HEALTHY AGING

     Many of these risk factors are modifiable, which mostly fall under the behavioral changes and environmental modifications category, and we can implement some fall prevention strategies to reduce the fall rate. There are a number of steps that can be taken to reduce or prevent falls in the home. These include [2,3,5,6]:

- Use of non-slip mats inside and outside of shower.
- Installing raised toilet seat to  make it easier to use.
- Installing grab bars by the toilet and shower area.
- Use of non-slip mats.
- Remove ottomans, coffee tables, walk around furniture etc.
- Make sure the path from bed to bathroom is unobstructed.
- Adequate illumination, replace 60W bulbs with 100W bulbs, light switches should be easily accessible, nightlights in bedrooms and areas               leading to bathrooms, and good lighting in stairwells.
- Stairways should be clear of clutter which can cause falls.
- Handrails should be installed on both sides of staircase.
- Always make sure you have a clear view of where you are going, specially if you are carrying something up or down the stairs.
- Make sure that tables and lamps are stable everywhere.
- Make sure to put on clothes and shoes in a sitting position.
- Don’t rush to answer the phone and try to use a cordless phone.
- Wear supportive, non-slip footwear.

Outdoors
     > Make sure railings and stairs are secure. Install railings on both sides of outdoor stairways.
     > Make sure pathways are clear of clutter such as tools, leaves, snow shovels etc.
     > When carrying items into the house make sure they are in small amounts. If necessary make a few trips back and forth from the car to the             house and back carrying smaller items.
     > Make sure there is salt always available near the doorway to use in winter for slippery conditions.
 
In the kitchen
     > Wipe up spills immediately.
     > Use non-slip floor wax.
     > Everyday items should be placed on shelves that are easily within reach.
     > Always ask for assistance if something is out of reach and never try to climb up something to reach for it.
     > Make sure that there are no extension cords in the pathway.

     WHO suggests three approaches with respect to strategies to fall prevention. These three approaches are Awareness, Assessment, and Intervention. Awareness encompasses the fact that falls among seniors is not a natural consequence of aging, as is believed to be the case in some cultures. Assessment is the process of screening those seniors who are most-at-risk of falling, like those with conditions such as advanced osteoporosis, or those who have gait disturbances or are on multiple medications. The assessment can be done through a series of questions referred to  as SPLAT questions. SPLAT stands for the following five questions [6]:    

     S: Symptoms at the time of the fall, like dizziness.
     P: Prior falls. This could help in identifying chronic or recurrent risk    factors.
     L: Location of the fall.
     A: Activities at the time of the fall.
     T: Time of the day when the fall occurred.

     Intervention refers to strategies like home safety checklist as was described earlier, monitoring of medication usage, environmental changes, exercise program if there is a concern with any specific muscle, assessing the individuals readiness for change, providing regular and encouraging feedback, etc.     

       It is also important to be able to motivate an individual to implement fall prevention strategies into his/her life. This could be in the form of making sure the person knows what the consequences of a fall could be. Or benefits of exercise could be pointed out like lower blood pressure, sleep improvement, improved body shape, better sex function, enhanced endurance and flexibility, etc [4].

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