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The Caregiver’s Guide to Understanding and Prioritizing Aging-in-Place Accommodations

Rose Wilkins - Ability Home Pros

An article about creating a safer environment for aging-in-place seniors:

Aging in Place is the Preference of Many

Most people want to carry out their golden years aging in place. In other words, they’d like to continue residing in their own homes for as long as possible. According to SeniorHomes, 70 percent of seniors already spend the rest of their lives where they celebrated their 65th birthdays.

That number is likely to increase as the United States Census Bureau has indicated the population of those 60 and older will go from 43,043,000 in 2005 to 73,769,000 in 2020, which itself would be a whopping 71 percent increase. The Census Bureau also projects the population of those 85 and over could grow from 5.3 million in 2006 to 21 million in 2050.

The website for The Centers for Disease Control and Prevention has guidance on “healthy places,” the label it gives to communities that are “developed, designed and built to promote good health.”

It describes aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” As a caregiver, your job is to make sure that you can help the resident do just that to the best of your ability. It starts with understanding and prioritizing aging-in-place accommodations.

The Top Cause of Injurious Death Among Seniors

The CDC has indicated that falling is the leading cause of injurious death for seniors, and it goes without saying that those aging in place are at great risk, particularly during those times when not in the company of caregivers, friends, or family. To say that addressing fall prevention should be a top priority is an understatement.

According to the CDC, one out of three people 65 and over falls every year, and less than half of them actually tell their doctors. This is even more problematic as falling once is said to double the likelihood that the person will fall again.

Over 700,000 people are hospitalized each year due to an injury related to falling, it says. The most common are head injuries and hip fractures with the latter putting 250,000 elderly people in the hospital each year. Over 95% of hip fractures are a direct result of a fall (typically a sideways fall), and falls are the number one cause of traumatic brain injuries (this again from the CDC).

Over half (55%) of all falls occur inside the person’s dwelling, and over three-fourths happen either inside or close to the home.

Even in cases in which a senior falls, but does not injure himself or herself, many can’t get up without assistance. According to LearnNotToFall.com, this is the case for as many as 47% of non-injured fallers. This can present its own set of problems.

“For the elderly who fall and are unable to get up on their own, the period of time spent immobile often affects their health outcome,” it says. “Muscle cell breakdown starts to occur within 30-60 minutes of compression due to falling. Dehydration, pressure sores, hypothermia, and pneumonia are other complications that may result.”

Not only are falls dangerous and detrimental to a person’s health, but they’re also incredibly costly. Another noteworthy piece of data from the CDC’s batch of stats is that the direct medical costs for fall injuries are $34 billion per year with hospital bills accounting for two-thirds of that.

Residents may fall for a variety of reasons, including (but not limited to) lower body weakness, vision problems, Vitamin D deficiency, tripping, poor balance, sore feet, or medication. When so many variables can result in the same outcome, it’s no wonder that falls are so prevalent among the elderly. You must take every possible precaution to reduce the chances of this happening to those in your care.

Prioritizing Aging-in-Place Accommodations

When it comes to aging in place, there are a lot of potential home modifications to consider for the resident. While not all of these are directly related to the dangers of falling, many are, and if you can prioritize these, you’ll be helping prevent the most common types of injuries that can lead to the deaths of seniors.

Below, we’ll walk you through some areas you should be prioritizing specifically to prevent falls and help seniors age in place in a safer and therefore more comfortable (for the long term) environment.

Remove Tripping Hazards

Let’s start simple. Out of all precautions related to fall prevention, this is perhaps the easiest to implement and is basically self-explanatory. According to the National Floor Safety institute, half of all accidental deaths in people’s homes are caused by a fall, and that’s not even just among the elderly.

Most fall injuries in the home, it says, happen at ground level as opposed to from an elevation. In other words, people are more likely to fall and hurt themselves while they’re just walking around the house as opposed to being on the stairs, on a stool, or from some other point of elevation.

Removing items that can lead to trips is a no-brainer.

There are a lot of different types of materials people can trip over. Start by removing any rugs or other portable floor coverings (like mats) from the premises unless they’re in place to prevent slips. These can be tripped over or can slide underneath the resident’s feet. They’re a recipe for disaster that can be easily prevented.

Look for any cables and cords that are exposed and make sure they’re tucked away and out of any potential path of walking. A simple adjustment such as moving a cord behind a piece of furniture could actually save a life.

Look for any other items the resident might have lying or sitting around on the floors throughout their home and remove them or place them in a safer spot. The less obstacles the better, and when aging in place, this is an absolute must on the checklist. Considering the ease of which this can be implemented, we’d recommend this as your top priority as it can be done quickly and for no cost whatsoever.

Address Slick Floors

According to the Consumer Product Safety Commission (CPSC), floors and materials related to floors directly contribute to over 2 million fall injuries every year. For a person aging in place, slick floors are a constant threat that can lead to a trip to the hospital (or worse).

The most common areas in a home that are likely to have slick floors are the kitchen and the bathroom, though depending on the material of the flooring (not to mention any spills), this can be a threat in any room.

When possible, slick floors should be converted to carpet or textures with more grip that the resident can get better traction with as they walk through their home in footwear or bare feet. If replacing the floor of a room isn’t a feasible option, there are other measures that can be taken.

Powr-Flite cleaning trainer Mike Englund says at CleanLink, “The most common reason a floor may be slippery is that it simply has not been cleaned properly or as frequently as needed. Many slip-and-fall hazards are eliminated just by properly cleaning the floor and using the right tools, chemicals, and equipment.

“In some cases, a slippery floor may need to be stripped and refinished,” he said. “But, before going through all that trouble, machine scrub first. Oftentimes, this will remove any soiling or film on the floor that may be causing it to be slippery.”

“Always clean wood floors with cleaning solutions designed for the type of floor you have. Using the wrong cleaners leaves a slippery residue on wood. If you can’t find an appropriate commercial cleaner, clean the floors with a vinegar solution,” says Stephanie Mitchell for SFGate, who recommends mopping a wooden floor with a solution made of one part vinegar and two parts water.

Mitchell, who separately provided SFGate readers with advice for preventing slippery kitchen floors, wrote, “Apply a non-slip floor treatment if your kitchen floor is made of a suitable material, such as porcelain or ceramic tile or travertine concrete. These products invisibly etch the surface of the floor and make it less slippery when wet. Check the product’s instructions to make sure it is usable on your floor.”

You may also want to look into anti-slip floor coating products such as non-skid floor waxes. There are a variety of such products on the market, and they can be purchased for relatively little money.

Safer Stairway Navigation

If there are no stairs or steps whatsoever in the resident’s home, than this is a huge burden removed by default. Many seniors who have lived in multi-level dwellings have elected to age in places that do not have stairs, and with good reason.

According to the National Safety Council, over a million injuries happen every year as the result of falling on or down stairs. Such accidents represent the second leading cause of accidental injury (after car accidents). According to the council, there are 12,000 stairway accident deaths every year. Naturally, this is a serious threat to senior citizens.

Unfortunately, many seniors do live in homes with stairways, and must navigate up and down them on a daily basis. In such homes, there are a number of precautions that can (and should) be taken to reduce the likelihood of an accident.

For starters, all stairs, both indoor and outdoor, whether full staircases or a smaller number of steps, should have handrails. If possible, they should have rails on both sides. Rails should also be examined to make sure they are secure and not loose at any part.

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