The menu is planned, the table is set, and the guests are invited. But if you're hosting older relatives and friends this holiday season, you'll also need to prepare your home inside and out to make sure their visit is comfortable and safe.
The biggest risk for aging adults in the home is tripping and falling, said Kenneth Chakour, MD, a University of Chicago Medicine orthopedic surgeon who specializes in comprehensive joint care.
"As we get older, there can be gait instability and underlying disease or arthritis that takes away mobility," he said. "Vision may not be as good, making it harder to see obstacles, and reaction time goes down, making it harder to catch yourself if you do fall."
Not only is there a higher risk of falling, there's a higher risk of serious injury because of falls.
Many older patients are on blood thinners, so a normal hit on the head, for example, could cause bleeding on the brain. And because bone quality deteriorates, older adults are more susceptible to fractures, particularly hip fractures."
Kenneth Chakour, MD, University of Chicago Medicine orthopedic surgeon
Every year, more than 300,000 people ages 65 and older are hospitalized for hip fractures, according to the Centers for Disease Control and Prevention, most due to falling. The mortality rate is high: About 10 percent of patients die within one month after a hip fracture and 30 to 50 percent within a year.
But, you can vastly reduce the risk of falling by evaluating your home before relatives arrive, said Megan Huisingh-Scheetz, MD, MPH, UChicago Medicine geriatrics specialist and Co-Director of the Successful Aging and Frailty Evaluation (SAFE) Clinic. From your exterior walkway to every room where guests will spend time, make sure paths are clear, the handholds and railings are secure and lighting is good throughout.
If you have a choice of locations, Chakour suggested, consider holding holiday celebrations in a single-level home, or have most activities on the first level to avoid stairs.
A step-by-step guide to prepping your home for older visitors
Outside: Walkway, driveway, steps
- Clear ice, snow and loose leaves to prevent slips/falls.
- Make sure steps are well-salted and handrails are tightened.
- Increase exterior lighting so visitors can see clearly where they are stepping and walking.
- Pick up all loose papers or items on the floor and stairs.
- Tighten all handrails so they are secure and easy to grip.
- Stairs should be well lit, with light switches at the top and bottom.
- Eliminate any potential tripping hazards, especially loose electrical cords and rugs.
- Make sure there are clear, easy paths to walk through and between every room.
- Move furniture that obstructs direct walking paths.
- Pets are a tripping hazard. Make sure they are under control, either in another room or away from visitors.
- Keep pots and pans accessible and not on top shelves, especially if older relatives like to help cook.
- Clear all kitchen obstacles. Don't let pets or children get underfoot.
- If an older adult is spending the night, put a lamp near the bed so they can turn it on before getting up to use the bathroom at night.
- Is there a lit pathway to the bathroom? Put a nightlight in the hallway and bathroom so space is easy to navigate.
- Getting on and off toilets can be challenging. If a toilet is too low, get a raised toilet seat with bar from a home medical store or have someone help your relative.
- If your guest is using the shower, provide a bench and rails to grip if needed.
For more safety information, see the STEADI program materials from the Centers for Disease Control and Prevention.
Other ways to make the holidays safe:
- Medications can impact blood pressure, and sitting-to-standing can cause some older people to become dizzy. Make sure your guest's walker or cane is nearby and available. Encourage them to move slowly from one position to another.
- While mood lighting and candles are fun, they aren't best for those with poor vision. Turn up the lights!
- Make sure older guests stay hydrated. Be aware that since metabolism is slower, alcohol can have a greater effect on older adults' balance. Medication may also interact with alcohol and affect balance and gait.
- If something does happen – a slip and fall – don't let the fact that it's a holiday delay you from seeking treatment. "As an orthopedic surgeon, we want to fix these fractures within 24 hours because we end up with better outcomes," said Chakour, who explains that pneumonia and blood clots are common risk factors after hip fracture.
"There are a substantial number of falls that are preventable," said Huisingh-Scheetz. "Home safety is part of that, but you also want to make sure that your older relative or friend's vision is evaluated, glasses are up to date, canes and walkers are properly fit to their height and are being used correctly (many people borrow one), and that strength and balance work and exercises are being done on a regular basis."
All of those issues, as well as other health screenings, can be evaluated at UChicago Medicine's Successful Aging and Frailty Evaluation (SAFE) Clinic.