Maggie McKay (Host): Like it or not, the reality is, falls happen, even where we live. So today, occupational therapist Darcie Olson will give us some safety tips on how to prevent falls at home.

 Welcome to Stoughton Health Talk from Stoughton Health. I'm your host, Maggie McKay. It's so good to have you here, Darcie. Thanks for making the time.

Darcie Olson, Occupational Therapist: It's good to be here.

Host: So how do falls affect individuals?

Darcie Olson, Occupational Therapist: Well, the biggest thing is falls can result in injuries and that can result in, you know, a whole cascade of things, including hospitalization or a change in their ability to live independently, or the lingering effects of the injury is probably the more major effects. But there are some minor effects like being afraid and the fear of falling can be a big risk factor for future falls, as well as limiting people's interest or ability or comfort level with leaving the home and just engaging those social activities that are very important.

Host: And from your expertise, your point of view, what do you see as the impact of falls in general just beyond the individual?

Darcie Olson, Occupational Therapist: The impact of falls, beyond the physical impact, beyond the physical changes or injuries that occur to people; I think, just like I was starting to talk about the fear of falling or the limitations that people put on themselves; restricting their social activities, their engagement in things that are important, their engagement in family activities or the change in the ability to live independently or at that least restrictive level that they were previously living. For example, if a person is already in an assisted living, maybe a fall would cause them to have to be in a more restricted environment like a nursing home. So, those changes can be really devastating.

Host: And how do you approach fall prevention?

Darcie Olson, Occupational Therapist: Well, there is a lot of research that's out there on looking at falls and particularly here in Wisconsin, we're very interested because, whether people realize it or not, falls in Wisconsin rank very high as compared to other states. So, in terms of, I do have a little bit of statistic on that.

In 2020, the last time we really had some comparative information, the CDC ranked Wisconsin as 35th among states for the percentage of individuals over 65 who are falling. However, falls related deaths, we are number one as compared to other states in our country. That is important, and scary.

Host: Very, so how do you approach fall prevention? What should we be paying attention to in our homes as it relates to fall hazards?

Darcie Olson, Occupational Therapist: Well, preventing falls is sort of a multi component process. The research has found that the best strategies are for people to take an approach that's varied, and that would include education, being educated about what are the, the risk factors and what are the things that people can do to be engaged in some sort of exercise up to three hours a week of exercise that specifically includes balance related kinds of things like moving in multiple directions, moving in ways that your feet are planted and you're just moving in space a little bit, stretching, flexibility, strengthening, all of those kinds of things are important. And that alone can reduce your incidence of falls probably about between 20 and 25 percent. But the number one way that people can reduce falls as a single intervention would be a home hazard assessment and interventions, meaning go through your home, figure out what are the risk factors for falls, for example, things like cluttered pathways, poorly illuminated areas, not having handrails or sturdy things to hold onto as you navigate your home.

And the interventions would be solving all of those kinds of things, and that can also include things like keeping a phone with you in case you do fall, or, you know, having somebody come in and help you with identifying what the hazards really are. There are also other factors that people should look at, such as periodically having their medications reviewed to make sure that there are no complications or interactions between medications, and that can be done with your primary provider or it could be done with a pharmacist.

And also making sure that your eyewear is up to date and that you are very aware that bifocals sometimes can contribute to falls. So if you're doing a lot of stair climbing, you might want to be aware that if you look through the lower part of your lens, things are really at a focal point about 10 inches from you. So those stairs are going to be a little blurry. Other things that you can do, having someone come in and look at your bathroom to make sure that you're safe getting in and out of your tub and that getting on and off the toilet, that grab bars are installed only by certified individuals who are bonded for that type of work.

Host: What do you think of, with all those, with that list, top of mind, let's say, what are the top two home alterations that make the biggest impact?

Darcie Olson, Occupational Therapist: Yeah. Reducing clutter. Having clear pathways and rugs. So, a big thing among really my generation and older is that we love our rugs for some reason. You know, we've sort of grown up with it. And so as people their gait is changing, the pattern that they walk; there is a tendency to shuffle your feet a little bit more, or perhaps you're using a cane or a rolling device, something like that.

Rugs don't work well with those things. Often rugs that we've had for a long time tend to wrinkle up or have edges that curl. All of those things are falls hazards or risks. So getting rid of rugs everywhere, unless it's really necessary. For example, when you step out of the tub, it's a good idea, or a shower, it's a good idea to have something that's going to absorb water and not create a slippery surface.

But then you maybe want to look for a rug that is very sturdy and firm and has beveled edges, not something that's going to wrinkle or change shape as you step on it or slip. So rugs are number one, and then clutter, as I said, making sure that your pathways are clear. We all have tendencies to set things on the floor next to our favorite chair, or that basket of clothes that we're going to get to later, that's in a walkway.

And things that are in our pathways to get to important places, from your bed to the bathroom, when you are making that transition during the night. Make sure that that is illuminated at the floor level with night lights. And you can get little night lights that only come on at night, that just plug into the outlets.

But also, making sure that that pathway, that things are out of the way. Don't leave any shoes in that path, because at night you're not going to see them.

Host: That's so true. And even the littlest thing can trip you.

Darcie Olson, Occupational Therapist: Oh, absolutely.

Host: Darcie, are there any local resources to help with home safety recommendations? Because as you were saying, when people are installing bars, et cetera, you want to make sure that they are qualified to do that.

Darcie Olson, Occupational Therapist: Absolutely. There is a service in Dane County called Age Better Today and the website is agebettertoday.org. They offer free in home safety assessments to prevent falls. The assessment takes anywhere from 15 minutes to an hour. During the school year, it's conducted by the Occupational Therapy Assistant students from Madison College.

During the summer, and other times, there are retired occupational therapists and others who have been trained in going through a person's home. People usually come in a pair and will go through your home and they have a checklist that they use that they give to the homeowner to be able to see what things they've identified as falls risk, and it includes some recommendations.

If they need resources such as a new tub bench or an elevated toilet seat or grab bars installed, they can make recommendations for providers. The other thing would be there is a website that's called SaferCommunities.net. t   And within that website is, under Programs, you would go to Falls Prevention.

Under the Falls Prevention section, they do have resources, and they have a list of people who will come into your home and make those kinds of alterations. So, they are individuals familiar with accessibility options in a person's home. There are also several places in town that have free elevated toilet seats or tub benches or things like that. So you can find some of those resources on that website as well.

Host: Oh, that's interesting. I remember when our son was a baby and we had the person come in and earthquake proof all the furniture and all that. And we said, the next time we'll be doing this is when we get older and need help, you know, with exactly what you're talking about. So it's good to have these resources.

Darcie Olson, Occupational Therapist: Yeah, the in home assessments are very interesting because, they usually will highlight something that you have maybe lived with for years and years and years and really don't recognize the fact that that's a loose railing on your stairway or that there is no railing at all but you've just reached ahead to the wall or that you've always kept that beautiful vase next to the couch but when you go to stand up your tendency is to reach out and and put your hand on that vase but it may not be a stable surface that is designed for that particular thing.

What people also may or may not be aware of, is when you're in the bathroom, getting out of the tub, getting on and off the toilet, towel bars, toilet paper holders, faucets are not grab bars, they cannot take a person's weight. So if a person is getting out and using those items for balance, and their weight, they would slip in any way, and all of their weight would go on those objects, they will come out of the wall and a person will fall.

So, just being aware of safety factors, things that are not designed really to support our weight.

Host: That's really a good point to bring up. In closing, Darcie, is there anything else you'd like to add that we didn't cover?

Darcie Olson, Occupational Therapist: I think that people really benefit from being advocates for their own safety by looking to the community to see what the community is offering. The, different senior centers, hospitals, different agencies in town offer classes like Stepping On, which is, a falls prevention kind of workshop for a series of classes.

Just look to your local communities, especially your senior centers, to see what their offerings are. Be an advocate in your own health and safety. And by attending these kinds of events, you can find out what the resources are in your community.

Host: Well, thank you so much for sharing this useful information, Darcie. We really appreciate it. I'm sure it is going to help a lot of people.

Darcie Olson, Occupational Therapist: Happy to spread safety.

Host: Again, that's Darcie Olson. For more information on preventing falls, please visit safercommunity.net/falls-prevention.

If you're interested in exploring a wider range of health related podcasts, check out the Stoughton Health Podcast Library at stoughtonhealth.com. Thank you for listening. I'm Maggie McKay. This is Stoughton Health Talk, a podcast from Stoughton Health.