How to fall-proof your body and your home

Although many of us want to live at home as long as we can as we grow older, home is where most injuries occur because of falls, forcing us to move. Numbers tell part of the story.

• Falls are the leading cause of fatal and nonfatal injuries for people older than 65 in the United States.

• Ninety percent of the 300,000 hip fractures treated annually occur because of falls, most at home.

• One in three people over 65 fall each year.

But numbers don't begin to describe the devastating pain, trauma, cost, embarrassment, inconvenience and permanent disabilities that a fall can bring. First you're on your feet, then you're on your face. In less time than it takes to read this sentence, your days of living independently may be over.

Greta Wolfe of Lake Stevens, age 81, recently e-mailed me her experience: "I am SO very careful, never rush and watch my step. Still, things happen. I stepped out onto the balcony to bring in a plant, and I must have got one foot wet, because stepping back into the kitchen, I slipped and fell but GOOD! I sat for a time and decided I had not broken anything, then slowly pulled myself up, holding onto cabinet handles and the door handle. I hurt, but stood still to make sure I was OK. Otherwise I wondered, how would I reach the phone and close the door if I HAD broken anything??? It was scary."

Most of us assume that age leads to frailty, and frailty leads to falls — that it's normal, inevitable, and there's nothing we can do to stop it. Incorrect, say the experts. While our bodies certainly change as we get older, most falls can be prevented. And when they can't, there are ways to handle them, to get help and prevent further injury. Now there are two books — each a companion to the other — to tell us how.

Written by two physical therapists with well over 40 years combined experience, Gail Davies and Fran Scully of New Jersey worked in a long-term care facility and saw firsthand "the devastating effects that a fall can bring, a fall that might have been prevented," wrote Davies in an e-mail. "That's what prompted us to write the books."

Geared to older people and their families, rather than professionals in the health-care field, both books are highly readable with large print and no medical jargon, amply illustrated and easy to understand.

At first they put all the material into one book, then were concerned it would be too heavy, so they divided it into two.

"Fall Prevention: Don't Let Your House Kick you Out!" ($13.95, Infinity Publishing, 133 pages) helps readers identify and eliminate fall hazards by inspecting the entire house — from the front door to the back, with side trips through the garage, basement and garden then pointing out simple things you can do to keep from splatting on your nose.

Fifty percent of falls occur on stairs, the book says. What makes stairs challenging is that they require our muscular, visual, cardiac, sensory and balance systems to work together, which is why, "stairs need to be as safe as possible." The book offers dozens of safety tips and solutions. Some will seem obvious "install a secure hand rail" — and others less so, such as avoiding plush or patterned carpets, extending the hand rail beyond the stairs' length, and planting your foot fully on shallow treads.

Other topics include floor dangers, including throw rugs (my, ahem, downfall), glare, the pros and cons of floor materials; bathrooms ("the most dangerous room in the house"); kitchens; bedrooms; and outdoor spaces. It offers solutions in lighting, telephones, how to stop procrastinating on repairs ("FYI: The cost of one to two months in a nursing home or assisted-living facility equals the cost of updating your bathroom") and how to prepare for home emergencies.

While the first book talks about structural and instrumental ways to prevent falls, the second book, "Fall Prevention: Stay on Your Own Two Feet," ($12.95, Infinity Publishing, 108 pages) addresses the human element: Us!

The build-up to falling begins early, the book says: At age 40, a person's muscle mass, strength and balance begin to decline. However, strength and balance exercises can increase muscle mass and improve balance, even among 90-year-olds.

"Inactivity is not the answer to preventing falls," says one heading, "Inactivity can actually cause a fall!"

The trauma of falling — and the vicious circle of fear it begins — becomes a continuing spiral of inactivity and fear that can easily result in more falls. The book talks about how to address this fear, as well as how to get up from the floor and dust yourself off. My reader, Greta Wolfe, did it right.

Other important topics include your posture, your balance (my favorite question: Can you stand securely on one leg?), your muscle strength, simple exercises to do in your kitchen, painful feet, vision and how to select a doctor you can trust to help you.

The authors' Web site is www.fallpreventionadvisors.com.

Liz Taylor's column runs Mondays in the Northwest Life section. A specialist in aging and long-term care for 30 years, she writes and gives workshops. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110. You can see all of her columns at www.seattletimes.com/growingolder/.