American Medical Association Family Medical Guide - American Medical Association [147]
• Make sure chairs and tables are sturdy, stable, and balanced in case the person leans on them for support.
• Set the thermostat at a warm temperature (at least 72°F) to help keep an older person’s joints from stiffening. Stiff joints can lead to falls.
• Place guardrails on the bed or a sturdy chair bedside to help the person get in and out of bed. Place a telephone with volume control and a lighted dial next to the bed.
• Place a nonslip rubber mat on the floor in front of the sink. Clean up spills on the floor and countertops immediately. Keep frequently used items within easy reach to avoid having to bend or climb up on a chair or stepladder to reach them. Be sure that the person wears low-heeled, slip-resistant shoes that fit properly.
• Put a nonslip rubber mat or nonslip adhesive strips on the floor of the tub or shower. Install handrails and grab bars that are attached to underlying studs on the walls around the toilet and along the bathtub. Tell the person you are caring for never to use towel bars for support—they are not strong enough. Place a nonslip bath mat on the floor outside the tub or shower. Some people find an elevated toilet seat easier to use.
• Do not lock the bathroom door. It may be necessary to remove locks to prevent the person from accidentally locking himself or herself in the bathroom.
• Have all medications reviewed by the person’s doctor to be sure that they are necessary, especially drugs with possible side effects such as drowsiness, dizziness, or fainting.
• When going outdoors, have the person wear comfortable, sturdy walking shoes with soles that grip the pavement. If he or she uses a cane or walker, make sure it is sturdy and in good condition. Encourage the person to stay indoors, if possible, when the weather is bad, especially when the pavement is wet or icy. During the winter, keep porches, steps, sidewalks, and driveways clear of snow and ice. Always spread sand or salt on icy surfaces.
• A person who has difficulty walking may benefit from working with a physical therapist, either as an outpatient or through a home health care agency. If walking is a problem, talk to your doctor about having a gait evaluation and starting an exercise program to improve the person’s ability to walk and increase his or her strength.
In spite of the best preventive measures, falls still may occur. If the person you are caring for falls, don’t move him or her; try to determine the nature and extent of any injuries, and call for emergency medical assistance immediately.
Regulating Home Temperature
As you age, your body becomes less able to regulate temperature. A life-threatening drop in body temperature (hypothermia; see page 165) can develop quickly in an older person if the room temperature is lower than 65°F. Make sure that the heating system in your loved one’s home is in proper working order and that there is enough heat throughout the day, especially if the person lives in an apartment building, where tenants usually do not have control over the heat. It also is vital to have the furnace checked regularly for carbon monoxide leaks.
Older people also are vulnerable to the effects of high temperatures, which can lead to life-threatening conditions such as heat exhaustion and heatstroke (see page 166). Experts strongly recommend that room temperature be maintained at a constant 72°F, if possible. In the summer, fans may be helpful, but in many parts of the United States, air-conditioning is the only way to keep the temperature at a comfortable level. However, many older people do not own an air conditioner or cannot afford to pay high electric bills. Watch the person carefully for signs of heat exhaustion and heatstroke. In some communities, social service agencies provide air conditioners free to older people on limited incomes. Check with your local area agency on aging