Slip, trip and fall prevention:

        Can you remember a time when you had a bad fall or tripped over something in your path? It happens so fast! Were you able to recover quickly or did it take a while? Falls are the leading cause of injury and death for older people. They are the most common cause of non-fatal injuries and hospital admission for trauma. When an older person falls, his/her ability to function physically can be decreased and he/she may become permanently disabled. This loss of independence can lead to further decline in physical abilities, depression, feelings of helplessness and social isolation.

What are the common causes of slips, trips and falls?

        Think about a time when either you or someone you know slipped, tripped or fell. How did it happen? Take a look around the room you are in now. Do you see any hazards that could result in someone tripping, slipping or falling?

        Some of the common causes of falls include the following:

1. Frayed carpet and slippery rugs.
2. Loose tiles or lifted edges of floors.
3. Wet floors.
4. Cluttered hallways or paths.
5. Shoes, slippers or socks that are slippery.
6. Ice or snow.
7. Poor lighting, including burnt-out light bulbs.
8. Loose or missing handrails on staircases.
9. Slipping in bathtubs or showers.
10. Trying to get out of bed or a chair without necessary assistance.

        Other hazards are unlocked safety brakes on wheelchairs and broken walkers or canes. These are all devices that may be used by older persons to assist them in remaining as independent as possible. The risk of falls increases when older persons take medications that cause drowsiness or dizziness or have physical weakness and walking problems.

What can the direct care staff person do to reduce the risk of slips, trips and falls?

If you think about the causes of slips, trips and falls, you will think of answers to reducing them. For example, if throw rugs cause tripping, remove them and replace them with safer carpeting or non-slip flooring. Let’s look at some additional ways to reduce slips, trips and falls:

• Use wheelchairs to provide safe mobility.
• Encourage clients to use grab bars, raised toilet seats, adjustable bed heights and handrails in hallways to help them get up and down and move from one place to another safely.
• Make sure all cords, including extension cords do not lay where people walk.
• Remove hall clutter.
• Check to see that stairways are well lit so that each step, particularly the step edges, can be clearly seen by the clients while going up and down the stairs. The lighting should not produce glare or shadows along the stairway.
• Use the maximum wattage bulb allowed by the light fixture. If you are uncertain about the recommended wattage, use a 60-watt bulb or lower.
• Do not store anything on the stairs, even temporarily.
• Ensure that handrails are sturdy and fastened securely on both sides of the stairway.
• Help clients remain mobile by encouraging them to do exercises that build up leg muscle (walking, tai chi, etc.). This is one of the best ways to prevent falls.
• Use rubber mats and slip-proof tub mats inside and outside bathtubs and showers.
• Be attentive to the client’s need for assistance to get into or out of bed and in and out of a chair.
• Keep a night light on in the client’s room so they can get to the bathroom safely. (Nighttime rising to go to the bathroom is a common time for falls.)
• Wipe up spills immediately – liquids, snow, mud, sugar, salt, powder.
• Keep frequently used items easily available – telephone, remote controls, tissues, etc.
• Clear walkways of obstacles.
• Install grab bars in bathrooms and hallways. Encourage the care recipient to use them.
• Remind the care recipient to wear proper footwear with rubber soles. 
• Lock the wheels on wheelchairs when transferring.
• Encourage exercise to maintain strength.
• If the care recipient has pets, watch for them when walking.
• Make sure the furniture is the right height. Armrests are helpful for getting in and out of chairs.
• Check stairways for clutter, handrail stability, step width, and safety.
• Don’t move any of the furniture. .
• Remind the care recipient to allow enough time to get to the bathroom for toileting so he/she doesn’t have to hurry.
• Remember safety outside of the home. Check lighting, steps, handrail stability, and for items the care recipient could trip on.

        Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. Whenever you observe any safety hazard, follow the agency policy for reporting it.