1. The client/caregiver can discuss the importance of safety and fall prevention for the older adult.
   1. Falls are the leading cause of injury death for Americans 65 years old and older. Each year, between 35% and 40% of adults 65 years old and older will fall at least once.
   2. The Centers for Disease Control and Prevention has four suggestions to improve safety and prevent injuries.
      1. Begin a regular exercise program.
      2. Have your healthcare provider review your medicines (especially any that would increase the risk of falls).
      3. Have your vision checked.
      4. Make your home safer.
   3. In the same year, 1.6 million people over the age of 65 years were treated in emergency departments because of falls.
   4. For many older adults, being able to drive their automobile is a very large symbol of independence. The decision of whether to continue driving is a difficult problem for individuals and their families. The American Association of Retired Persons (AARP) and other organizations offer testing and refresher courses for older adults to help improve safety, and they even serve as an evaluation tool for driving ability.
2. The client/caregiver can list general measures to promote safety and prevent falls.
   1. Display emergency numbers and home addresses near all phones.
   2. Install smoke alarms near all bedrooms and in the kitchen.
   3. Make sure handrails are installed on both sides of stairways
   4. Keep hallways and stairwells clear of all clutter. Do not use these areas for storage.
   5. Install nightlights for late-night trips to the kitchen or bathroom.
   6. Do not use throw rugs.
   7. Avoid clutter. Keep walking areas free of clutter and furniture.
   8. Wear shoes with nonskid soles.
   9. Keep all cords, phones, extension cords, and so forth safely out of the flow of traffic.
   10. Make sure that electrical cords are in good condition, with no fraying or cracking.
   11. Provide adequate lighting. Change light bulbs as needed. Use the appropriate size and type of light bulk for each fixture.
   12. Do not rush or run—allow plenty of time to get things done. Change positions slowly.
   13. Maintain an adequate fluid intake.
   14. Eat a well-balanced diet.
   15. Wear visual aids (i.e., glasses) and hearing aids.
   16. Place a contrasting color along the edge of the tread to help differentiate the steps.
3. The client/caregiver can list measures to promote safety and prevent falls in the bathroom and kitchen.
   1. Adjust the temperature of the water heater to 120°F to avoid burns.
   2. Consider dismantling the garbage disposal.
   3. Keep good, clean lighting over the stove, sink, and countertop work areas, especially where food is sliced and cut.
   4. Keep towels, curtains, and other flammable items away from the range.
   5. Wear clothes with short or close-fitting sleeves when cooking.
   6. Make sure that kitchen ventilation systems or range exhaust is functioning.
   7. Install smoke detectors, and check batteries routinely.
   8. In the bathroom, use grab bars on the walls and nonskid mats or strips in the bathtub and shower.
   9. If needed, use an extended toilet seat with handrails.
   10. Use shower stool/chair and hand-held showerhead for bathing.
   11. Keep ashtrays, smoking materials, and other fire sources (heaters, hot plates, etc.) away from beds and bedding.
   12. Keep a telephone close to the bed and have lamps and light switches in reach.
   13. Clean any spills immediately.
   14. Store frequently used items in easy-to-reach locations.
4. The client/caregiver can list measures to promote safety and prevent falls outside of the home and entryways.
   1. Make sure outdoor steps and walkways are kept in good repair.
   2. Spread sand or salt on icy walkways.
   3. Consider using a ramp with a handrail as needed.
   4. Avoid clutter on walkways such as toys, gardening tools, hoses, and so forth.
   5. Eliminate uneven surfaces or walkways.
   6. Place a small bench or table by entry to hold packages while unlocking doors.
   7. Check entryways and walk for adequate lighting.
   8. Keep shrubbery and foliage away from the pathway and doorway.
5. The client/caregiver can list precautions regarding the telephone.
   1. Place an enlarged or lighted dial on the phone to aid with impaired vision.
   2. Place adaptive devices on the phone to help with the hearing impaired.
   3. Keep phone within easy reach day or night. Make sure the phone is properly charged.
   4. Keep emergency numbers, including doctor, police, fire department, ambulance, nearest neighbor, and relative, near the phone.
   5. Consider a medical alert and alarm system that the client can wear to signal for help.

Resources

Senior centers

Adult day care centers

Office of the aging in local county

American Association of Retired Persons (AARP)
www.aarp.org

AARP—Driver Safety Classes
www.aarp.org/families/driver_safety/driver_ed

Gerontological Society of America
www.geron.org

Home Safety Counsel
www.homesafetycouncil.org

National Safety Counsel
www.nsc.org

The U.S. Administration on Aging
www.aoa.dhhs.gov

References

Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
National Center for Injury Prevention and Control. (2006). What you can do to prevent falls. Available from: www.cdc.gov/ncipc/pub-res/toolkit/WhatYouCanDoToPreventFalls.htm . Washington, DC: Centers for Disease Control and Prevention.
National Center for Injury Prevention and Control. (2007). Older adult drivers: Fact sheet. Available at: www.cdc.gov/ncipc/factsheets/older.htm. Washington, DC: Centers for Disease Control and Prevention.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
The Older Adult Driver ( American Family Physician). (January 1, 2000). Available at www.aafp.org/afp/20000101/141.html.
Timby, B. K. (2005). Fundamental nursing skills and concepts. Philadelphia: J. B. Lippincott Williams & Wilkins.