Question: With my parents and my in-laws now in their 80s, my wife and I are concerned about them continuing to live at home. Since we all live in the same area of our state, we see our folks often and have noticed safety hazards in their homes. We are most concerned about the potential for falls. Our suggestions, though, about having them move into a staged-living community are met with cold stares. What is the best way to bring up our concerns?

Answer: While your worries about falls and safety are certainly valid, moving your parents into gated communities not the best solution. As you have learned from your folks – and as you will probably experience yourselves when you reach their ages – seniors want to remain in their homes and in the community for as long as possible.

Studies tell us that the longer seniors can retain their independence and remain in their homes – even if assistance from third persons is required to keep them there – the better their quality of life. Seniors who have moved, or who have been talked into moving out of their homes too quickly feel they have been robbed of their freedom and autonomy. And, quite frankly, we don’t blame them for feeling that way if appropriate alternatives are available. Adult children who attempt to impose their ideas of the best living arrangements for their parents can ruin a good relationship very quickly.

That said, more than one-third of all adults over age 65 fall each year, and falls are the leading causes of both injury-related deaths and hospital admissions in seniors. According to the Centers for Disease Control, in 2001 more than 1.6 million seniors sought emergency room treatment, and some 388,000 seniors were hospitalized, due to falls. More than 11,600 of those seniors died from fall-related injuries.

Moreover, the older you get, the more prone you are to die from fall-related injuries; more than 60 percent of those who die from falls are older than age 75. Falls can cause serious hip fractures and brain injuries – not to mention other injuries that often require care in a nursing facility.

By properly addressing some of the “modifiable risk factors”, the risk of falling can be lessened. For example, seniors should strengthen their lower bodies and improve balance through regular exercise, review the side effects of both prescription and over-the-counter medications that may cause instability, and seek the help of professionals when dealing with Parkinson’s Disease, stroke, arthritis, cognitive impairment, and visual impairments.

Seniors should be aware that as they age, their eyes are less able to become accustomed to sudden changes in lighting. This, in turn, means that moving between dim and brightly-lit areas can cause visual loss and falls.

Because seniors are at home most of the time and because more than half of all falls occur at home, safety in the home is essential. Contrary to popular belief, studies indicate that most falls at home occur on the same level, not because of stairs. Therefore, removing items from heavily used walkways inside and outside to avoid tripping is helpful, as is installing railings, grab bars, and more lights in appropriate places. When required, although seniors don’t particularly like them, walking aids can help prevent falls.

Taking the NextStep: A particularly good book on the subject is Betty Perkins-Carpenter’s How To Prevent Falls: A Comprehensive Guide to Better Balance. And, for good measure, the United States Congress, in a joint resolution called the “Elder Fall Prevention Act of 2003”, recognized the seriousness of seniors falling and has committed dollars – subject, of course to having the money to do so -- for studies to help combat this leading cause of death among people over age 65. While this study may not get funded, a review of the text of this resolution is important. See our links page for more information.