press the button and summon that help yourself.
Staying Safe and Comfortable with a Wheelchair
There are many types of wheelchairs, but the most common are the manual wheelchair and the electric wheelchair. The manual, foldable wheelchair is often light enough to be manipulated even by someone who doesn’t have much upper-body strength. The electric wheelchair is almost always much heavier and has many more bells and whistles. The manual wheelchair requires that you move yourself or that someone push you, while the electric wheelchair moves at the touch of a button.
Before sitting down in a wheelchair, make sure the brakes are on. Adjust the footplates at the bottom so they are not obstructing the way when you go to sit down in the chair. Position yourself in front of the chair, with your back to the seat, and hold onto the armrests. Grip them tightly for support. Gradually sit down in the chair – don’t rush. Take your time in getting comfortable. Push the footplates back into place if you can; if you can’t, have someone else do it for you. Use them to rest your feet. Now you can roll yourself along in the wheelchair or someone can assist you.
When getting out of the wheelchair, simply reverse the steps. Make sure you have something sturdy to hold onto as you stand, such as a handrail.
These safety tips can help you stay safe in the wheelchair, as well as help you in getting in and out of it without a fall:
· Choose the right cushion. Many wheelchairs come with a standard cushion, but that might not be enough for comfort, and you might slip out of the wheelchair. A pommel cushion has a rise at the front that helps keep you steady in the chair. A wedge cushion under the knees might also be a good idea (and could help with back pain).
· Consider a lap belt or a lap bar that will help you stay in place.
· Make sure you can feel the wheelchair against the back of your legs before you sit down.
· Always make sure the brakes are on before moving in or out of a wheelchair.
· If it’s a foldable wheelchair, make sure all parts are appropriately locked before using it.
· If something is too far away to pick up when you are sitting in a wheelchair, move closer to it – never overreach, as this could tip the wheelchair over and lead to a serious fall. According to the Rehabilitation and Research Training Center at the University of Washington, tipping over in a wheelchair is a leading cause of falls from this mobility device.
· If you need to transfer from the wheelchair to a bench or other seat, it’s always best to have assistance to do so.
· Make sure your wheelchair is the right size for you. A very tiny person won’t do well in a chair designed for someone larger. On the other hand, a larger individual might not fit well into a standard chair and should have a bariatric chair instead.
· Never take your wheelchair into an unstable area, such as a gravel driveway.
Emergencies and accidents can happen even from the safety of your wheelchair. That’s why it’s so important to include an emergency response system wherever you go. When you can simply press a button for assistance, your confidence will build and you’ll feel better about getting out and about.
Overall Tips for Fall Prevention
One of the biggest ways to prevent falls, whether you are using mobility aids or not, is through cleaning up your home to avoid clutter and employing smart home modifications for the elderly. By reducing clutter, you are reducing your fall risk. By choosing aging in place home modifications, such as a taller toilet seat or grab bars, you are making it easier to move around your home and remain independent.
Here are other fall prevention strategies that work, no matter what mobility aid you use:
· Wear a medical alert system with fall detection at all times. A medical alert device should be on your body at all times, including in the shower or while you are out and about town. This helps ensure that you can get help immediately in the event of accident or emergency.
· Stay as strong as you can through regular exercise. Talk to a personal trainer or your physical therapist about the proper exercises to keep you strong. Look into exercises that improve flexibility and balance.
· Use your mobility device anytime you’re on the move, even when you think you might not need it.
· Talk to an aging in place specialist for a home evaluation. Home modifications for elderly can work wonders to make your surroundings much safer.
· Ensure the lighting throughout your home is excellent – you want to be able to see where you are going, so you can better avoid any trip hazards.
· Make sure all stairs have handrails. Install grab bars near the toilet, in the bathtub, and at other places in the home where you might need an assistive device, such as near the bed.
· Keep the passageways of your home clear of clutter, throw rugs, or anything else that could catch your foot, the tip of a cane, or even impede your wheelchair.
· If you do fall, never hesitate to tell your doctor what happened, even if you have nothing more than bumps and bruises.
· Get your vision checked out every year, and corrected if necessary.
· Be aware of your medications and their side effects. Know how the medications might limit your ability to move well or increase your risk of falling, as many do. For instance, some blood pressure medications can cause dizziness or fainting if you stand up too quickly.
Fall prevention is vitally important to live a longer, healthier, more independent life. These tips can help, but there is always something else you can do to improve safety. Don’t forget the incredibly valuable (yet affordable) help you can get from Alert1 Medical Alert Systems. Your choice of medical alert watch, pendant, or wristband can give you the peace of mind you need to be more confident and thus, steadier on your feet. And alert systems with fall detection can save the day (and a life) if needed.