Home and self-modifications can create safer living environments for older adults
More than 36 million older adults fall each year, with an estimated 8 million resulting in injuries ranging from minor bruising to more serious hip fractures, broken bones and head injuries. In Texas, almost 34 percent of older adults reported falling each year on average—nearly 6 percent more than the national average.
Surprisingly, a majority of falls occur inside homes with no stairs. Living rooms and bedrooms see the most falls, with kitchens, bathrooms and hallways following close behind. Because of this, all older adults and caregivers should take the necessary steps to make their homes safer to prevent falls.
“Most Americans want to remain in their homes and communities as long as they can,” said Marcia G. Ory, founding director of the Texas A&M Health Center for Population Health and Aging. “Falls are not an inevitable part of aging. With the help of environmental, technological and social supports, older adults can take a proactive approach to improve their health to live longer and more independent lives.”
While falls prevention measures usually focus on the main living spaces, people often forget about taking preventative measures in their bedrooms and bathrooms. The following are several ways that older adults and their caregivers can create safety measures to prevent falls.
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The bedroom
First and foremost, make sure the floor is clear of all clutter. Remove any objects such as books and shoes to reduce tripping hazards. If there are any rugs, remove them or add non-slip backings so they won’t slip.
In addition, make sure cords from lighting, medical equipment and telephones are not placed across walkways and floors. These can be trip hazards and should be secured next to or against a wall.
Perhaps the most overlooked item to prepare against falls is the bed. First, check the mattress age and condition. Depending on the individual, the mattress should allow them to move easily in and out of bed without pain or discomfort. Next, make sure the bed is set at the correct height. When sitting on the bed, feet should be firmly on the ground with knees at a 90-degree angle. If help is needed to rise from the bed, safety rails can be installed for additional support and protection.
In addition, ensure that sheets and blankets are secured so they do not hang on the floor and cause trip hazards. Adding pool noodles underneath fitted sheets at the edge of the bed can create a roll barrier. Wedge pillows or a body pillow can also be used to create a barricade.
At night, make sure ample lighting is available and easily accessible next to the bed. Placing motion-sensor nightlights along walkways will light up hallway paths to the bathroom or other rooms in the home.
The bathroom
Making your way to the bathroom via the hallway lit with motion-sensor nightlights ensures safe movement into the bathroom. As with the bedroom floors, make sure clutter is removed from the area. For additional security, add non-slip rug tape to bathmats to secure them in place.
Before placing non-skip strips in the tub and shower to guard against falls, clean the shower and tub from soap scum and residue, and clean regularly to prevent buildup.
Some bathroom preventative measures may include minor to major physical home modification. While many can be done with the help of a caregiver or family member, some modifications may require the skills of a professional. A minor home modification is installing grab bars next to the toilet and tub. These provide extra support from getting off of or out of these devices.
Installing adjustable-height or handheld showerheads allows the water stream to be set at the correct level for each user. These can also be helpful for older adults who use a bench seat while showering.
To make sure surfaces are free of clutter, keep often-used items in cabinets that can be easily reached without having to use a step stool or a grab device.
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Protecting yourself
While the above list of safeguards and modifications allows older adults to create a safer living environment, there are six steps the National Council on Aging (NCOA) recommends people take to reduce their risk of falling.
“Daily lifestyle behaviors such as physical activity, nutrition and sleep quality can influence fall risk, and these are never too late to change,” said Matthew Lee Smith, PhD, MPH, co-director of the Center for Population Health and Aging. “Interventions can be successful for people of all ages. Among the most important is physical activity, namely, safely performing lower-body exercises to increase strength, balance and flexibility.”
Falls Prevention Awareness Week
Join the center and its colleagues September 20-24, 2021 for Falls Prevention Awareness Week. In 2020, the NCOA declared Falls Prevention Awareness as a weekly observance. In past years, falls prevention had received only a one-day observance. This year, the center and its colleagues will be offering online programming that will include sessions on the falls prevention checklist, how to integrate evidence-based falls programs into your programming, and working with community-based organizations to implement falls programs. For a full schedule, resources and events from around the state, visit fallspreventiontexas.org.
Your diabetes, your heart
With healthy habits and education, diabetes and heart health can be managed
More than 34 million Americans have type 2 diabetes, according the Centers for Disease Control and Prevention, which is about 1 in 10 people. Although type 2 diabetes more often develops in people over 45 years of age, more and more children, teens and young adults are developing it.
With type 2 diabetes, the body’s cells don’t respond to insulin normally, causing the pancreas to make more insulin to get cells to respond. As a result, blood sugar rises and damages the body, setting the stage for other health problems, including vision loss, kidney disease and heart disease.
Those with type 2 diabetes are at greater risk for developing cardiovascular disease than those not living with diabetes. According to the American Diabetes Association, cardiovascular disease—where heart and blood vessels are negatively impacted—is the number one cause of death for those living with type 2 diabetes. In addition, those with diabetes are twice as likely to have heart disease or a stroke than those not living with diabetes.
Despite the risks and complications, with proper diabetes self-management and education, those living with diabetes can lower their risk for cardiovascular disease.
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How diabetes affects the heart
“Diabetes is more than just having high blood sugar. It’s a blood vessel disease that causes damage to the major organs in the body if diabetes is not managed over a lifetime. Diabetes requires consistent daily, management and lifestyle change,” said Wendy Creighton, RN, BSN, with the Texas A&M Health Center for Population Health and Aging.
There are several types of cardiovascular diseases that can affect those living with type 2 diabetes, including atherosclerosis, heart failure and arrhythmias. Atherosclerosis occurs when fatty plaque builds up in the blood vessels and causes them to stiffen, preventing normal blood flow of oxygen and nutrients. Heart failure occurs when the heart’s muscles become too weak to pump blood properly to all areas of the body. Arrhythmias, or irregular heartbeats, occur when damage to the heart disrupts the electrical messages to keep the heart beating.
Cardiovascular disease can present itself as several symptoms like shortness of breath and fatigue; chest, throat, back, leg, neck, jaw, upper abdomen and arm pain; as well as numbness in the arms or legs.
Those living with type 2 diabetes can prevent cardiovascular disease complications by staying on top of their diabetes and heart health.
“The good news is with education, support and practice you can make small changes over time that will have a large impact over time,” Creighton said. “You don’t have to be perfect at managing your diabetes, you just have start right where you are now and keep pressing forward! When you get off track, be kind to yourself, re-evaluate and hop back on again! Let your health care provider, friends and family know your plan for success so they can support you along the journey.”
The American Diabetes Association (ADA) has several recommendations for keeping an eye on your heart health:
Education and resources for diabetes management
To bring attention to diabetes prevention, treatments and diabetes itself, November has been named National Diabetes Month. During the month communities and outreach organizations come together to share education and resources about diabetes prevention.
The Center for Population Health and Aging is one such organization that is committed to diabetes education through research studies and community education.
The center offers Your Diabetes, Your Heart on the center’s online education platform Enlighten Together Training (cphatraining.com). This free 30-minute online diabetes management course allows users to learn about heart health and diabetes. In addition, it gives users access to the American Diabetes Association’s Know your Diabetes by Heart free resources: ask the Experts Q&A Series, healthy recipes and monthly newsletter.
“The Your Diabetes, Your Heart is a joint effort with ADA to promote heart health among people with diabetes,” said Ninfa Peña-Purcell, PhD, MCHES, a research scientist with the center. “Many individuals with diabetes do not fully understand the link between diabetes and heart disease. There is a great need for education on this topic because of the high rates of diabetes and heart disease comorbidity. Through this collaboration, we will join forces with ADA to respond to this need both in Texas and nationally.”
In addition to free online programming, the center’s Living Healthier with Diabetes research team has been studying how diabetes self-management education and support impacts health and health care. This study is designed to look at the effectiveness of different kinds of diabetes education. They hope the results will help us better understand the effects of diabetes self-management education and also benefit people with type 2 diabetes.
“I believe the Living Healthier with Diabetes project has demonstrated the great success virtual diabetes education and support services can have on disease management,” said Keri Carpenter, MPH, RDN, LDN, CHES, with the center. “A1cs are improving and healthy behaviors are being adopted. I hope this study will provide evidence for providers and organizations who may currently be hesitant to implement their own virtual health education programs. Virtual education can be one tool of many to efficiently and cost-effectively help patients who need support and face barriers that occur in some in-person education scenarios.”
Diabetes Self-Management Education and Support emphasizes seven self-care behaviors: healthy coping, healthy eating, being active, taking medication, monitoring, reducing risks and problem solving. These foundational behaviors coupled with a person-centered approach to goal setting can create true lifestyle changes over time.
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