As Bucks County's population continues to age, preventing falls is becoming increasingly important for older adults who want to remain healthy and independent.
Cindy Caldwell, a Bucks County Community College instructor who teaches fall prevention, shared Commonwealth of Pennsylvania data estimating that more than 32,000 county residents age 65 and older experience a fall each year. She also cited state data showing that adults 65 and older now account for more than 21% of the county's population, while nearly 72% of falls among older adults occur in the home.
Although the numbers are concerning, Caldwell, an occupational therapist with 25 years of experience in acute home care, said many falls can be prevented through simple changes around the home, regular physical activity and speaking up before a minor stumble turns into a serious injury.
One of the biggest obstacles to preventing future falls is that many older adults never tell anyone when they fall.
"The biggest fear I always found, especially in home care, is that they didn't want to say anything," Caldwell said. "They were scared to tell any of the professionals or family members that they had fallen because they were so scared that they would be taken out of their home and deemed unsafe."
Instead of hiding a fall, Caldwell encourages seniors to discuss it openly with family members and healthcare providers.
"I always tried to talk to them in a nonjudgmental way," she said. "I wanted to know that they fell and the details about it so that I could help educate them on how to prevent it."
She said family members play an important role in recognizing subtle changes before a serious injury occurs.
"Spend time with them in their home," Caldwell said. "Then you really see what they can do when they're walking around, taking them to the store or taking them out to eat. Spending time with them is critical because then you really see how they function."
If family members notice increasing weakness, balance problems or repeated falls, Caldwell recommends contacting the senior's primary care physician.
A physician can order home health services even if the individual has not recently been hospitalized. Nurses can review medications that may contribute to dizziness or low blood pressure, while occupational therapists evaluate the home for safety hazards and recommend modifications that help seniors remain independent.
"These professionals do a home assessment and really look at the home," Caldwell said. "Occupational therapists focus on the environment and modifications to the home that seniors don’t realize should be made."
According to Caldwell, the bathroom is one of the most dangerous places in the home because of hard surfaces and wet floors.
"The bathroom probably has the most incidences of falls because everything in the bathroom is very hard to hit," she said. "When people are getting in and out of the shower, it could splash water on the floor."
She recommends installing properly mounted grab bars, not towel bars, along with shower chairs, handheld shower hoses and nonslip shower mats.
"Sometimes people think it's OK if they just hold on to a towel bar," Caldwell said. "That's not enough. Instead of the towel bar, get a grab bar which is much more secure."
Other common hazards include loose electrical cords, worn carpeting, slippery throw rugs and poor lighting.
"As we age, we need more light to be able to see," Caldwell said.
She also encourages seniors to create visual contrast around stairs because declining eyesight can make it difficult to distinguish the last step.
Even everyday habits can increase the risk of falling. Caldwell recalled one client who routinely placed newspapers on the floor beside a chair.
"It was just a habit we had to really try to break," she said. "We gave other options of where he could put his papers so it was safer."
Blankets hanging over the edge of a bed can also become tripping hazards, particularly for seniors wearing rubber-soled shoes.
Maintaining strength and balance is another important part of fall prevention.
"Our muscles decline as we age," Caldwell said. "Making sure you're active and going to SilverSneakers or going for walks with your friends in the park, or any exercise as long as you're safe while doing it, is important."
She also recommends having handrails on both sides of stairways whenever possible, especially for individuals who have weakness on one side of the body.
Proper footwear also makes a difference.
"Anything you have on your foot should be secure on your foot," Caldwell said, noting that open-back slippers and flip-flops can increase the risk of slipping.
Although most falls happen indoors, Bucks County seniors also face risks outside the home.
Tree roots can create uneven sidewalks, while grass, gravel and stone walkways at parks, festivals and community events may present additional challenges. During the winter months, black ice can make even familiar walkways dangerous.
"When going to outdoor community events, take a look at what you're walking on," Caldwell said. "If you are having balance issues, make sure you have somebody with you. You could walk arm in arm."
She also encourages seniors to use canes, walkers or walking sticks whenever they need them.
"Some people don't like to go out in the community with a device because they feel self-conscious about it," Caldwell said. "People think of it as a detriment, but this equipment is allowing you to be independent. It's just a tool so that you can be safe."
Caldwell said Bucks County seniors have access to numerous programs that promote balance, strength and safe mobility.
SilverSneakers fitness classes are offered through many local YMCAs and fitness centers and are often covered by Medicare Advantage or other insurance plans. Local senior centers also provide exercise programs designed specifically for older adults.
The Bucks County Area Agency on Aging offers fall-prevention resources, educational programs and referrals to services that help older adults remain safely in their homes.
Ultimately, Caldwell said the most important step seniors can take is speaking up before a fall leads to a serious injury.
"If I could give Bucks County seniors one piece of advice," she said, "I would say don't be too proud to ask for help.”
By recognizing potential hazards, staying physically active and asking for help when needed, Bucks County seniors can reduce their risk of falls while continuing to live safely and independently in their own homes.
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