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Spring Clean for Safety

Spring is just around the corner!  What a wonderful time of the year, with thoughts of renewal and rebirth and the fact that we have survived another harsh winter have my thoughts turning towards that annual ritual spring cleaning.   Spring cleaning has it roots in the times where people heated their homes with coal, oil and wood.  Houses kept shut tight against the cold of winter became soot covered and filled with residue from heating methods.   With the warmth of spring, people would open their homes to the fresh air, remove all the furniture and bedding and wash down all surfaces in their home.  Modern conveniences have all but eliminated the necessity of a complete clean out, however a better focus might just be on safety issues especially in the homes of our aging population. 

One in three adults over the age of 65 will experience an injury in their home resulting in an estimated 20 Billion dollar cost in treatment annually. According to statistics from the Centers for Disease Control: 

  • Falls prompted 2.1 million elderly adults to seek care in emergency rooms in 2006, and accounted for one in 10 emergency visits among patients age 65 or older.
  • Falls among women over age 84 were more frequent, one in seven, compared with falls among men over age 84, one in 10.
  • Fractures were the biggest reason for fall-related injuries among seniors, accounting for 41% of emergency room visits after a fall. Superficial injuries or contusions accounted for 22.6%, and open wounds 21.4%.
  • Hip fractures accounted for one in eight injurious emergency room visits among the elderly.
  • Those seniors who were admitted to the hospital for treatment due to a fall were more likely to be discharged to a long-term care facility than elderly patients admitted to the hospital for other conditions.

A home safety inspection is an excellent way to promote wellness and prevent injuries and spring cleaning time is a great opportunity to start! Here are a few tips and starting points: 

Develop and practice an emergency exit plan and an alternate emergency exit plan in case of a fire. Once a fire starts, it spreads rapidly. Since you may not have much time to get out and there may be a lot of confusion, it is important that everyone knows what to do. Choose a meeting place outside your home so you can be sure that everyone is capable of escape quickly and safely. 

Station phones in multiple areas of the home.  Purchase a cordless phone with several handsets and locate them near high risk areas such as the bottom of stairs, kitchen and bedrooms. 

Many fire injuries and deaths in homes are caused by smoke and toxic gases, rather than the fire itself. Smoke detectors provide an early warning and can wake you in the event of a fire.

  • Purchase a smoke detector if you do not have one.
  • Check and replace batteries and bulbs according to the manufacturer's instructions.
  • Replace any smoke detectors which can not be repaired.
  • Purchase and install Carbon Monoxide detectors.

General Home

  • Check lighting to assure it is adequate; consider installing timers or motion detectors on lights.
  • Arrange furniture so that outlets are available for lamps and appliances without the use of extension cords.
  • If you must use an extension cord, place it on the floor against a wall where people can not trip over it.
  • Move the phone so that telephone cords will not lie where people walk.
  • Replace damaged and frayed cords.
  • Remove rugs and runners that tend to slide.
  • Apply double-faced adhesive carpet tape or rubber matting to the backs of rugs and runners.
  • Purchase rugs with slip-resistant backing.
  • Check rugs and mats periodically to see if backing needs to be replaced.
  • Place rubber matting under rugs. (Rubber matting that can be cut to size is available.)
  • Purchase new rugs with slip-resistant backing.

Over time, adhesive on tape can wear away. Rugs with slip- resistant backing also become less effective as they are washed. Periodically, check rugs and mats to see if new tape or backing is needed.

Bathroom:   

  • Apply textured strips or appliqués to the tub floor or place a rubber slip resistant mat in bathtub.
  • All rugs in the bathroom should have slip resistant backing.  Check the 
  • temperature of hot water heater; it should be set on low or a temperature of 120     degrees Fahrenheit to prevent burns and scalding.
  • Install or check the integrity of grab bars in the shower area.
  • Check the lighting; consider replacing the switch with a "glow switch that can be easily seen in the dark, install a night light.
  • Medications that are not clearly and accurately labeled can be easily mixed up. Taking the wrong medicine, or missing a dosage of medicine you need, can be dangerous.
  • Be sure that all containers are clearly marked with the contents, doctor's instructions, expiration date, and patient's name.
  • Dispose of outdated medicines properly.
  • Request non-child-resistant closures from your pharmacist only when you cannot use child-resistant closures.

Many poisonings occur when children visiting grandparents go through the medicine cabinet or grandmother's purse. In homes where grandchildren or other youngsters are frequent visitors, medicines should be purchased in containers with child-resistant caps, and the caps should be properly closed after each use, store medicines beyond the reach of children.

Bedroom

Lamps or switches located close to each bed will enable people getting up at night to see where they are going.

  • Rearrange furniture closer to switches, or move lamps closer to beds.
  • Install night lights.

Burns are a leading cause of accidental death among seniors. Smoking in bed is a major contributor to this problem. Among mattress and bedding fire-related deaths in a recent year, 42% were to persons 65 or older.

  • Remove sources of heat and flame from areas around beds.
  • Don't smoke in bed.

Use electric blankets according to the manufacturer's instructions. Don't allow anything to be on top of the blanket while it is in use. This includes other blankets or comforters, and even pets sleeping on top of the blanket.  Don't set electric blankets so high that they could burn someone who falls asleep while they are on.

Never go to sleep with a heating pad if it is turned on because it can cause serious burns, even at relatively low settings.

Is there a telephone close to your bed? In case of an emergency, it is important to be able to reach the telephone without getting out of bed.

Kitchen

Placing or storing non-cooking equipment, such as potholders, dish towels, and plastic utensils on or near the range may result in fires or burns.

  • Store flammable and combustible items away from the range and oven.
  • Remove any towels hanging on oven handles. If towels hang close to a burner, change the location of the towel rack.
  • If necessary, shorten or remove curtains which could brush against heat sources.

70% of all people who die from clothing fires are over 65 years of age. Long sleeves are more likely to catch fire than are short sleeves. Long sleeves are also more apt to catch on pot handles, overturning pots and pans and causing scalds.

  • Roll back long, loose sleeves or fasten them with pins or elastic bands while you are cooking.

Stairways

For all stairways, check lighting, handrails, and the condition of the steps and coverings.

 Stairs should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs. The lighting should not produce glare or shadows along the stairway. Even if you are very familiar with the stairs, lighting is an important factor in preventing falls.

  • Use the maximum-wattage bulb allowed by the light fixture. (If you do not know the correct wattage, use a bulb no larger than 60 watts.)
  • Install light switches located at both the top and bottom of the stairs.
  • If no other light is available, keep an operating flashlight in a convenient location at the top and bottom of the stairs.
  • Install night lights at nearby outlet

Worn treads and worn and loose carpeting can lead to insecure footing, resulting in slips and falls.

  • Try to avoid wearing only socks or smooth-soled shoes or slippers when using stairs.
  • Make certain the carpet is firmly attached to the steps all along the stairs.
  • Consider refinishing or replacing worn treads, or replacing worn carpeting.
  • Paint outside steps with paint that has a rough texture, or use abrasive strips.

 Even a small difference in step surfaces or riser heights can lead to falls.

  • Mark any steps which are especially narrow or have risers that are higher or lower than the others. Be especially careful of these steps when using the stairs.

Have a safe and wonderful spring!

 
Spring Clean for Safety

Spring is just around the corner!  What a wonderful time of the year, with thoughts of renewal and rebirth and the fact that we have survived another harsh winter have my thoughts turning towards that annual ritual spring cleaning.   Spring cleaning has it roots in the times where people heated their homes with coal, oil and wood.  Houses kept shut tight against the cold of winter became soot covered and filled with residue from heating methods.   With the warmth of spring, people would open their homes to the fresh air, remove all the furniture and bedding and wash down all surfaces in their home.  Modern conveniences have all but eliminated the necessity of a complete clean out, however a better focus might just be on safety issues especially in the homes of our aging population. 

One in three adults over the age of 65 will experience an injury in their home resulting in an estimated 20 Billion dollar cost in treatment annually. According to statistics from the Centers for Disease Control: 

  • Falls prompted 2.1 million elderly adults to seek care in emergency rooms in 2006, and accounted for one in 10 emergency visits among patients age 65 or older.
  • Falls among women over age 84 were more frequent, one in seven, compared with falls among men over age 84, one in 10.
  • Fractures were the biggest reason for fall-related injuries among seniors, accounting for 41% of emergency room visits after a fall. Superficial injuries or contusions accounted for 22.6%, and open wounds 21.4%.
  • Hip fractures accounted for one in eight injurious emergency room visits among the elderly.
  • Those seniors who were admitted to the hospital for treatment due to a fall were more likely to be discharged to a long-term care facility than elderly patients admitted to the hospital for other conditions.

A home safety inspection is an excellent way to promote wellness and prevent injuries and spring cleaning time is a great opportunity to start! Here are a few tips and starting points: 

Develop and practice an emergency exit plan and an alternate emergency exit plan in case of a fire. Once a fire starts, it spreads rapidly. Since you may not have much time to get out and there may be a lot of confusion, it is important that everyone knows what to do. Choose a meeting place outside your home so you can be sure that everyone is capable of escape quickly and safely. 

Station phones in multiple areas of the home.  Purchase a cordless phone with several handsets and locate them near high risk areas such as the bottom of stairs, kitchen and bedrooms. 

Many fire injuries and deaths in homes are caused by smoke and toxic gases, rather than the fire itself. Smoke detectors provide an early warning and can wake you in the event of a fire.

  • Purchase a smoke detector if you do not have one.
  • Check and replace batteries and bulbs according to the manufacturer's instructions.
  • Replace any smoke detectors which can not be repaired.
  • Purchase and install Carbon Monoxide detectors.

General Home

  • Check lighting to assure it is adequate; consider installing timers or motion detectors on lights.
  • Arrange furniture so that outlets are available for lamps and appliances without the use of extension cords.
  • If you must use an extension cord, place it on the floor against a wall where people can not trip over it.
  • Move the phone so that telephone cords will not lie where people walk.
  • Replace damaged and frayed cords.
  • Remove rugs and runners that tend to slide.
  • Apply double-faced adhesive carpet tape or rubber matting to the backs of rugs and runners.
  • Purchase rugs with slip-resistant backing.
  • Check rugs and mats periodically to see if backing needs to be replaced.
  • Place rubber matting under rugs. (Rubber matting that can be cut to size is available.)
  • Purchase new rugs with slip-resistant backing.

Over time, adhesive on tape can wear away. Rugs with slip- resistant backing also become less effective as they are washed. Periodically, check rugs and mats to see if new tape or backing is needed.

Bathroom:   

  • Apply textured strips or appliqués to the tub floor or place a rubber slip resistant mat in bathtub.
  • All rugs in the bathroom should have slip resistant backing.  Check the 
  • temperature of hot water heater; it should be set on low or a temperature of 120     degrees Fahrenheit to prevent burns and scalding.
  • Install or check the integrity of grab bars in the shower area.
  • Check the lighting; consider replacing the switch with a "glow switch that can be easily seen in the dark, install a night light.
  • Medications that are not clearly and accurately labeled can be easily mixed up. Taking the wrong medicine, or missing a dosage of medicine you need, can be dangerous.
  • Be sure that all containers are clearly marked with the contents, doctor's instructions, expiration date, and patient's name.
  • Dispose of outdated medicines properly.
  • Request non-child-resistant closures from your pharmacist only when you cannot use child-resistant closures.

Many poisonings occur when children visiting grandparents go through the medicine cabinet or grandmother's purse. In homes where grandchildren or other youngsters are frequent visitors, medicines should be purchased in containers with child-resistant caps, and the caps should be properly closed after each use, store medicines beyond the reach of children.

Bedroom

Lamps or switches located close to each bed will enable people getting up at night to see where they are going.

  • Rearrange furniture closer to switches, or move lamps closer to beds.
  • Install night lights.

Burns are a leading cause of accidental death among seniors. Smoking in bed is a major contributor to this problem. Among mattress and bedding fire-related deaths in a recent year, 42% were to persons 65 or older.

  • Remove sources of heat and flame from areas around beds.
  • Don't smoke in bed.

Use electric blankets according to the manufacturer's instructions. Don't allow anything to be on top of the blanket while it is in use. This includes other blankets or comforters, and even pets sleeping on top of the blanket.  Don't set electric blankets so high that they could burn someone who falls asleep while they are on.

Never go to sleep with a heating pad if it is turned on because it can cause serious burns, even at relatively low settings.

Is there a telephone close to your bed? In case of an emergency, it is important to be able to reach the telephone without getting out of bed.

Kitchen

Placing or storing non-cooking equipment, such as potholders, dish towels, and plastic utensils on or near the range may result in fires or burns.

  • Store flammable and combustible items away from the range and oven.
  • Remove any towels hanging on oven handles. If towels hang close to a burner, change the location of the towel rack.
  • If necessary, shorten or remove curtains which could brush against heat sources.

70% of all people who die from clothing fires are over 65 years of age. Long sleeves are more likely to catch fire than are short sleeves. Long sleeves are also more apt to catch on pot handles, overturning pots and pans and causing scalds.

  • Roll back long, loose sleeves or fasten them with pins or elastic bands while you are cooking.

Stairways

For all stairways, check lighting, handrails, and the condition of the steps and coverings.

 Stairs should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs. The lighting should not produce glare or shadows along the stairway. Even if you are very familiar with the stairs, lighting is an important factor in preventing falls.

  • Use the maximum-wattage bulb allowed by the light fixture. (If you do not know the correct wattage, use a bulb no larger than 60 watts.)
  • Install light switches located at both the top and bottom of the stairs.
  • If no other light is available, keep an operating flashlight in a convenient location at the top and bottom of the stairs.
  • Install night lights at nearby outlet

Worn treads and worn and loose carpeting can lead to insecure footing, resulting in slips and falls.

  • Try to avoid wearing only socks or smooth-soled shoes or slippers when using stairs.
  • Make certain the carpet is firmly attached to the steps all along the stairs.
  • Consider refinishing or replacing worn treads, or replacing worn carpeting.
  • Paint outside steps with paint that has a rough texture, or use abrasive strips.

 Even a small difference in step surfaces or riser heights can lead to falls.

  • Mark any steps which are especially narrow or have risers that are higher or lower than the others. Be especially careful of these steps when using the stairs.

Have a safe and wonderful spring!

 
April 16 Is National Medical Decision Making Day

   The "death with dignity" or "right to die" movement has a long history. The first living will was attempted in the late 1906 in Ohio and today continues to stir controversy.  

The initial legal attempt of allowing patients and families to make decisions concerning end of life care was first introduced in 1968 by a physician turned legislator in Florida. The bill was rejected, but sparked other states to consider their own laws regarding the issue. In September 1976 California passed the first right to die laws and the age of Advanced Directives was born.  Over the next several years other states joined California by passing similar legislation, but it was not until 1992 that all US states had enacted laws regarding end of life care. 

In 1991, the U.S. House of Representatives enacted the Patient Self- Determination Act. The Act mandates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. 

There are several types and formats of Advanced Directives. Some allow the patient to designate a medical decision making proxy while others allow for specific instructions in the type of care acceptable and situations in which to refuse or limit care. Patients and their families should evaluate and plan for the format that will best meet their needs.

One common issue is that the advance directive is not transferable from state to state.  A hospital or physician is not required to recognize an out of state directive. Often, as elderly patients are being moved to residences closer to family this is missed.  

It is estimated that today, less than 50% of the population over the age of 70 has an Advanced Directive.  We have included several links that offer information and state by state instructions for Advanced Directives. 

U.S. Living Will Registry

http://uslwr.com/formslist.shtm 

Caring Connection

http://www.caringinfo.org/i4a/pages/index.cfm?pageid=1 

Aging with Dignity

http://www.agingwithdignity.org/

 

 
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