Older Adults and Falls

fixingrailingAccording to the Public Health Agency of Canada, 1 in 3 older adults experience a fall each year. When older adults fall, 40% will fracture their hip. The Technology for Injury Prevention in Seniors (TIPS) program at Simon Fraser University found that “Approximately 20% of hip fracture patients die within a year, and 50% will not return to their pre-fracture level of mobility and independence”. TIPS stresses that falls are the number one cause of injury for older adults.

Most of these falls occur at home. Falls are generally caused by poor balance, decreased muscle and bone strength, impaired vision or hearing and unsafe conditions within the home.

Preventing Falls

The best ways to avoid falls are to:
- eat well and stay hydrated
- stay fit
- have your eyes checked annually
- wear proper footwear
- take medication properly and,
- use safety aids such as a cane if necessary.

Another way to prevent falls is ensuring that the home environment is safe.

The Public Health Agency of Canada states that older adults account for 70% of stair related deaths. The agency offers 12 tips for stair safety at home:

  1. Make sure that your stairway is well lit.
  2. Ensure that the stairs are in good repair.
  3. Uneven steps should be fixed.
  4. If you are unable to see the edges of the steps install special strips.
  5. Fasten covering on stairs securely or consider removing it.
  6. Handrails should be fastened securely and you should be able to get your full hand around it.
  7. There should be at least one handrail and it should be at a height of 34” to 38”.
  8. Remove clutter.
  9. Remove loose rugs from the stair landings.
  10. Rushing is a major cause of falls – go slowly.
  11. If you are carrying something make sure it does not block your vision and keep one hand free to use the rail.
  12. Remove your reading glasses before using the stairs.

Visit the Public Health Agency of Canada website to view a comprehensive list of ways to prevent falls throughout the home.

Wearing the right shoes can be important for falls prevention. The Finding Balance website, coordinated by the Alberta Centre for Injury Control and Research, offers valuable information on ‘Choosing the Ideal Shoe’. Finding Balance also suggests seeing your doctor if you often feel dizzy or lightheaded. To avoid dizziness after lying in bed or sitting in a chair they suggest “clench your fists and circle your ankles 10 times, then take your time and get up slowly”.

Various technologies have been developed to assist with falls prevention. Tactonic Technologies , for example, has created a floor mat called the InteliMatTM. The mat senses gait, walking, movement and balance. Caregivers can monitor the balance (the risk of falling) and activity of older adults in the home. The mats may also be able to detect health conditions such as Parkinson’s and stroke.

The National Council on Aging website has created a list Debunking the Myths of Older Adult Falls. One of the myths listed is the notion that “If I limit my activity, I won’t fall”. Staying physically active helps to maintain strength and range of motion. Another good reason to stay active.

Older Adults and Technology Use

On April 3, 2014 the Pew Research Center (an American, self-described, ‘non-partisan fact tank’) released a report entitled Older Adults and Technology Use. The report explores the use of cell phones, Internet, digital technology and broadband by older adults 65+ in the United States.

Among the main findings is the emergence of two distinct groups of older adults, who appear to relate to technology differently. The first group is younger, more highly educated and affluent. They are more likely to possess new technology and view technology in a positive light. The second group is older, less affluent and often have chronic health conditions. The report finds these individuals ‘largely disconnected from the world of digital tools and services, both physically and psychologically’.

Age itself is an important distinction for technology use. For example, 68% of older adults in their early 70’s go online, whereas only 47% of Americans age 75-79 go online.

As with age, affluence plays a substantial role in online use. For example, 90% of older adults with an annual income of $75,000 or more, go online as opposed to 39% of older adults with an income of less than $30,000.

Education is also a factor for online participation. Of the older adults with a college degree, 87% go online. Only 40% of those who did not attend college go online.

Barriers and Challenges

  1. Physical challenges. Health conditions such as loss of vision and dexterity make it more difficult to use technology.
  2. Skeptical attitude. Many older adults (49%) who are not currently using the Internet agree that they are at a disadvantage when it comes to accessing information. However, 35% of non Internet users disagree and 18% strongly disagree.
  3. Difficulty learning technology. The majority of older adults (77%), say they need assistance with learning new technology.

Unique Differences in Device Ownership from the General Population

  1. Cell phones. Fully 77% of older adults own a basic cell phone. Only 18% of older adults have a smartphone compared to more than half of all Americans.
  2. Tablets and e-books. For the general public, smartphone ownership is ‘much more common’ than tablets and e-books as compared with 27% of older adults who own a tablet, an e-book or both.

Social Networking Sites

  1. Twitter. Only 6% of older adults who are online use Twitter (3% of all older adults).
  2. Facebook. Older Americans (46%) are increasingly using social networking sites such as Facebook. The national average is 73% of Americans.

Older adult centres and libraries often provide opportunities for older adults interested in learning about new technology. The Elder Technology Assistance Group (ETAG) offers free technology assistance for adults 55+ throughout Oakville, Mississauga and Brampton.

Older Adults and Driving

night drivingStarting on April 21, there will be changes to the Driver Renewal Program for older adults 80+ in Ontario. According to the Ontario Ministry of Transport (MTO) once drivers reach 80 years of age, every two years they must:
- take a vision test
- undergo a driver record review
- attend a group education session
- complete two, brief, non-computerized in-class screening assignments and,
- if necessary, take a road test and submit a medical form.

The old process took approximately 3.5 hours. The new process, lauded by the MTO as a ‘better and less stressful way’ to be tested, takes only 90 minutes. The group education sessions have been shortened and the knowledge test will become two screening assignments. You can download practice examples of the screening component from the MTO website. “The new evaluation procedure came from years of work with Candrive, an interdisciplinary group of researchers seeking to keep the elderly driving safely” according to an article in the Globe and Mail.

In order to help older adults maintain their driver’s license a list of Safety Tips for the Older Driver are presented on the Canada Safety Council’s website. In addition, the Canada Safety Council offers a 55 Alive Driver Refresher Course to help individuals 55+ retain their driving privileges.

New technologies are rapidly adding features to cars that can help enhance an older adult’s driving abilities. MIT’s AgeLab and The Hartford Center for Mature Market Excellence have done extensive research on the ‘Top Technologies for Mature Drivers’ and have found the following ten technologies to be beneficial
for older adults:

  1. Smart headlights: adjust the range and intensity of light based on the distance of traffic to reduce glare and improve night vision
  2. Emergency response systems: offer quick assistance to drivers in the case of a medical emergency or collision, often allowing emergency personnel to get to the scene more quickly
  3. Reverse monitoring systems: warn of objects to the rear of the vehicle to help drivers judge distances and back up safely, which can help drivers with reduced mobility
  4. Blind spot warning systems: warn drivers of objects in blind spots, especially while changing lanes and parking, and helps those with limited range of motion
  5. Lane departure warning: monitors the vehicle’s position and warns the driver if the vehicle deviates outside the lane, helping drivers stay in their lane
  6. Vehicle stability control: helps to automatically bring the vehicle back in the intended line of travel, particularly in situations where the driver underestimates the angle of a curve or experiences weather effects, and reduces the likelihood of a crash
  7. Assistive parking systems: enable vehicles to park on their own or indicates distance to objects, reducing driver stress, making parking easier, and increasing the places that a driver can park
  8. Voice activated systems: allow drivers to access features by voice command so they can remain focused on the road
  9. Crash mitigation systems: detect when the vehicle may be in danger of a collision and can help to minimize injuries to passengers
  10. Drowsy driver alerts: monitor the degree to which a driver may be inattentive while on the road and helps alert drivers to the driving task

With April showers come slippery roads. Be careful and happy trails.


Putting the Spring Back in Your Step

Six days into spring, and although the air is frigid, and all the snow has yet not melted, the quality of light is trumpeting spring. It was an unusually harsh winter, even by Canadian standards, which left most Canadians avoiding the snow and ice-covered sidewalks. Now that the sidewalks are clear it’s time to think about heading back outdoors to exercise.

According to the Canadian Physical Activities Guidelines, “to achieve health benefits, and improve functional abilities, adults age 65 years and older should accumulate at least 150 minutes of moderate to vigorous intensity aerobic physical activity per week, in bouts of 10 minutes or more”. Brisk walking is considered a moderate intensity physical activity.

The weather may be improving but is the built environment conducive to safe and enjoyable walks for older adults?

The Senior Walking Assessment Tool – Revised (SWEAT-R) is, “an instrument for measuring built environmental features associated with physical activity of older adults” according to an article called “Revising the senior walking environmental tool“. According to the article, “SWEAT-R provides easy to gather, reliable data for use in community-based audits of built environment”. Some of the characteristics that are measured to ensure a good environment for older adults include:

  1. Intended pedestrian crossings at the end of the streets
  2. Crosswalk markings
  3. Traffic signals, stop signs, pedestrian crossing signs
  4. Pedestrian overpass or underpass
  5. Length of the traffic/pedestrian signal times
  6. Curb heights
  7. Trees
  8. Land use
  9. Gathering places
  10. Benches
  11. Quality of public use spaces
  12. Sidewalk quality
  13. Street lights
  14. Restrooms

How would you rate these characteristics on your favourite walking route?