Extracrted from various on-line sources.
The U.S. Consumer Product Safety Commission (CPSC) estimates that in 1981, over 622,000 eople over age 65 were
treated in hospital emergency rooms for injuries associated with products they live with and use everyday.
ALL AREAS
OF THE HOME
In all
areas of your home, check all electrical and telephone cords; rugs, runners and mats; telephone areas; smoke detectors;
electrical outlets and switches; light bulbs; space heaters; woodburning stoves; and your emergency exit plan.
CHECK ALL CORDS
v
Are
lamp, extension, and telephone cords placed out of the flow of traffic?
Are cords
out from beneath furniture and rugs or carpeting?
Are cords
attached to the walls, baseboards, etc. with nails or staples?
Are electrical
cords in good condition, not frayed or cracked?
Do extension
cords carry more than their proper load, as indicated by the ratings labeled
on the
cord and the appliance?
RECOMMENDATIONS
Cords
stretched across walkways may cause someone to trip.
Arrange furniture
so that outlets are available for lamps and appliances without the use of extension cords.
If you
must use an extension cord, place it on the floor against a wall where people cannot trip over it.
Move the
phone so that telephone cords will not lie where people walk.
Furniture
resting on cords can damage them, creating fire and shock hazards. Electric cords
which run under carpeting may cause a fire.
Remove cords
from under furniture or carpeting.
Replace
damaged or frayed cords.
Nails
or staples can damage cords, presenting fire and schock hazards.
Remove
nails, staples, etc.
Check
wiring for damage.
Use tape
to attach cords to walls or floors.
Damaged cords
may cause a shock or fire.
Replace
frayed or cracked cords.
Overloaded
extension cords may cause fires. Standard 18 gauge extension cords can carry
1250 watts.
If the
rating on the cord is exceeded because of the power requirements of one or
more appliances being used on the cord, change the cord to a higher rated one or unplug some appliances
If
an extension cord is needed, use one having sufficient amp or wattage rating.
CHECK ALL
RUGS, RUNNERS AND MATS
v Are
all small rugs and runners slip-resistant?
RECOMMENDATIONS
CPSC
estimates that in 1982, over 2500 people 65 and over were treated in hospital emergency rooms for injuries that
resulted from tripping over rugs and runners. Falls are also the most common cause of fatal injury for older people.
Remove
rugs and runners that tend to slide.
Apply double-faced
adhesive carpet tape or rubber matting to the backs of rugs
and runners.
Purchase
rugs with slip-resistant backing.
Check
rugs and mats periodically to see if backing needs to be replaced.
Place
rubber matting under rugs. (Rubber matting that can be cut to size is
available.)
Purchase
new rugs with slip-resistant backing.
NOTE: Over
time, adhesive on tape can wear away. Rugs with slip-resistant backing also become less effective as they are washed.
Periodically, check rugs and mats to see if new tape or backing is needed.
CHECK THE
TELEPHONE AREA
v Are
emergency numbers posted on or near the telephone?
Do you
have access to a telephone if you fall (or experience some other emergency which prevents
you from standing and reaching a wall phone)?
RECOMMENDATIONS
In
case of emergency, telephone numbers for the Police, Fire Department, and local Poison
Control Center, along with a neighbor's number, should be readily available.
Write the
numbers in large print and tape them to the phone, or place them near
the phone
where they can be seen easily.
Have
at least one telephone located where it would be accessible in the event of
an accident
which leaves you unable to stand.
CHECK SMOKE
DETECTORS
v
Are
smoke detectors properly located?
Do you
have properly working smoke detectors?
RECOMMENDATIONS
At
least one smoke detector should be placed on every floor of your home.
Read
the instructions that come with the smoke detector for advice on the best
place
to install it.
Make sure
detectors are placed near bedrooms, either on the ceiling or 6v12 inches below the ceiling on the wall.
Locate
smoke detectors away from air vents.
Many
home fire injuries and deaths are caused by smoke and toxic gases, rather than the fire itself. Smoke detectors
provide an early warning and can wake you in the event of a fire.
Purchase
a smoke detector if you do not have one.
Check
and replace batteries and bulbs according to the manufacturer's
instructions.
Vacuum
the grillwork of your smoke detector.
Replace
any smoke detectors which can not be re aired.
NOTE: Some
fire departments or local governments will provide assistance in acquiring or
installing smoke detectors.
CHECK ELECTRICAL
OUTLETS AND SWITCHES
v Are
any outlets and switches unusually warm or hot to the touch?
Do all
outlets and switches have cover plates, so that no wiring is exposed?
RECOMMENDATIONS
Unusually
warm or hot outlets or switches may in-fact cause injury.
Unplug
cords from outlets and do not use the switches
Have
an electrician check the wiring as soon as possible.
Exposed
wiring presents a shock hazard.
Add a
cover plate.
CHECK LIGHT
BULBS
v
Are
light bulbs the appropriate size and type for the lamp or fixture?
RECOMMENDATIONS
A bulb
of too high wattage or the wrong type may lead to fire through overheating.
Ceiling
fixtures, recessed lights, and "hooded" lamps will trap heat.
Replace with
a bulb of the correct type and wattage. (If you do not know the
correct
wattage, use a bulb no larger than 60 watts.)
CHECK SPACE
HEATERS
v
Are
heaters which come with a 3vprong plug being used in a 3vhole outlet or with a properly attached adapter?
Are small
stoves and heaters placed where they can not be knocked over, and away from furnishings and flammable materials,
such as curtains or rugs?
If your home
has space heating equipment, such as a kerosene heater, do you understand the installation and operating instructions
thoroughly?
RECOMMENDATIONS
The grounding
feature provided by a 3vhole receptacle or an adapter for a 2 hole receptacle is a safety feature designed to lessen
the risk of shock.
Never
defeat the grounding feature.
If you do
not have a 3 hole outlet, use an adapter to connect the heater's 3 prong
plug. Make sure the adapter ground wire or tab is attached to the outlet.
Heaters
can cause fires or serious burns if they cause you to trip or if they are knocked over.
Relocate
heaters away from passageways and flammable materials such as curtains, rugs, furniture, etc.
Unvented
heaters should be used with room doors open or window slightly open to provide
ventilation. The correct fuel, as recommended by the manufacturer, should
always be used. Vented heaters should have proper venting, and the venting system should be checked frequently.
Improper venting is the most frequent cause of carbon monoxide poisoning, and older consumers are at special risk.
Review
the installation and operating instructions.
Call
you local fire department if you have additional.
CHECK WOODBURNING
HEATING EQUIPMENT
v Is woodburning
equipment installed properly?
RECOMMENDATIONS
Woodburning
stoves should be installed by a qualified person according to local building
codes.
Local
building code officials or fire marshals can provide requirements and
recommendations
for installation.
NOTE: Some
insurance companies will not cover fire losses if wood stoves are not
installed
according to local codes.
CHECK THE
EMERGENCY EXIT PLAN
v
Do
you have an emergency exit plan and an alternate emergency exit plan in case of a fire?
RECOMMENDATIONS
Once
a fire starts, it spreads rapidly. Since you may not have much time to get out and
there may be a lot of confusion, it is important that everyone knows what to do.
Develop
an emergency exit plan.
Choose
a meeting place outside your home so you can be sure that everyone has escaped.
Practice
the plan from time to time to make sure everyone is capable of escape
quickly
and safely.
* Remember
periodically to recheck your home.
KITCHEN
In the
kitchen, check the range area, all electrical cords, lighting, the step stool, all throw rugs and mats, and the
telephone area.
CHECK THE
RANGE AREA
v Are
towels, curtains, and other things that might catch fire located away from the range?
Do you
wear clothing (with short or close fitting sleeves) while you are cooking?
Are kitchen
ventilation systems or range exhausts functioning properly and are they in use while you are cooking?
RECOMMENDATIONS
Placing
or storing non-cooking equipment like potholders, dish towels, or plastic utensils
on or near the range may result in fires or burns.
Store
flammable and combustible items away from range and oven.
Remove any
towels hanging on oven handles. If towels hang close to a burner, change
the location of the towel rack.
If necessary,
shorten or remove curtains which could brush against heat sources. CPSC estimates that 70% of all people who die
from clothing fires are over 65 years of age.
Long
sleeves are more likely to catch fire than are short sleeves. Long sleeves are also
more apt to catch on pot handles, overturning pots and pans and causing scalds.
Roll
back long, loose sleeves or fasten them with pins or elastic bands while you
are cooking.
Indoor air
pollutants may accumulate to unhealthful levels in a kitchen where gas or kerosene fired appliances are in use.
Use ventilation
systems or open windows to clear air of vapors or smoke.
CHECK ELECTRICAL
CORDS
v
Are
all extension cords and appliance cords located away from the sink or range areas?
RECOMMENDATIONS
Electrical
appliances and power cords can cause shock or electrocution if they come in contact
with water. Cords can also be damaged by excess heat.
Move
cords and appliances away from sink areas and hot surfaces.
move
appliances closer to wall outlets or to different outlets so you won't need
extension
cords.
If extension
cords must be used, install wiring guides so that cords will not hang
near
sink, range, or working areas.
Consider
adding new outlets for convenience and safety; ask your electrician to
install
outlets equipped with ground fault circuit interrupters (GFCIs) to protect
against
electric shock. A GFCI is a shock protection device that will detect electrical fault and shut off electricity
before serious injury or death occurs.
For more
information on cords, refer to the beginning of the checklist.
CHECK LIGHTING
Does
good, even lighting exist over the stove, sink, and countertop work
areas,
especially where food is sliced or cut?
RECOMMENDATIONS
Low lighting
and glare can contribute to burns or cuts. Improve lighting by:
Opening
curtains and blinds (unless this causes too much glare).
Using
the maximum wattage bulb allowed by the fixture. (If you do not know the
correct
wattage for the fixture, use a bulb no larger than 60 watts.)
Reducing
glare by using frosted bulbs, indirect lighting, shades or globes on light
fixtures,
or partially closing the blinds or curtains.
Installing
additional light fixtures, e.g. under cabinet/over countertop lighting.
* (Make
sure that the bulbs you use are the right type and wattage for the light fixture.)
CHECK STEP
STOOL
v
Do
you have a step stool which is stable and in good repair?
RECOMMENDATIONS
Standing
on chairs, boxes, or other makeshift items to reach high shelves can result in falls. CPSC estimates that in 1982,
1500 people over 65 were treated in hospital emergency rooms when they fell from chairs on which they were standing.
If you
don't have a step stool, consider buying one. Choose one with a handrail
that
you can hold onto while standing on the top step.
Before
climbing on any step stool, make sure it is fully opened and stable.
Tighten
screws and braces on the step stool.
Discard
step stools with broken parts.
* Remember:
Check all of the product areas mentioned at the beginning of the checklist.
LIVING ROOM/FAMILY
ROOM
In the
living room/family room, check all rugs and runners, electrical and telephone cords, lighting, the fireplace and
chimney, the telephone area, and all passageways.
CHECK FIREPLACE
AND CHIMNEY
v
Are the
chimneys clear from accumulation of leaves, or other debris that can clog them?
Has the
chimney been cleaned within the past year?
RECOMMENDATIONS
A clogged
chimney can cause a poorly burning fire to result in poisonous fumes and
smoke coming back into the house.
Do not
use the chimney until the blockage has been removed.
Have
the chimney checked and cleaned by a registered or licensed professional.
Burning
wood can cause a build up of a tarry substance (creosote) inside the chimney.
This material can ignite and result in a serious chimney fire.
Have the
chimney checked and cleaned by a registered or licensed professional
CHECK THE
PHONE AREA
For information
on the telephone area, refer to the beginning of the checklist.
CHECK PASSAGEWAYS
v
Are hallways,
passageways between rooms, and other heavy traffic areas well lit?
Are exits
and passageways kept clear?
RECOMMENDATIONS
Shadowed
or dark areas can hide tripping hazards.
Use the
maximum wattage bulb allowed by the fixture. (If you do not know the
correct
wattage, use a bulb no larger than 60 watts.)
Install
nightlights.
Reduce
glare by using frosted bulbs, indirect lighting, shades or globes on light
fixtures,
or partially closing blinds or curtains.
Furniture,
boxes, or other items could be an obstruction or tripping hazard, especially in
the event
of an emergency or fire:
Rearrange
furniture to open passageways and walkways.
Remove
boxes and clutter.
Remember:
Check all of the product areas mentioned at the beginning of the checklist.
BATHROOM
In the
bathroom, check bathtub and shower areas, water temperature, rugs and mats, lighting, small electrical appliances,
and storage areas for medications.
CHECK BATHTUB
AND SHOWER AREAS
v
Are bathtubs
and showers equipped with non-skid slipmats, abrasive strips, or surfaces that are not slippery?
RECOMMENDATIONS
Wet,
soapy tile surfaces are slippery and may contribute to falls. Apply textured strips or appliques on the floors
of tubs and showers.
CHECK BATHTUB
AND SHOWER AREAS
Use non-skid
mats in the tub or shower, and on the bathroom floor.
If you
are unstable on your feet, use a stool with a non-skid surface, or grab bars in
your shower can help prevent falls.
Check
existing bars for strength and stability, and repair if necessary
CHECK THE
WATER TEMPERATURE
v
Is the
water temperature 120 degrees or lower?
RECOMMENDATIONS
Water
temperature above 120 degrees can cause tap water scalds.
Lower
the setting on your hot water heater to "Low" or 120 degrees. If you are unfamiliar
with the controls of your water heater, ask a qualified person to adjust it for you. If your hot water system
is controlled by your landlords, ask them to consider lowering the setting.
NOTE: If
the water heater does not have a temperature setting, you can use a
thermometer
to check the temperature of the water at the tap.
Always check
water temperature by hand before entering bath or shower.
Taking
baths, rather than showers, reduces the risk of a scald from suddenly
changing
water temperatures.
CHECK LIGHTING
v
Is a
light switch located near the entrance to the bathroom?
RECOMMENDATIONS
A light
switch near the door will prevent you from walking through a dark area.
Install
a night light. Inexpensive lights that plug into outlets are available.
Consider
replacing the existing switch with a "glow switch" that can be seen in
the dark.
CHECK SMALL
ELECTRICAL APPLIANCES
v
Are small
electrical appliances such as hair dryers, shavers, curling irons, etc. unplugged when not in use?
RECOMMENDATIONS
Even
an appliance that is not turned on, such as a hairdryer, can be potentially hazardous if it is left plugged in.
If it falls into water in a sink or bathtub while plugged in, it could cause a lethal shock.
Unplug
all small appliances when not in use.
Never
reach into water to retrieve an appliance that has fallen in without being
sure
the appliance is unplugged.
Consider
installing a ground fault circuit interrupter (GFCI) in your bathroom
outlet
to protect against electric shock.
CHECK MEDICATIONS
v
Are all
medicines stored in the containers that they came in and are they clearly marked?
RECOMMENDATIONS
Medications
that are not clearly and accurately labeled can be easily mixed up. Taking the wrong medicine or missing a dosage
of medicine you need can be dangerous.
CHECK MEDICATIONS
Be sure
that all containers are clearly marked with the contents, doctor's
instructions,
expiration date, and patient's name.
Dispose
of outdated medicines properly.
Request
non-child-resistant closures from your pharmacist only when you cannot
use child-resistant
closures.
NOTE:
Many
poisonings occur when children visiting grandparents go through the medicine
cabinet or grandmother's purse. In homes where grandchildren or other youngsters are
frequent visitors, medicines should be purchased in containers with child-resistant caps,
and
the caps properly closed after each use. Store medicines beyond the reach of children.
BEDROOMS
In the
bedroom, check all rugs and runners, electrical and telephone cords, and areas around beds.
CHECK AREAS
AROUND BEDS
v
Are lamps
or light switches within reach of each bed?
Do you
ever go to sleep with a heating pad which is turned on?
Is there
a telephone close to your bed?
RECOMMENDATIONS
Lamps
or switches located close to each bed will enable people getting up at night to see where they are going.
Rearrange
furniture closer to switches or move lamps closer to beds.
Install
night lights.
Never
go to sleep with a heating pad if it is turned on because it can cause serious burns even at relatively low settings.
In case
of an emergency, it is important to be able to reach the telephone without getting out of bed.
Remember:
Check all of the product areas mentioned at the beginning of the checklist.
BASEMENT/GARAGE/WORKSHOP/STORAGE
AREAS
In the
basement, garage, workshop, and storage areas, check lighting, fuse boxes or circuit breakers, appliances and power
tools, electrical cords, and flammable liquids.
v
Are work
areas, especially areas where power tools are used, well lit?
Can you
turn on the lights without first having to walk through a dark area?
RECOMMENDATIONS
Power
tools were involved in over 5200 injuries treated in hospital emergency rooms to people 65 and over in 1982. Three
fourths of these were finger injuries. Good lighting can reduce the chance that you will accidentally cut your
finger.
Either install
additional light, or avoid working with power tools in the area. Basements,
garages, and storage areas can contain many tripping hazards and sharp or pointed tools that can make a fall even
more hazardous.
Keep
an operating flashlight handy.
Have
an electrician install switches at each entrance to a dark area.
Replacing
a correct size fuse with a larger size fuse can present a serious fire hazard.
CHECK FLAMMABLE
AND VOLATILE LIQUIDS
v
Are containers
of volatile liquids tightly capped?
RECOMMENDATIONS
If not
tightly closed, vapors may escape that may be toxic when inhaled. Check
containers
periodically to make sure they are tightly closed.
NOTE: CPSC
has reports of several cases in which gasoline, stored as much as 10 feet from a gas water heater, exploded. Many
people are unaware that gas fumes can travel that far.
CHECK FLAMMABLE
AND VOLATILE LIQUIDS
v
Are gasoline,
paints, solvents, or others products that give off vapors or fumes stored away from ignition?
RECOMMENDATIONS
Gasoline,
kerosene, and other flammable liquids should be stored, out of living areas in properly labeled, non-safe containers
STAIRS
For all
stairways, check lighting, handrails, and the condition of the steps and coverings.
v
Are stairs
well lighted?
Are light
switches located at both the top and bottom of inside stairs?
RECOMMENDATIONS
Stairs
should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs.
The lighting should not produce glare or shadows along the stairway.
Use the
maximum wattage bulb allowed by the light fixture. (If you do not know the correct wattage, use a bulb larger than
60 watts.)
Reduce glare
by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing blinds and
curtains.
Have
a qualified person add additional light fixtures. Make sure that the bulbs you use are the right type and wattage
for the light fixture.
Even if you
are very familiar with the stairs, lighting is an important factor in preventing falls.
You should be able to turn on the lights before you use the stairway from either end.
If no
other light is available, keep an operating flashlight in a convenient location at the
top and bottom of the stairs.
Install
night lights at nearby outlets.
Consider
installing switches at the top and bottom of the stairs.
CHECK APPLIANCES
AND POWER TOOLS
v
Has the
grounding feature on any 3vprong plug been defeated by removal of the
grounding
pin or by improperly using an adapter?
RECOMMENDATIONS
Improperly
grounded appliances can lead to electric shock. Check with your service person or an electrician if you are in
doubt.
CHECK FLAMMABLE
AND VOLATILE LIQUIDS
v
Are containers
of volatile liquids tightly capped?
RECOMMENDATIONS
If not
tightly closed, vapors may escape that may be toxic when inhaled. Check
containers
periodically to make sure they are tightly closed.
NOTE: CPSC
has reports of several cases in which gasoline, stored as much as 10 feet from a gas water heater, exploded. Many
people are unaware that gas fumes can travel that far.
STAIRS
For all
stairways, check lighting, handrails, and the condition of the steps and coverings.
v
Are stairs
well lighted?
Are light
switches located at both the top and bottom of inside stairs?
RECOMMENDATIONS
Stairs
should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs.
The lighting should not produce glare or shadows along the stairway.
Reduce
glare by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing blinds
and curtains.
Have a qualified
person add additional light fixtures. Make sure that the bulbs you use are the right type and wattage for the light
fixture.
Even
if you are very familiar with the stairs, lighting is an important factor in preventing falls. You should be able
to turn on the lights before you use the stairway from either end.
If no other
light is available, keep an operating flashlight in a convenient location at the top and bottom of the stairs.
Install night lights at nearby outlets. Consider installing switches at the top and bottom of the stairs.
CHECK THE
HANDRAILS
v
Are sturdy
handrails fastened securely on both sides of the stairway?
Do the
handrails run continuously from the top to the bottom of the entire flight of stairs?
Are the
coverings on the steps in good condition?
Can you clearly
see the edges of the steps?
Is anything
stored on the stairway, even temporarily?
RECOMMENDATIONS
The handrail should provide a comfortable grip and should
always
be used when climbing up or going down the steps.
Repair
broken handrails.
Tighten
fixtures that hold handrails to the wall.
If no handrails
are present, install at least one handrail (on the right side as you
face
down the stairs).
If the
handrail doesn't extend continuously the full length of the stairs, people who are not
aware of this might think they have come to the last step when the handrail stops.
Misjudging
the last step can cause a fall. A handgrip should be available for even one
step.
While
using the stairs, try to remember that if the handrail begins beyond the first step or ends before the last step,
you must be especially careful.
Replace a
short handrail with a longer one.
Worn
treads or worn or loose carpeting can lead to insecure footing, resulting in slips or
falls.
Worn
or torn coverings or nails sticking out from coverings could snag your foot or cause you to trip.
Falls may occur
if the edges of the steps are blurred or hard to see.
Paint
edges of outdoor steps white to see them better at night.
Add extra
lighting.
If you
plan to carpet your stairs, avoid deep pile carpeting or patterned or dark colored carpeting that can make it difficult
to see the edges of the steps clearly.
Prevention of Falls in the mature adult
An Occupational Therapist's Perspective
Falling is a serious health problem among mature adult
people. Approximately 30 percent of people over the age of 65 who live in the community fall each year! Unintentional
injury, which most often results from a fall, ranks as the sixth leading cause of death among people over 65 years
of age*.
Occupational Therapists are called upon to intervene with
safety instructions and recommendations for environmental adaptations to prevent falls. There are a number of extrinsic
factors.
Consider "Seeing", "Stairs", and "Slipping".
SEEING
v Install adequate lighting in all areas.
v Outline stairs with bright colored adhesive strips.
v Reduce glare with evenly distributed light.
v Locate light switches at top/bottom of stairs, near every doorway, and within easy reach from bed.
v Maintain night light for halls, bathroom, bedroom.
v Consider motion sensitive lighting.
STAIRS
v Risk of tripping is reduced when the rise between steps is limited to 6 inches or less.
v Handrails on both sides allows grasping with either hand.
v Handrails 2v3 inches from the wall permit good hand grasp.
v Ends of handrails turned inward signal that the top or bottom step has been reached and should extend beyond
the last step.
v Avoid slippery step surface by applying nonskid treads securely to each step.
SLIPPING
v A phone in every room can prevent falls for those living alone.
v Chairs with armrests and sturdy legs assist with transferring.
v Reduce the need for unsafe climbing in the kitchen by locating frequently used items at or below waist level.
v Entranceways, bathroom, shower, laundry, sinks, and other surfaces likely to get wet should have non-slip mats
around them.
v "grab bars" for bathtub, shower, toilet area improve safety.
v Footwear with a rubber, non-slip sole reduces risk.
v Walking pathways should be free of clutter, banana peels, etc.
v Avoid highly polished slippery floors and scatter rugs.
v Carpet edges should be firmly fixed to the floor with carpet tape of rubber backing. Choose dense, short-pile
carpets. Choose floor coloring that is a solid color.
v Ice and snow should be cleared from walkways. Cat litter can be used as an alternative to salt for winter condition
walkways.
What are the benefits/risks of ASSISTIVE DEVICES?
Assistive devices are items that help individuals to maintain or regain functional capabilities and promote independence.
Included are wheelchairs, walkers, raised toilet seats, grab bars, and adapted utensils.
Howver, assistive devices can be hazardous when cognition
limits a person's ability to use them properly. A quad-cane not placed in front may trip the user. Assistive devices
may also function improperly. Canes and walkers with worn rubber tips or when used on icy/wet surfaces are risky.
Add an "icepick" when indicated.
What aspects of FOOTWEAR are important to consider?
Correct fitting, firm support, adjustable fastening, and nonslip sole reduces callouses and unsteadiness. Attention
paid to comfort (1vinch heels) and donning (long-handled shoe horns, velcro closure) make usage more likely.
There are a number of intrinsic factors to be considered.
Memory, orientation, attention, judgement, mood. Impairments resulting from drugs or alcohol. Wandering or aggressive
behaviours. Incontinence. Gait, balance, motor/sensory impairment, arthritides. Vision/hearing, hypotension/dizziness,
and seizures.
Occupational Therapists can assist in determining risk
by using various assessment tools. The Folstein Mini Mental Status is most commonly used. When indicated, Brief
Cognitive Rating Scale, Dementia Rating Scale, Cognitive Abilities Screening Test, Neurobehavioural Cognitive Status
Exam, and Geriatric Depression Scale can test for judegment, safety, and abstraction.
Morbidity associated with falls without apparent injury
that lead to fear, dependence, and disuse weakness is recognized. Input from a multidisciplinary approach is required
to fully assess risk of falls and to educate the individual and those around him/her.
"Preventing Mature Adult Falls"
When we are young, falls are a natural part of life, but
as we age, falls can be life threatening.
Falls are the number one cause of injury related death
for people over 65. According to the National Center for Injury Prevention and Control, one out of four people
who break a hip dies within six months, and another 25 percent need lifelong care.
Broken hips are one of the most serious results of a fall,
but broken ankles, wrists and feet are common as well.
Experts at the Huffington Center on Aging at Baylor College
of Medicine in Houston say while the fractured bones are a concern, it is the immobility caused by the falls that
does the most long term damage to an mature adult person. Immobility affects virtually every system of the body
and makes the normal effects of aging more pronounced.
As we age, we naturally begin to lose bone and muscle mass.
The loss can be compounded if a person is forced to stay in bed to recover from a fracture.
Since most falls occur in the home, there are steps to
take to lessen the risk:
Throw out slippery throw rugs, or place nonskid material
on the back.
Keep electric cords, telephone cords, newspapers and other
clutter out of walkways. In the bathroom, install grab bars or handrails
in the bathtub and by the toilet. And use a nonskid shower mat.
Make sure the home is well lit.
Put a strip of brightly colored tape on the top and bottom step of stairways.
Arrange items in cabinets to make them easier to reach.
Many falls can be prevented, and taking the necessary steps to "fall proof" a home can help older persons
continue to be independent and live in their own home with a new measure of safety.
Fire Safety for Mature Adults
Residential fires continue to be the main source of U.S.
fire deaths. Fires in residential properties account for 71% of all structure fires and 83% of all fire deaths.
Casualties occur in all age groups, but there are millions of Americans
against whom fire holds heavy odds. These are people with limited capabilities the very young, the mature adult
and the physically or mentally handicapped. Lacking the ability to cope effectively with fire accidents, these
persons require protective watchfulness from their families, friends and associates. The fire death rate among
these groups is three times that of the rest of the population.
There is an old saying in the fire protection field to the effect that fires have three causes: men, women and
children. It takes the careless or unwise action of a human being, in most cases, to begin a destructive fire.
In the home environment we live our daily lives amid flammable
materials close to potential sources of ignition. Several categories of the fire problem are well known to all
who work in the fire service and in fire safety education. These include:
Cigarettes
v carelessly disposed smoking materials, often dropped next to seat cushions in sofas or stuffed easy chairs; smoking
in bed; smoking while under the influence of alcohol, drugs or medication.
Portable heaters
v placed near combustibles such as curtains, furniture, papers and magazines; left unattended while functioning.
Cooking stoves
v clothing, hot pads and hand towel ignition, unattended cooking results in grease fires which produce burns.
Electricity
v faulty light cords or extension cords; overloading circuits and cords by running several appliances on them;
faulty appliances or misuse of appliances such as kitchen ranges for home heating; poor and inadequate maintenance
of electrical equipment.
Solid fueled Heating Appliances
v improper installation and maintenance, including creosote buildup in chimneys and flues; combustibles too close
and inadequate clearances.
Flammable Liquids
v used for starting or "refreshing" dying fires; used as a cleaning solvent in the home; improper storage
resulting in vapor leakage.
The threat of fire to the mature adult and handicapped
is often present in two scenarios. The first is the combination of simultaneously smoking a cigarette, sitting
in a stuffed easy chair or sofa and being under the influence of medication, stress or fatigue.
Hot ashes or the cigarette itself when dropped in the folds
of overstuffed furniture will result in a fire in two to four hours, usually after occupants have gone to bed.
The second scenario is clothing ignition, in particular while cooking.
The hours between 7 A.M. and 10 A.M. are statistically
documented as the time when most such disasters happen to the mature adult.
Loose fitting clothing, such as house coats and night wear,
are easily ignited by stove heating units. The mature adult are especially vulnerable because they may be living
alone and experience limitations in general mobility.
Several fire safety provisions are of great importance
in meeting the needs of the mature adult and handicapped. Special emphasis should be given to early warning smoke
detection near sleeping areas, escape planning, including easy access to exits, placing telephones with emergency
numbers near beds, close fitting clothing with short sleeves while cooking, and regular maintenance of heating
appliances.
Systems are now available which allow fire and medical
emergency alarms to be transmitted directly to emergency dispatch centers monitored on a 24 hour basis by trained
personnel.
The handicapped person requires the same fire safety information
as any other individual or group. The difference for the handicapped is in their response to a fire, smoke or heat
situation. The "correct" behavior will be the one that fire compensates for the specific handicap.
For the deaf person it means finding a way of sensing a
smoke detector's warning other than through sound and hearing. For the paraplegic it may mean learning an alternative
to the stop, drop and roll procedure in case of clothing ignition. Smoke detectors are now available which can
be equipped with strobe lights or bed shakers to alert the hearing impaired to fire situations.
Speech and/or hearing impaired persons may communicate
with emergency dispatch centers through special devices which transmit written messages by telephone. Handicapped
persons will need to develop escape procedures which take into account the extent of their disability.
For example, ramps may be constructed which allow wheelchairs
to exit the home. In the instance of the mature adult and handicapped, basic precautions and fire safety measures
which apply to all individuals or groups must be observed.
However, for these specific groups the need for prevention
and pre-planning is crucial and its importance must be emphasized.
We must all "learn not to burn."
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