Watch your step in and out of your home

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Falls are the leading cause of death from injury among people ages 65 years and older in the United States, with more than a third of adults aged 65 years or older falling each year. In 2001, this was more than 1.6 million older adult emergency room visits with nearly 388,000 associated hospitalizations.

By 2020, the estimated cost of fall-related injuries may reach $32.4 billion. The majority of fall-related injuries occur in older adults living independently. In many cases, this leads to depression when their physical functioning does not improve after a fall. Most alarming is that some 70 percent of the fall injuries consist of falls indoors or within the housing area.

In Colorado, nearly 7,750 people are hospitalized for fall-related injuries annually, and about 197 older adults die as the result of falls. Colorado is among a block of states in the West and upper Midwest with age-adjusted, fall-related death rates that are significantly above the U.S. rate of 4.7 per 100,000 population.

Fall risks are generally due to one of two factors. They can occur due to intrinsic factors such as Parkinson's disease and normal age-related changes in vision, joints, muscles, gait and balance. They can also occur due to extrinsic factors occurring in the environment - both indoors and outdoors - and can include low lighting and low-height seating.

Conflicting information on predictors of falls and the role of home environmental hazards have been described including a number of observational studies indicating no difference in the rate of falls based on number and type of hazards in the home. Still others have linked low lighting and low seating with falls in the home.

Recommendations and modifications include installation of stair railings (inside and outside), tub benches for sitting while showering and sitting to enter the tub instead of stepping over the tub wall, taping the edges of or removing throw rugs, using step stools with hand railings, tub grab bars, changing the swing direction of screen/storm doors to allow easier entrance, and raised toilet seats and toilet grab bars. Increased awareness should also focus on small pets in the house, using lights when walking into garages and up and down stairs, and reducing clutter of walking pathways in the home.

Additional information on Healthy Aging is available on the Colorado State University Extension Web site at www.ext.colostate.edu under Family/Consumer

Dr. David Greene is an Associate Professor of Occupational Therapy, Colorado State University

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