What we Want and Why it Works
As we age there are many things that we want and need. Two of the most prominent of which are the desire to maintain our independence and, at least most of the time, trying to find ways to remain both as physically and psychologically comfortable as we can. As we watch ourselves and the people we love age around us another significant desire is also raised, safety.
Sometimes, when we look at the methods and products available to meet these goals it seems impossible to obtain without having to choose between them. For example, how can anyone be comfortable sitting in a shower chair made of cold hard plastic even if it will help keep you safe from falling in the shower? Do you have to sacrifice comfort for safety and independence? I would suggest not.
As a Registered nurse with over 10 years of experience working with seniors in their day to day lives I have had both the privilege and challenge of researching and trying many ways to help my clients meet these goals in their everyday lives. Over time I have learned that independence, comfort, and safety are not, nor should they be mutually exclusive. In fact, in many cases you can have all three.
In this article I will briefly look at each of these three goals as they impact real life and explore just how they can work together in many cases. I will do this by looking at a couple of the leading concerns for seniors as we age and demonstrate a few ways in which those concerns can be overcome without sacrificing any of the independence comfort, or safety that we desire.
As we age most people will end up taking more and more medications and supplements throughout their day. Remembering when why, and how much of each of those pills to take every day becomes increasingly difficult the more pills we must manage. In fact, it is estimated that 50% of seniors do not take their medications correctly all the time. Likewise, 30%, or more of all hospital admissions for seniors are related to medications not being take correctly. (Marek KD, Antle L. Medication Management of the Community-Dwelling Older Adult. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 18. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2670/).
Sadly, many seniors lose their independence and must move to a community setting such as foster care or a nursing homes due to their family and/or medical professionals concerns regarding their medication mismanagement. Yet, in many cases this does not have to happen. Studies show that when seniors have the right tools and the right education they can usually successfully manage their medications independently and safely within their own homes. But how? Here are a few tips to help get you started.
1. Medication Review
Talk with your doctor about your medications and see if the NUMBER or FREQUENCY of pills that you take can be reduced. This is because it is much easier to remember to take a pill once a day than three times a day and likewise easier to take one pill than four pills for the same thing. DO NOT change your prescribed medications without talking with your doctor first.
2. Medication List
Write down, or have your doctor or loved one write down, your medications in a chart form that shows what pill to take when and how many. This visual reminder should be placed near where the pills will be used and easy to read and follow.
3. Medication Education
If you feel like a medication you are taking is not working right or makes you feel bad in some way, make sure to talk to your doctor about it right away. It is possible that the dose of the medication could be changed, or a different medication prescribed that does not make you feel bad but still provides the same desired effect in your body. It is also important to ask your doctor to explain why you are taking your medication and how it is helping your body. We are all much more likely to take medication when we understand how it is benefiting us, even if we don’t readily see the benefit.
4. Medication Organization
Consider purchasing a pill reminder and organizer system. There are many systems available. There are even electronic pill organizer systems that are easy to use and can be set up to provide you with visual (lights) and audible (alarm) reminders that it is time to take your medications. Some of these systems can be connected to a smartphone devices and alert you via that device that it is time to take your medication as well. Some also have a locking mechanism so that you cannot accidentally take another dose of medication too soon. Most medication reminder systems can be set up in advance up to 4 weeks at a time. If you are setting up your pill box, make sure to do so with your medication chart in hand in a quiet location where you will not be disturbed or distracted during the time it takes to fill the box.
Falling and breaking a hip is one of the greatest fears of most seniors, and with good reason. As we enter our older years our bones generally become weaker, less dense, and more likely to break. This is especially true of women. In fact nearly 70% of hip fractures occur in women age 65 and older. Other factors, including lack of exercise, poor diet, certain medications, and impaired mobility and vision loss can also increase your risk for falling and fracturing a bone.
For those who experience hip fractures nearly all will require surgery to fix it and about 20% of those who have surgery will experience post-surgical complications such as blood clots, infection like pneumonia or urinary tract infections, or pressure sores.
After surgery, nearly 50% of those who experience a hip fracture are never able to recover their pre-fracture independence. Many are forced to move into to a community setting such as foster care or a nursing homes due to safety concerns of their family and/or medical professionals. What’s worse, once you have had a hip fracture your risk for falling again and for breaking another bone also increases. (May Clinic https://www.mayoclinic.org/diseases-conditions/hip-fracture/symptoms-causes/syc-20373468)
Fortunately, there are many things that you can do to help decrease your risk for falls while maintaining your independence in the comfort of your own home. Below are listed a few tips to help improve your home safety especially if mobility and balance are a concern for you. Factors such as diet and exercise, reviewing medications and regular vision screening are not included in this list. This is only a sampling of ways to decrease falls with a goal of demonstrating that safety and independence do not have to be mutually exclusive.
1. Falls from Tripping
Remove trip hazards. Whether you walk independently or use an assistive device to help you get around, trip hazards such as throw rugs, cords, and even transition strips in doorways often cause serious falls. Evaluate your walkways in your home for these items and remove them. Remove them from your kitchen and bathroom as well. If you would like a shower mat, keep it on a rack or the edge of the tub, not on the floor next to the tub. Move any and all cords out of walkways, have a loved one help put them against a wall or even up across the ceiling if needed to get them out of your walkways. Finally, look for high or uneven transition strips and consider replacing them with low-profile transition strips to help decrease your risk for tripping over them.
2. Falls in the restroom
A huge percentage of falls happen in relation to using, or needing to use, the restroom. Falls getting on or off the toilet are common due to how many things we are trying to manage while using the facility (clothing adjustments, toilet paper, toilet seat or lid movement, balance while providing peri-care). Giving yourself less things to move and more secure things to hold onto can significantly decrease your risk for falling while using the restroom. Install grab bars around your toilet (actually not that expensive either) or consider purchasing a toilet seat riser with built in grab bars. These devices are usually freestanding and do not require any modification to your restroom. They will help you maintain your balance and give you something to hold onto while using the restroom.
3. Falls in the shower
Falling in the shower or while getting in or out of the shower is also a huge concern of many seniors. In fact some seniors stop bathing (in the traditional sense) altogether for fear of falling in the shower. Yet, there are many ways to help remain safe, comfortable, and independent with your bathing. First, make sure that the bottom of your shower or tube has some form of traction such as a bath mat or adhesive traction pads to help decrease your risk for slipping. Second, if your shower permits, consider installing grab bars for you to hold onto in the shower. A detachable shower head is also handy because you can move the shower head around instead of turning yourself around in the water thus decreasing your risk for falls. Finally, consider purchasing a shower bench/chair to sit on while you bathe. This not only decreases your risk for falls but can also help you conserve energy so you don’t have to stand so long while bathing. There are numerous shower/tub seat options available including washable, padded seats that are quite comfortable.
4. Falls from bed
Getting out of bed (often in response to needing to use the restroom) can also be a cause of falls with injury. To help decrease this risk as much as possible consider the following:
- Have a lamp you can reach or otherwise turn on without getting out of bed.
- Make sure your bed height is such that when you sit on the edge of your bed that your feet rest flat on the floor and that your knees form a 90-degree angle between your buttocks and your feet. Beds that are too high can lead to falls from sliding off the edge of the bed both trying to get out and in the bed.
- When you sit up in bed make sure to wait a minute before trying to stand. If you stand up quickly your blood pressure may drop, causing you to feel suddenly dizzy or lightheaded and fall.
- Consider installing a small rail on the side of your bed. There are many kinds that simply slip under your mattress or tie to your bed-frame without requiring significant modification to your bed. This will give you something to hold onto while getting in and out of bed. Some come with pockets and covers as well which can be handy for holding important items such as your phone that you may wish to keep near you while in bed.