Falls Prevention Awareness Day is September 22, 2021, and September 20-24 marks Falls Prevention Week. We at Caregiven want to honor this month with awareness and understanding. Let's start with a personal caregiving story that I am living right now.
My mom, who just turned 79, recently sold the house she lived in on 15 acres of Oregon farmland-- this is the same home where she and my father made a life together for 30 years. Her choice to buy a little house in a senior care community could not have been an easy one. While I can only imagine the bravery in her decision, part of my reflex is to be a gold star daughter who comes in and makes the place super safe for her. After all, I'm the CEO of a company in the caregiver space, and I should be an expert (or be able to find an expert).
In response, my mind narrowed in on two questions:
How can we make her new home a place where she lives longer AND she's safe?
What preventative planning and safety measures can we do before she moves in?
The house she chose is in a senior community and has considerable design features for older adults: wide door frames, knobs instead of levers (for dexterity issues), windows lower to the floor (to preserve views for the bed-bound), and many other modifications to help people age in place. But this house still needs some additional safety refinements, in my opinion.
Where I see a chance for new life hacks, my mom sees technological intrusion and further reducing her independence.
For example, recently, I was geeking out about a "SMART" light fixture with motion detection technology that can read rooms to see if somebody has fallen and notify help. I said, "Mom, this is my industry." She did not share my enthusiasm. My mom is fiercely independent and mowed two acres with a push mower until the month she left her house; perhaps I didn't sit with that fact long enough.
Our conversation patterns went like this:
Me: Let's spend the money now to get the place perfect before you move in, just in case.
Mom: No, no, we'll put that in when I need it.
As often happens in the child-caregiver and parent-loved one dynamic, the winds of our respective fears swirl into a big, fat, emotionally charged fear tornado. What should be a straightforward process grows more and more emotionally complicated. In our case, the tornado touched down on the topic of new flooring. Mom wants new hardwood floors and has managed her finances well so that she can afford them.
I want the luxury vinyl floors that look like wood but have a gripping texture to help prevent falls. She wouldn't have any of it. And there we were, together -- stalemate.
We are both right.
Why Falls Prevention Matters for Mom
For the elderly, falls are a genuine concern for a variety of reasons:
Falls are dangerous and can be deadly for seniors. You fall, break a hip, and need a hip replacement -- that's major surgery.
Fall treatment is expensive; a single fall can cost upwards of $30K in medical treatments.
With a senior's typically slower recovery time, that fall and surgery can start a chain of events that strip their confidence and quality of life.
Falls can be preventable with regular visits to an elder care doctor and installing helpful home safety features.
We want to include some statistics to help frame the issue:
Over 25 % of older people fall each year, but less than half tell their health care provider, according to the (CDC).
Falls account for 2.8 million older people's emergency department visits each year and over 800,000 hospitalizations.
20 % of these falls are severe, with a broken bone, head trauma, or similar injuries.
Falling once doubles your chance of experiencing another fall in the future.
As many as 300,000 older people experience hip fractures each year, and 95 % of these fractures result from a fall.
Over 27,000 older adults die from unintentional falls annually, reports the CDC.
These numbers are eye-popping without considering the preventability of most falls. But, as with most parts of the human condition, it’s never that easy.
How to Reach Common Ground
Looking back, I can see that the stalemate between my mom and me resulted from not considering the other's perspective. As Atticus Finch would advise, “You never really understand a person until you consider things from [their] point of view.”
Maybe I could've ended it sooner by starting a conversation rooted in empathy by saying something like: "I know you want to be in control of planning your new house, but these home features can further your independence." And maybe I could've known that even this approach might not have been well received.
The truth is that someone like me, a leader in the field, struggles with these same limitations as many of you. None of us have an answer, but I know what you're facing.
So, how do we have these conversations?
Maybe by being very, very real. By holding that clash of wanting to take care of and support them and see it through their eyes, and then honor where our parents stand in their aging alongside our fears.
A lot of families go through the fear of a tornado touching the ground, but that is okay. When my mom looks at me, she sees the eight-year-old girl who didn't want to go away to gymnastics camp who now wants to give her advice on living and designing her house. I don't want her to see me that way, but I also want to use my experience to protect her.
Products, Apps, and Solutions We Love
As caregivers and children, we want our parents to live independent, physically, mentally, financially, and emotionally rich lives as they age.
To help with the tornados and messes human emotions bring, there are fabulous technology solutions to install in a home related to fall preparation and safety.
WalkWise uses technology for remote walker use and activity/safety monitoring of routines and helps to identify safety issues.
Nobi's smart lamps have fall detection that notifies trusted contacts. Nobi focuses on fall prevention with smart lighting and risk prevention, as well as other safety features.
FallCall pairs with the Apple Watch to report falls with smart fall detection technology + a personal emergency response system designed for Apple Watch.
Silver Spaces offers home assessment as the new and convenient way for anyone to assess universal livability in a home.
What About Other Fall Prevention Programs?
According to the World Health Organization (WHO), an effective fall prevention program aims to reduce the number of people who fall, the rate of falls, and the severity of injury if a fall happens.
Clinical interventions mitigate risk factors with medication review and modification, treatment of low blood pressure, vitamin D and calcium supplementation, and treatment of correctable visual impairment. Group programs may incorporate fall prevention education through other methods like Tai Chi-type exercises or dynamic balance and strength training.
If you are helping care for someone who has physical, medical, or other risk factors or has a history of falls, here are several topics to think about to build your fall prevention toolkit via an article from the National Council on Aging:
Screen living environments for fall risk
Do a home assessment
Make environmental modifications
Address physical and sensory impairments with appropriate assistive devices
Sharing My Learned Lessons and Finding Common Ground
When I was pregnant with my son, my mother-in-law was adamant that we use flushable diapers. She went out and bought them for us. I was resentful of what I thought was an intrusion even though she'd raised a child. Those diapers could have been the best thing in the world, but resentment followed because I felt forced toward them.
I now realized that I am doing the same thing to my mom with her floors. I don't know if it's the nature of child-parent relationships, but understanding that this dynamic exists is essential for reaching a mutual agreement and not feeling resentment.
One piece of earned wisdom from my work in the caregiving industry is that the starting point of your particular situation with a loved one is first to try and remove your ego. The goal is to help one another, but that is lost unless we approach with an empathetic mindset, not only for a loved one but ourselves as children and caregivers.
As children, we can be generous and selfish in the same instant. I want to make my aging mother's home safer from falls and be free from worrying about her. On her side, she wants to maintain independence as long as possible. We are two sides of the same coin.
So, what about my mom's flooring?
After pushing and trying and trying to intercede, I failed on my terms. I withdrew and felt petulant. Then, a week or so later, she sent me an email. In it was the picture of the flooring that she chose with a comment saying, "Yes, it is textured for gripping."
I should have all the answers, but I don't; however, some of my advice did resonate with her. If we tell our stories honestly and with willing vulnerability, we can help one another. There was a happy ending or at least as good as we're going to get.
I know that it is a good place for us both to start.