How to avoid injuries in the most common of places
By: Cynthia R. Nelson

Accidents in the home happen more frequently than many of us like to believe, and older Americans are at the greatest risk. Numbers vary, but studies by numerous consumer groups indicate that almost one million people over age 65 are treated in hospital emergency rooms for injuries associated with everyday products like stairs, bathtubs, furniture and carpeting.  Falls are the leading cause of injury and hospital admission for older adults.

“Falls and injuries among the elderly are issues of extreme importance to the National Safety Council,” said Alan C. McMillan, president and CEO of the organization. “In 2003, more that 15,000 Americans 65 and older died as a result of unintentional injuries in their homes.”

According to the group, typically the most falls occurred while either going up or down stairs, transitioning from standing to sitting (or vice versa) and tripping over loose carpets or other obstacles.

Risk factors for falls increase with age, but age is not the only culprit. “Reduced vision, a decrease in hearing, and balance problems can all lead to falls, too,” says Marie Hegarty of Elder Safety Products, whose company is a part of a Bucks County consortium, Children of Aging Parents, which offers products and services to assist mature individuals.

Certain medications can also contribute to accidents, she adds, since many may cause side effects like dizziness.

There are simple ways to avoid becoming a statistic.

First, suggest Jill Garaffa, Occupational Therapist and Marketing Liaison at The Rehabilitation Hospital of Tinton Falls, take a room-by-room tour and consider any potential hazards. Look for loose carpeting, extra furniture, lamps, poor lighting, and even shelves of knickknacks.

“I do not recommend any type of throw-rug at all except in the bathroom. It’s very easy to trip on the side of the rug’s edge,” says Ms. Garaffa, noting that seniors should stay away from high-pile carpeting. Low-pile carpets are best.

If you are going to install new flooring, she adds, it should have good contrast, not big prints or patterns. “You don’t want Las Vegas-style carpeting. Visually, this is a nightmare to navigate. And if you have depth perception problems or any visual abnormality, which many people do and may not realize, your chances of falling are much higher.”

It is important to keep halls, stairways, and pathways well-lighted and free of clutter and obstacles. Consider moving or removing pieces of furniture, particularly oversized or accent pieces, which can help you better navigate a room, particularly if you are using a walker or cane, says Ms. Garaffa.

Keep commonly used items within easy reach but stored in a way that will prevent falls. Also, keep a phone nearby.

And be aware of man’s best friend.

Many seniors have pets at home, and while they are constant company and offer unflagging love, they can also contribute to accidents, Ms. Garaffa says.

“Big lovable dogs that don’t know their own strength have been known to topple over a healthy person, let alone someone using a cane or walker. Little dogs and cats can also get in under your feet, so you need to watch out for them, too.

Bathing Beauty

The bathroom is the most frequently used room in any home and it is also a prime danger zone for seniors. 

Approximately 25,000 bathroom accidents occur each year, says Lynn Kohn, who along with her husband Howard, operates TubEZ, LLC, a business focused on helping seniors and the physically challenged remain independent and ensure their safety in the bathroom.

Ms. Kohn offers some simple tips to avoid bathroom accidents:

Eliminate excessive items. A clothes hamper for instance, may make a small bathroom even smaller and harder to navigate.
Ensure electrical items are stored properly and away from the sink, tub, and shower.
Avoid storing medications over the toilet or sink as they can too easily be knocked in.
Avoid burns in and out to the shower. Set the hot water to a maximum of 120 degrees and consider a single-lever faucet rather than separate hot and cold controls.
Raise or lower items as needed such as toilet seats, soap dishes, cabinets, and mirrors.   Adjusting the height will enable easier access and reduce accident risk.  
Additionally, Ms. Kohn says, place appliqués or a non-skid mat in the tub to avoid slipping, and if stability is a problem, consider adding a shower bench and an adjustable hand-held showerhead so you can sit and bathe more easily. 

For people who do have difficulty standing or bending, grab bars around the toilet and tub are essential. “Towel racks will not properly support you,” she says.

If your bathroom has a tub, consider modifying it with an easier walk-thru entry or converting to a barrier-free shower.

“It can be difficult for some people to get over the edge of a bathtub, especially if they have balance or other issues,” says Ms. Kohn, who previously worked as a counselor at two local retirement and assisted living communities, noting that many people would avoid bathing as a results. TubEZ helps them maintain independence around their personal hygiene.

“We can cut out the side of the tub and convert it from something that has a 15-inch step into either a walk-through shower that has a 6-8 inch lip or a barrier-free shower that can accommodate a wheelchair or walker,” Ms. Kohn explains.

Clients include individuals retirement homes and organizations such as the Princeton Housing Authority.

“We saw the need to have more accessible bathtubs or showers for residents,” recalls Scott Parsons, executive director of the authority, who hired TubEZ last year to transform two standard bathtubs into walk-thru showers. The process was simple and did not require any major renovations to the rest of the bathroom, he says, noting that one of the elderly residents who is wheelchair-bound is thrilled with the change. “Now she doesn’t have to worry because there are no obstacles in her way that may cause her to fall and injure herself in the bathroom.”

Look in the mirror

Once you’ve taken a look at your home, don’t forget to do a head-to-toe evaluation,
Ms. Garaffa advises. “Body-awareness is an important factor in preventing a fall, knowing your own personal limits regarding balance and strength. It may be time to consider a walker or cane.”

Other easy suggestions:  Make sure your eyeglass prescription is current. “At the least: keep your eyeglasses clean,” Ms.  Garaffa recommends. Second, check your hearing aids. 

“If you can’t hear, chances are, you’re not paying attention as well, and may be tuned-out to your environment.”

If you are unsteady, you may also want to consider a hip protector. “The most common fall-related injury is a hip-fracture. Those who survive a hip fracture do not go home right away,” explains Ms. Hegarty with Elder Safety Products. “Hip protectors are specially-designed under garments with plastic shields or foam pads held in place at the hips. They absorb the force of a fall and divert it away from the hip bone.”

A two-year study conducted in Finland showed hip protectors reduced the incidence of hip fractures dramatically, she adds. “Participants who wore hip protectors when they fell reduced their risk of hip fracture by 80 percent.”

Hip protectors come in different sizes to assure a comfortable fit. Unlike some underwear, Ms. Hegarty notes, hip protectors are not bulky. Taking precautions can help avoid falls and keep seniors safe at home. But it’s important, Ms. Garaffa says, to know your limitations. She advises seniors to ask for assistance when they need it,  “It can be the difference between a fracture and freedom.” For information on some of the products mentioned, visit www.tub-ez.com www.Bathfitter.com and www.eldersafetyproducts.com.

Living With In-Laws Linked to Heart Risks in Japanese Women
By RONI CARYN RABIN - Original article posted in The NY Times

Japanese women are generally not at high risk for heart attacks — unless they live with in-laws, according to a new study.

Married Japanese women who live with both their husbands and a set of parents — in Japan, that almost always means the husband’s parents, according to the researchers — were three times more likely to suffer a heart attack than those living just with their husbands.

Having children at home also was associated with an increased risk of heart attacks among Japanese women, but not by as much, the study found. When women lived with both parents and children, the risk of heart attacks doubled rather than tripled.

The heart attack risk was slightly higher among women living with both spouses and children, the study found.

The study was conducted by researchers at the Harvard School of Public Health and was published in this week’s issue of the journal Heart.

“We tend, in the West, to view family relations and social support as being protective of health,” said Dr. Ichiro Kawachi, an epidemiologist at the school and one of the study’s authors. “This is the first epidemiological study to show that these traditional living arrangements in Japan are rather harmful for women.”

He added, “If you’re balancing a spouse and children, it’s also a problem.”

Remarkably, however, the living arrangements do not affect men’s health.

“One of the overwhelming things that stands out is that it doesn’t matter for Japanese men what the living arrangements are,” Dr. Kawachi said. “They’re immune from the stresses in the home.” Young Japanese women are “voting with their feet” by postponing marriage and having fewer children, he added.

The researchers followed 91,000 Japanese men and women living in different household arrangements for more than 10 years. The participants ranged in age from 40 to 69 and had not been diagnosed at the start of the study with any serious illnesses, including heart disease, stroke or cancer.

By the end of the study, 671 participants had been diagnosed with coronary artery disease, 339 had died of heart disease, and 6,255 had died of other causes.

Women who lived with their spouses and parents, usually in-laws, were less likely to smoke or drink heavily, but were three times more likely to have had a heart attack, the researchers found.

They were not more likely to die of a heart attack than the women who lived alone with their spouses. Dr. Kawachi speculated that once the women fall ill, they begin to receive the support they need, in which case “having parents around is probably helpful.”

The results were adjusted to control for age, smoking and other factors.

“This is yet another study that shows a link between stress and increased rates of cardiovascular disease, although we don’t have the definitive study that proves it,” said Dr. Nieca Goldberg, a cardiologist specializing in women and author of the book “The Women’s Healthy Heart Program.”

An earlier study from Sweden found that marital stress increased the risk of heart disease for women, she noted. But emotional stress may be a marker for other risk factors and not necessarily a risk in itself, Dr. Goldberg added.

Dr. Kawachi said that the risk for heart attacks may not be quite as high among Japanese women who live with both parents and children, compared to those living just with parents, because parents may be helping with child care and other responsibilities, offsetting other stresses.

Four Scottish hospitals are to take part in an international study to see whether early rehabilitation can aid stroke patients.

Stirling Royal Infirmary, Monklands, Wishaw General and Glasgow’s Western Infirmary will join the study over the next four years.

The trial will assess the impact of activities like sitting, standing and walking after suffering a stroke.

Researchers hope the trial will help cut death and disability rates.

The programme called AVERT (A Very Early Rehabilitation Trial) will be offered to patients who arrive at participating hospitals within 24 hours of suffering a stroke.

Figures show that stroke is the biggest cause of disability in Scotland.

Cost effectiveness

There are currently about 13,000 strokes a year, with more than one in five suffered by people under the age of 65.

Although past research has looked at the effects of different medication after stroke, those behind the study, which began in Australia, said no high quality trials had assessed the benefits of very early rehabilitation.

NHS Forth Valley consultant neurologist Dr Malcolm MacLeod, who is leading the trial at Stirling, said: “These studies are the best way of finding out if this type of treatment works.

“In particular, it may reduce death, disability and dependence of stroke patients long term, thus reducing the number of people who need to go into nursing homes.”

The trials are being funded by Chest, Heart and Stroke Scotland, and co-ordinated by a Glasgow University research team and the Scottish Stroke Research Network.

The research team will also test the feasibility and cost effectiveness of the early mobilisation plan within the Scottish healthcare setting

There are plenty of things you can do to protect your heart health, such as maintaining a healthy weight, never smoking, eating a healthy diet or getting regular exercise. While any of those steps taken individually can improve your heart health, a new study finds that doing them all together may have a far greater impact on reducing the risk of premature death than any single lifestyle change.

During a 24-year period, more than 77,000 women participating in the Nurses’ Health Study completed questionnaires about their health and lifestyle. During the study, almost 9,000 of the women participating in the study died, including 1,790 women who died as a result of cardiovascular disease.

Based on their analysis of the questionnaires, researchers from the Harvard School of Public Health found that 72 percent of these deaths could have been prevented if the women had eaten a healthy diet, maintained a healthy weight, participated in regular physical activity and had never smoked. The study was published in September in the British Medical Journal.

“Our findings suggest that the combination of lifestyle factors has a substantially larger impact on survival than any single factor,” says Rob van Dam, Assistant Professor of Nutrition at the Harvard School of Public Health and the study’s lead author. “Clearly, avoiding smoking is of major importance for health, but regular physical activity, a healthy diet and weight management can result in large additional health benefits. Even modest lifestyle changes such as 30 minutes of moderate intensity physical activity (e.g., brisk walking) per day significantly reduced risk of premature death.”

So how is a healthy lifestyle measured? Club Red asked Mary Lou Perry, a registered dietitian and certified diabetes educator at UVA Health System’s Heart & Vascular Center, and Cindy Parnell, a registered clinical exercise physiologist at the UVA Heart & Vascular Center, for some answers.

A healthy weight: This study, Perry says, defined a healthy weight as anyone with a Body Mass Index (BMI) between 18 and 25. BMI is a measure of height relative to weight and is a reliable indicator of total body fat, she says. (Here’s a BMI calculator from the National Heart, Lung and Blood Institute.) Although the study didn’t measure waist size, Perry adds, “healthy weight isn’t so much about how much there is, but where it is. It’s all about location, location, location. Carrying weight in the middle leads to inflammation and release of dangerous chemicals that increase cardiovascular risk.”

Healthy eating: The key elements of a healthy diet, Perry says, are generous amounts of fruits and vegetables, whole grains, nuts, fish and chicken. Red meat should be eaten on rare occasions, and trans fats should be avoided entirely.

Regular physical activity: 30 minutes of moderate exercise, such as a brisk walk, on most days of the week will help boost your heart health, Parnell says, though as little as 10 minutes of exercise per day provides some health benefits.
By: University of Virginia Health System - Wed, 11/05/2008 - 16:50