Home Safety for Older Adults

By Carole Larkin and Elaine Wiant

We’ve written about Medicare Prescription Drug Plans (see www.theirvingjournal.com, July 15 and August 1, 2005 issues or www.thirdageservices.com). In this article we turn to home safety for older adults.

Q. My Mom lives alone. What can I do to make sure that she takes her prescription and over the counter drugs properly?

A. A good tool for monitoring medications is a daily or weekly pillbox. These pillboxes are available in various sizes and shapes at drugstores and grocery stores. If you can visit weekly, make sure the medications are put in the pillbox. If Mom can’t remember to take medications, give her a daily reminder call.

Q. What is the most important thing I can do to ensure home safety for my Mom?

A. Take a walk through the home as if you were Mom. If she has poor vision or is hard of hearing, has a balance or mobility issue, has memory problems or other cognitive complaints, then what she sees, hears and feels is not the same as what you see, hear and feel. Walk around (without Mom to distract you or to rationalize an unsafe condition) the house and look for accidents and danger zones in the making. Think about needed changes. Take this walk. Make a list. Check with an expert in eldercare home safety if you’re not sure whether the condition you see is safe.

Q. What should I look for?

A. Each of the five senses – vision, hearing, touch, taste and smell – can deteriorate with age and that deterioration can lead to safety issues. Let’s take vision first.

• Depth perception can decrease even without specific eye problems such as glaucoma or macular degeneration. Floor coverings that are patterned can add to the depth perception problem. Consider replacing “busy” floor covering with a solid color. Create color contrast between the floors and the walls.
• Light should be evenly distributed throughout the house. Glare and deep shadows add to distortion of depth perception. Replace regular light bulbs with “soft” or frosted light bulbs. Use the same or similar wattage throughout the house to reduce glare and even out the light.
• If the house has stairs, mark the edges with contrasting edging or tape to highlight the elevation change. Put a light switch at both the top and bottom of the stairs. Extend handrails beyond the first and last steps.
• Nightlights in hallways are as important as the nightlight in the bathroom, even if the master bedroom has its own bath.
• Motion activated lights should be installed at BOTH the front and rear entrances to the home and positioned to light the door entrance itself. They can also be installed in interior hallways, the kitchen and in bathrooms.

Q. What about hearing?

A. We usually think of hearing as a safety issue outside the home (driving a car), but consider these home safety issues:

· Smoke detectors. Consider buying a detector that has a flashing light feature as well as sound.

• Telephones. Simple devices are available to make both the ringer and the voice at the other end of the line louder so Mom can answer and talk on the phone. This type of device will be used! Hearing aids are often purchased, and lay in a drawer unused. Monitoring devices or a baby monitoring system are appropriate for bedfast or minimally mobile elders.

Q. What about the sense of touch?

Be aware of the changes in the body of an older adult. The skin is thinner and more fragile.

• Water heaters set at 150 degrees will burn an older adult’s skin. Reset the water heater to 120 degrees to help avoid burns from scalding tap water.
• Pad the sharp edges of furniture to help avoid cuts or big bruises. If you can’t pad the edges, try sanding them down as much as you can.
• Older adults often do not feel pain when cut or severely bruised. This can lead to infection or worse if not attended to by a medical professional. Without pain, many elderly dismiss the seriousness of burns and cuts. Ask to see the skin on arms and legs. If you see a cut or bruise ask about it, and determine what else was affected.
• Certain tools may no longer be appropriate. Watch dexterity with eating utensils. If this is not good, you can assume that it is not good with sharp tools. If Mom or Dad has trouble lifting and controlling heavy objects (over 10 lbs) you can assume that they can’t control heavy tools, or deal with machinery. Using a hammer may be appropriate, but not a saw. Now may be the time for you or someone else to be doing those things for them.

Q. What about smell and taste?

A. Both the ability to smell and taste is dulled with age. You need to be alert to smells when entering the front door, the kitchen, the bath, and the garage.

· Check the smoke detector frequently, Mom may not smell smoke from a house on fire.

· Check the refrigerator at least once a week. Mom may not be able to smell or taste when food has gone bad. Keep a list of emergency numbers by the phone and include poison control (1-800-222-1222 or 911).

· Smell the bathroom for sour or musty smells, older adults can get infections easily from use of soiled articles on open cuts (from shaving and otherwise).

· Smell the garage for odors from gasoline or from hazardous materials stored there. Inspect the containers, even if you don’t smell anything, as sometimes hazardous materials have NO smell.

· Check pet food and waste areas. If they are dirty, this could be an indication that other areas of the house that need regular cleaning are not being attended to either. Infection, asthma and other respiratory issues can result from bacteria in the air. If necessary, hire a cleaning service. Smell the pet! If the pet smells bad, hire a service to come to the house and bathe the pet.

Q. I don’t live near Mom. How can I make sure these safety checks are done on a regular basis?

A. If you don’t have someone near Mom who can check on her weekly, you can hire a Geriatric Care Manager or other eldercare professional to look in on her and monitor safety and other concerns.

Q. Any final words on safety?

A. We can’t conclude without repeating these warnings for caregivers of older adults:

· Floors should be non-slip surfaces. Use non-skid wax on hardwood floors. Tack down or remove area rugs. Install low rise ramps for elevation changes between rooms. Install ramps at front and rear entrances to the home.

· Bathroom safety means non-skid mats or decals and a shower stool in the tub; grab bars in the tub and shower and next to the toilet or an extended toilet seat with rails.

· Monitor medications using the daily or weekly pillboxes.

· Make sure electric cords are out of the flow of traffic.

· Keep a flashlight within reach of the bed.

· Avoid clutter!

· Place emergency phone numbers lists in the bedroom, the kitchen and the bathroom.

Q. What resources are available to help me with these suggestions?

A. Call 211 -- the social service agency helpline. Contact the Callier Center at the University of Texas at Dallas (214) 905-3010 for hearing issues. Check www.thirdageservices.com for links to additional resources.

Our next article will address special precautions that need to be taken with a memory-impaired older adult in the home.

Carole Larkin is a Geriatric Care Manager with an M.A. degree in Applied Gerontology from University of North Texas. Elaine Wiant is a Certified Fraud Examiner and Fellow of the Society of Actuaries. They are owners of ThirdAge Services LLC, a provider of care services and financial services to older adults and their families and friends.

Contact ThirdAge Services with questions or to request a speaker for your organization at 214-649-1392 or clarkin@thirdageservices.com.