Versatile Methods for Fall Prevention in the Home

Demographic studies, white papers, statistics, graphs and charts—we’ve seen them, heard them and even presented them to audiences of HME providers just like you. The undisputed fact is that the need for independent living/home accessibility is a rapidly growing opportunity for all in the HME/rehab marketplace. And don’t leave out other opportunities, because your target audience is not only the aging boomer population, but also anyone dealing with problems resulting from any physical disability.

Power Access allows wheelchair and scooter users to open doors to independence with ease.

As you look at accessibility issues for your clientele, keep an open mind and an open ear. The entire home—inside and out—has potential mobility/maneuvering obstacles as well as safety issues to address. Look for the obvious and listen for the subtle hints for help with these issues. They often seem minor in nature, but can make a world of difference to your clients. Falls are the leading cause of injury among the aging population. By aging, I mean those mature in their years, as well as those commonly referred to as the elderly. Most falls happen in or near the bathroom area, yet many times also occur in other areas of the home. The bathroom is the area of natural/common concern and too often becomes the only focus for families and accessibility professionals. For those using wheeled mobility devices, the concerns are maneuverability, transfer, entry and exit, which encompass much of their immediate needs. But for those who are ambulatory to any degree, issues in connection with safety and the reduction of falls become far more important. In these cases, the entire home atmosphere comes into play, with minor changes that can make a huge difference for your client. As you look around, take into consideration the floor coverings, lighting, security and available helpful aids for any room in the home. Ambulatory issues may often lend themselves to several product possibilities to help your client feel safe within their home or simply assist them in their everyday lifestyle. They want to use their entire home, and as you will find out, product vendors have been working to develop products to answer that need in an aesthetically pleasing fashion to fit the home atmosphere. Grab bars and their fashion lines are of utmost importance in the bathroom. They fill the need well and have become widely accepted by all ages. Advanced aesthetic designs offer a selection of towel rods or toilet paper holders that can now be used in areas where the traditional grab bar would once be considered out of place. The common needs for a grab bar—stability and assistance—can be useful in places other than the bathroom. Rob Geller, Promenaid Handrails (promenaid
.com), believes it’s also necessary to look at hallways, stairways and anywhere that a secure handhold might be useful. Geller says, “A house is a home when you feel safe, comfortable and can go wherever you want to go.” The unique design and mounting capability of grab bars allow for a smooth and safe transition from a scary pathway to one of security and more frequent use by your client. The possibility of a continuous yet smooth handrail system is an innovative solution to traditionally difficult and time-consuming installations. Safety comes in many forms offering many solutions. When looking at a client with ambulatory issues, put yourself in their shoes and consider that client’s instability, degree of vision clarity, safety from exterior and interior hazards and their overall hope to be less of a burden on loved ones. All of these factors should be discussed during the home assessment process. As previously mentioned, grab bars and handrails are definite aids for instability, but when looking at the entire home and your client’s condition, also consider possibilities that may prevent a fall or make for a more user-friendly environment. For many, vision impairments are a fact of life. But for those having difficulty with ambulation, help with lighting can be a welcome adjustment. Checking for proper lighting in relation to brightness and placement can make a world of difference to someone living alone. Any dimly lit area of the home can lead to an accident. 
Motion sensors, especially for outdoor areas and entryways, and large paddle-style light switches can also be introduced. Area rugs are a concern for risk of falling in the home. Not only can they become caught in the feet or wheels of a walker, but these rugs also tend to slip easily and bunch up underneath shuffling feet. While clients may consider their looks or design as an enhancement to the home’s decor, removal of these loose rugs should be considered. A close-nap carpet or other nonslip flooring are much safer options. Along with the flooring issues, clear and adequate space should be discussed. Room clutter and movable obstacles are areas of concern for those using wheeled mobility products or ambulatory aids. Close quarters and blocked pathways lead to difficult maneuvering, possible future injuries and likely damage to walls, doors and furnishings. A recommendation to clear the clutter is a good suggestion. Security systems, along with health and activity monitoring, are possible solutions for those who don’t want to be a bother to their loved ones and families. Innovations and new product releases in this technology field happen quickly, and products/systems are being introduced 
by many big-name suppliers and special niche companies as well. Nearly 40 years ago, Philips Lifeline (lifelinesys.com) entered the medical alert service industry with one mission—to help customers live independently and confidently. Their system now includes far more than a pendant to press for help when a fall occurs. An auto medication dispensing service is another way Philips 
has advanced its line of monitoring 
products.

PromenAid handrails feature support brackets that can be easily installed in any location.

Other systems monitor activity within the home. Sensors that monitor daily movements and activities will confirm with family members that their loved one is having a normal day of activity within the home. Monitoring motion, door functions, cooking, water usage, lights, etc., Lowe’s home-improvement stores (lowes.com) have entered the industry in a large way with customized wireless monitoring of the home environment in the form of its Iris system and care service program. These types of systems are becoming very popular with out-of-town adult children who worry about older parents living alone. The industry surrounding complete home monitoring is predicted to grow by leaps and bounds as the demand rises and new technologies are developed. Another area of concern is doorway entries and exits. Clear opening space to ensure ease of door operation and smooth transitions to make for a safer and manageable entry and exit process are both necessary. We are all aware of the recommended five-foot turning radius for any wheeled mobility device, but this also applies to those with ambulatory issues. A clear area on both sides of a door makes entry and exit much more effortless and safe. As far as the door itself, many have found that a power door opener is a welcome addition to their active lifestyles. Power Access (power-access.com) has been affecting lives since 1978—with products designed not only for those with wheeled mobility, but also for anyone with diminished strength or difficulty in ambulating. A real sense of security is inherent as these openers self-lock with power operation, but also act as a normal door for family members and caregivers. Your evaluation of all entry doors should also include a look downward to the threshold. It doesn’t matter if it’s a normal swing door or a sliding patio door—if the entryway is important to your client, then it’s important to you. Many times the height of a threshold can be an obstacle, hazard or deterrent to the use of that passageway. Simple solutions to these barriers are available and easy to install. EZ-ACCESS (ezaccess.com) offers doorway transitions of all sizes for easy installation and a quick solution to common accessibility problems. Doors also present other obstacles in their method of operation. Traditional round door knobs are often difficult for many to operate, either due to lack of grip strength or the lack of wrist rotation ability. A simple fix is to replace the round styles with lever-operated handles. Lever handles fall in line with ADA practice and Universal Design 
parameters. The physical door opening or width of the opening are other problems presented by doorways. Often, a piece of wheeled mobility is slightly too wide to fit through the door freely or not at all. One option to correct this problem is to install a set of full-swing hinges. These will allow about 1.5-1.75 inches of additional opening width to any swinging door, often allowing a much easier transition through the entry. These hinges can be found at almost any large chain home-improvement store and are typically available in either a silver or brass finish to match the home’s existing decor. Personal safety, accessibility and simple peace of mind are all major components of any home assessment. The accessibility professional of today is certified and educated to help those in need. The Certified Environmental Access Consultant (CEAC) is a recognized certification and a symbol of competence that separates the accessibility professional from a para-professional trade. Manufacturers, vendors and industry consultants/associations are there with answers and solutions. The market is growing and the technology is advancing. Real and viable solutions for independent living strategies are available and the options are abundant. Be a part of this exciting market for accessibility and open your eyes to the possibilities that lay ahead. This article is part of a 12-month home accessibility series. Each segment will focus on a particular aging-in-place need to provide the insight and resources necessary to be successful in this growing market. Read all the articles in this series at www.homecaremag.com/unlocking-accessibility.