TABLE OF CONTENTS
Each year, more than 800,000 seniors arrive at the emergency department with a head or hip injury caused by a fall. Not only are these the most common types of injury you’re likely to get from falling, but they’re also among the most serious. Below, you’ll learn more about these injuries, as well as some of the other common injuries that can occur in the bedroom.
Hip injuries are most often caused by falling sideways. Seniors can take a long time to recover from a hip injury, which is often a broken bone near the point where the ball of the leg joins with the socket of the pelvis. This can limit mobility, sometimes permanently, and requires months or years of difficult and costly physical therapy to recover from.
Head injuries have even more potential for serious harm and can happen in any type of fall, both from hitting your head on the floor and from objects in the way while you’re falling. Depending on which part of the head was injured and how hard the hit was, you could wind up with superficial scrapes or cuts, mild concussions, serious traumatic brain injuries or bleeding in the brain cavity. Like a stroke, this can cause all kinds of damage and may even be fatal. Seniors are especially vulnerable to this kind of injury, and even the recovery process from milder head injuries can be extremely difficult.
Another common injury caused by falling down is skin avulsion. While this is usually a far less serious health threat than broken bones and brain trauma, torn skin can be unsightly and alarming to look at, since the affected area tends to be large and likely to bleed. Skin tears happen when the affected area is put under more stress than the skin can handle, such as when a person falls against a surface and twists the skin. Because seniors’ skin tends to be low in collagen, it’s less springy than younger people’s skin and more likely to tear, leaving a flap of skin exposed.
The good news is that these injuries cause low to moderate amounts of pain and are almost never life-threatening. In many cases, the tear can be treated by carefully replacing the flap of skin and dressing the wound. Basic wound care helps prevent infection, and the recovery usually doesn’t require therapy or extensive medical attention.
Less common fall-related injuries can happen to any part of the body, but they tend to be less serious than head trauma. Bruises and scrapes are among the most often reported. Presumably, more of these injuries happen than appear in medical literature, since many people with a bruise caused by falling down will skip the hospital and deal with it at home. Sprains and pulled muscles are in a similar category of underreporting, although they can be more serious for seniors.
If you’re over 65 and have any fall-related injury, including what you think could be a sprain or a pulled muscle, it’s a good idea to contact your doctor for advice. Your injury may feel minor, but it takes an X-ray to make sure you don’t have a broken wrist or ankle. Any sprains that don’t feel better in a few days, however mild, should also get checked out to be safe.
While falls can happen in any part of the house, even in a supervised living arrangement, such as assisted living or a nursing home, the bedroom has hazards of its own. Seniors tend to spend a lot of time in their bedrooms for sleep, during bouts of illness and when relaxing with a book, making the bedroom one of the most used rooms in the home. Below, you’ll learn about some of the most common hazards that can make a fall in the bedroom more likely or more dangerous.
Falling out of bed is one of the most commonly reported reasons seniors fall in their bedrooms. Getting in and out of a too-high bed increases the risk of having a fall, especially if you’re groggy in the morning or drowsy at night, the two times you’re most likely to be getting in or out of bed. Beds that are too high are also likely to increase the severity of a fall. While no fall to the floor is safe for seniors, there’s a difference between falling a few inches onto a carpet and falling a couple of feet onto a hard floor.
Seniors are more likely than most adults to have a bed that’s set to the wrong height. This is because many seniors sleep in adjustable beds, such as a consumer-grade adjustable bed you bought for your own comfort or an adjustable hospital-style bed you’re using to manage a health condition or recover from an injury. A fall near the bed can also happen if you need a Hoyer lift to get into or out of bed, since this complicates the process.
If you have an adjustable bed, make sure it’s adjusted to the height that’s most comfortable for you to safely get in and out. If the bed is motorized, you can usually lower it to near floor level after you climb in, which reduces the harm that could result from falling out.
Consider putting up the rails or installing tubular rails that can be braced under the mattress to help prevent you from rolling out of bed in your sleep. Clipping a fall alarm on your nightgown or pajamas can wake you up if you’re about to fall, or it can summon help from your family, a caregiver or a staff member, depending on your living situation.
It’s usually a good idea to lay a soft mat alongside your bed that can cushion you in case you do fall. This doesn’t have to be an expensive or complicated piece of gear. At the low end, a simple gym mat or thickly padded throw rug can be better than nothing. Near the higher end, you can buy a specially designed safety mat that might tie to the legs of your bed or drape over the side rail.
Clutter is often overlooked as a source of falls, but it’s one of the easiest ways to fall in the bedroom. If you have laundry on the floor, large obstacles in the way or an object below your line of sight, you’re running a risk of tripping and having a fall. Even recently moved furniture, such as a dresser you’ve slid to a different wall, can be a hazard, since you’ve probably gotten used to the room’s old layout and can easily stub a toe or trip over the object in its new location.
Fortunately, clutter is one of the more easily managed hazards in the bedroom. If you have a hard time picking up the laundry and other dropped items by yourself, ask your caregiver to help you. This should be easy in an assisted living or nursing care community, although you might need extra help if you live on your own. In fact, having trouble keeping your bedroom safely clutter-free could be one of the earliest signs you need an in-home caregiver or help with housekeeping. These services can make all the difference in both your standard of living and the safety of your home environment.
Consider changing the layout of your bedroom to give yourself more space. If you have a narrow walkway between the bed and the bathroom, for example, you could trip over obstacles during a late-night trip out of bed. Strategically moving a few things around to open up the floor space can dramatically reduce the risk of tripping over a corner or cable or losing your balance by weaving between a dresser and the TV stand.
While you might be very familiar with the layout of your bedroom, poor lighting can still create a hazard that puts you at risk of falling. If, for example, you have a pet that likes to get underfoot, it’s much easier to miss the animal and trip in a room with poor lighting than in a room where the light is good.
Poor lighting can also hide clutter on the floor, oddly positioned furniture and wet patches on the hardwood or carpet you might otherwise have not seen. A bare bulb in one corner of the room, rather than an evenly distributed light , can also disorient you if you look at it and temporarily impair your vision. That can also make tripping, slipping and falling down more likely to happen.
There isn’t a good reason to have bad lighting in your bedroom, and fortunately, it’s an easy fix. During the day, try leaving your blinds and curtains open to let in as much natural light as possible. Even if it isn’t much, it can soften shadows that would otherwise hide loose laundry or a grandchild’s toy. When it’s dark outside, turn on the lights and carefully look around the room to identify any dark spots where a hazard can lurk. Ideally, you should have good enough light to read by in every corner of the room.
If you don’t have this level of illumination, consider moving the lamp you have in the room already or adding a light or two in strategic places. Ideally, you can plug at least one lamp into the outlet linked to the wall switch, so you can have the lights on as soon as you step into the room. Supplemental lighting, such as a touch-operated battery light you can mount on the wall, can have a dramatic effect on how well lit your room is, and these lights are widely available and relatively cheap.
The floor itself can be a source of trouble for seniors. Old, worn-out carpet can come up at the edges or fray in high-traffic zones. Laminate and linoleum can warp and curl, wooden floors may twist and come loose and tiles can loosen over time, leaving a potentially disastrous slip-and-fall hazard. Hard floors can also increase the severity of injuries from a fall, turning what could have been a bruise or a sprain into a fracture and a trip to the hospital.
Flooring is harder to fix than lighting, but minor fixes don’t have to be too complicated or pricey. If you don’t have a flooring replacement in your budget, you can address shallow dips and minor seams in the carpet or wood by covering them with a thick rug, ideally with a pad underneath to prevent slippage. You can cover up a curling linoleum corner with a piece of furniture, although any structural issues or serious damage should be fixed or replaced as soon as you can get it done.
Wet spots and other temporary hazards should be cleaned up or at least marked with a rag or towel as quickly as possible. If the issue is something you can’t fix right away, try to keep it in mind, so you can avoid that area until it can be fixed.
People fall down for all kinds of reasons. Sometimes there’s no obvious reason, and it just happens. Seniors and children under 18 are especially likely to fall for no apparent reason due to limited mobility and a sometimes-off sense of balance.
Several types of medication are known to cause vertigo, which can make you dizzy and lead to a fall, even when you’re bracing against a countertop or walker. The following table includes the most commonly prescribed drugs for seniors that can cause vertigo.
|Class of Medication||Prescribed to Treat||Common Examples|
|Antibiotics||Bacterial infections||Azithromycin, Levoxacin, Quinolones, Macrolides, Ciproflaxin, Gentamicin|
|Diuretics/Hypertensives||Water retention, blood pressure||ACE inhibitors, ARBs, calcium channel blockers (Lisinopril), Zofenopril, Furosemide|
|Anti-inflammatories||Inflammation, infections, fever||NSAIDs, Ibuprofen (Motrin), Aspirin, Acetaminophen (Tylenol), Naproxen|
|Antidepressants||Depression, anxiety, mood disorders||Mirtazapine, Paroxetine, Sertraline, Amitriptyline|
|Antifungals||Fungal infections (e.g. athlete’s foot, yeast infections, thrush)||Itraconazole, Fluconazole, Amphotericin B|
|Antimalarials||Malaria and other parasitic infections||Chloroquine|
|Neuroleptics||Psychosis and other mental health conditions||Chlorpromazine (Thorazine), Clozapine, Thioridazine|
|Parkinsonians||Parkinson’s disease, various neurological conditions, management of side effects from neuroleptics||Bromocriptine, Levodopa/carbidopa|
Some falls are caused by an environmental hazard, such as something in your surroundings that’s making you either trip or lose your balance. Some environmental hazards, such as exposed wires near floor level, can directly cause you to fall, while others, such as a slippery floor, just increase the odds that you’ll fall. Common household hazards that can directly cause a fall include:
Safety hazards don’t always cause a fall, although they can make a fall much more likely or serious. These types of hazards include:
The quality of air inside your bedroom is an often-overlooked contributor to falls, especially among seniors. At night, your bedroom probably experiences a buildup of CO2, which can cause dizziness and disorientation in high enough concentrations due to poor ventilation. To improve the ventilation in your bedroom, you can:
No matter how safe you try to be at home, there are probably a lot of changes you can make to reduce your risk of falling in your bedroom. Some of these involve changes to your routine, others are alterations of the bedroom environment and some may require getting and installing new safety equipment.
As people age, even routine physical activities, such as getting out of bed, can become more dangerous. If you have a caregiver or family member at home who can help you with potentially risky activities, don’t be shy about asking for help. You can also put off lifting heavy objects or moving furniture until you have the help you need.
Falls become much more likely if you’re wearing footwear that doesn’t have enough traction. Likewise, if you have to stand at odd angles or walk in an unnatural way to manage poorly fitted or old shoes, your risk of having a fall goes up. Try to only wear slippers and shoes that are fairly new and in good shape or non-slip socks. If you don’t have any of these, most people can get decent traction and walk safely when they’re barefoot.
Many of the falls seniors have are the result of a moment of inattention or because a new object or hazard entered the environment without them noticing. Before you move, look around the bedroom for obstacles you have to walk past. Be aware of pets and small children in your environment. Watch out for doors, drawers and other movable objects that are slightly ajar, and be extra careful to not bump into them.
Slowing down might be the single most effective way to prevent falls. By taking your time and moving carefully, you can give yourself more leeway for spotting and responding to hazards that could otherwise cause a fall. Also, if you have a history of dizziness, vertigo, hypotension (low blood pressure) or dehydration it’s important to change your position (laying to sitting; sitting to standing) slowly.
It’s common for many people to move around their bedroom under less-than-ideal light conditions. If, for example, you have to head to the bathroom late at night, you might be in the habit of making the trip with the lights off. Walking in the dark is inherently dangerous, so it’s a good idea to turn on the lights and watch out for hazards.
A staggering 93% of seniors aged 65 and over need glasses, and very few wear them all the time at home. You’re especially likely to not wear glasses in the bedroom, especially if you’ve been sleeping or are about to fall asleep. Putting your glasses on before you get out of bed is a very effective way to make sure you’re seeing everything clearly, so you won’t miss a small obstacle or misjudge a distance when you’re getting out of bed.
If you’ve ever fallen before, there might be a reason. Talking about the incident, even if it was minor, with your doctor can help spot potential issues before they may cause a future fall. A persistent ear infection, for example, can affect your sense of balance, and only your doctor can properly diagnose it. Even if your doctor doesn’t find a specific medical issue that contributes to falling, your doctor may refer you to physical therapy for a balance and fall prevention program if they believe you could benefit from this type of therapy.
Arguably, your recovery from falling starts the second you realize you’ve fallen. Try not to move for a moment, so you can determine whether you’re seriously hurt before trying to get up. If you can’t get up or it doesn’t feel safe to try, stay where you are and call for help.
Depending on your living arrangements, this might be as simple as shouting to family members in another room. If you live in an assisted living or nursing home, you probably have a pull cord or call button nearby that will bring staff to your room to help you. This has the additional benefit of getting you immediate assessment for injuries in case you need medical attention.
If you live alone, it is a good idea to have a friend or caregiver who can do a daily check to make sure you’re okay. Some nonprofit organizations do this for free, and you can usually find them through your local Area Agency on Aging.
Several medical alert systems offer bracelets and pendants that connect you to help over an intercom. Some of these services autodial a phone number you’ve programmed in advance, while other services have operators on standby in dispatch centers. If you can spend a little extra each month, consider automatic fall detection and GPS, so dispatchers can pinpoint your location.
Smart home systems, such as Alexa and Siri, are always monitoring sounds and will bring someone on the line to make sure you’re okay if you call for help. You might also get into the habit of carrying a wireless phone on you wherever you go. If you always have a phone in your pocket, you can call for help without having to fight your way to the phone on the nightstand. In the United States, you can generally reach emergency services, even on a phone that doesn’t have a service plan, which makes them an excellent and very low-cost option if you need an emergency-only help option.
Some of the modifications you should think about making to your home are free or very low cost. Others cost a lot, and you might struggle to cover the expense if you’re on a fixed income. Fortunately, there are resources available to help seniors make necessary home improvements for free or at a reduced cost.
Your area probably has a local nonprofit or government agency that can help you with mobility or safety-based home improvements, such as a state-level Medicaid waiver. These options are available nationwide, and they can make a real difference in the safety of your home environment:
Section 203(k) is a type of home loan you can use to rehabilitate, upgrade or repair your home without refinancing your mortgage. If you’re buying a new property that needs extensive rehab or your current housing needs a lot of work, your mortgage lender is likely to charge higher interest and put special conditions on a conventional loan. Getting 203(k) insurance eliminates that risk, so you’re likely to get a simpler home loan at a low fixed rate.
The Specially Adapted Housing (SAH) program issues grants of up to $101,754, as of 2022, to current service members and veterans with certain service-connected disabilities. These grants can be used for building, remodeling or buying a home. If you qualify for a grant, you can use the money to pay for safety and mobility-related home improvements, such as new flooring, ramp access and handrails.
Special Housing Adaptation (SHA) grants are another veteran benefit. These are not to be confused with SAH grants, though they operate in a similar way. If you’re a service member or honorably discharged veteran with a qualifying disability, the SHA program provides up to $20,387 to upgrade and improve your home. You don’t have to use all the money at once, and qualifying veterans can access the program up to six times in a lifetime. You can use the money from an SHA grant to make safety improvements in any part of your home or upgrade the accessibility of the property.
Medicare may be able to help you pay for some of the cost of safety equipment. If you have Part B benefits or you participate in a Medicare Advantage plan, you can ask your doctor to prescribe durable medical equipment for your bedroom. Medicare benefits pay up to 80% of the cost of these items, if the devices:
Ask your doctor about whether specific safety devices can be covered under your Medicare benefits. Common devices for Part B benefits to provide include: