The Current - How to keep seniors safe from dangerous falls at home

Episode Date: March 11, 2025

Many people want to stay in their own homes as they get older, but things like stairs and slippery bathtubs can lead to falls and injury. As part of our ongoing series on getting older, we look at what kind of improvements and modifications can keep seniors safe — and in their homes longer.

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This is a CBC Podcast. Hello, I'm Matt Galloway and this is The Current Podcast. It is a fact, there's nothing you can do about it. All of us are getting older and with that comes changes, whether it's for ourselves or watching our parents have to adapt to how they are living as their bodies and minds age. Last week on this program, we spoke with two experts on how to have those conversations and make those choices about how we want to live as we get older. We are continuing that conversation today with a look at falls and our producer,ellie Goumish taking us to visit a woman

near St. Catharines Ontario. Hi, hi you can come on in. Thank you. I'm Laurie. Hello. This is Linda Hawley. Hi. How are you today? I've been better. I didn't get any sleep last night. I'm sorry to hear that. Sore legs keep me awake. Linda's 72 years old. She lives on her own with her three cats and she has lived in this trailer for more than 35 years. This trailer is 70 years old. I did fix up the outside but then when I lost my job I wasn't able to renovate the inside and I went on disability. So I've been on old age pension since 65 and it's a little bit

more money so it makes me more comfortable. Disability is awful. You just can't afford anything. I'm comfortable here because it's familiar. My neighbors are wonderful and I just don't want to go anywhere where it's strange. And plus, my animals. I wouldn't be able to take them and I need them. Linda's sons live out of town. Her brother and sister-in-law help her out. But life is getting harder. She has conditions that are painful and that are affecting her mobility and ability to

manage some of her day-to-day tasks. Today Lori Elliott Leach is at Linda's home to do a home safety assessment. Lori is a safety home program manager at Happy in My Home Community Support Services of Niagara. What I'm going to do is I'm going to ask you some questions just to get a better understanding of where you're at mobility wise. Inside, you know, it's not really my place to tell somebody I don't think you should live here. My goal is to try and keep them in their homes. People tend to be nervous when I come in. They're gonna say your home's not safe, you can't stay here and that's the opposite of what I'm doing.

I'm trying to make their home safe. I can feel it in my legs. Yeah and then I'm gonna take a walk around and we'll take a look at your place. Okay Linda have you ever had a fall? Oh yeah plenty. When's the last time you had a fall? About a week ago. And where was that? Oh yeah, plenty. When's the last time you had a fall? About a week ago.

And where was that? In the grocery store. Oh dear. Were you able to get up? Two men lifted me. Oh, that was nice of them. And other times, there was my balance. Okay.

Are you afraid of falling? Is that a worry? Yep. Yeah, I am. Do you have any services at all helping you with anything or am I the first person to connect? You're the only person. Okay.

I ended up calling my sister-in-law breaking down crying because I can't do anything. Do you wear any type of emergency detector around your neck? Do you have a cell phone that you keep with you at all times in case of emergency? Yeah, that's my cell phone. Is that with you all the time? Yeah. Sleeping, watching TV. Pocket, putting the garbage out.

So is there an area of your home that is of most concern to you? Just the bathtub. So that's your main area of concern? It scares me. So that's all I got. Okay. Okay, let's go look. I'll let you lead the way.

You okay? Yeah. Do you want your walk? I was gonna say you want your walker instead. Let's move that back in so you can get it by. It wouldn't be so bad if I could breathe a bit better. That just makes things worse, doesn't it? Yeah. That's bad on top of everything else.

Do you not open your walker? Do you walk with it like that? Because my concern is, is it's very wobbly like it? Yeah. Do you not open your walker? Do you walk with it like that? Because my concern is is it's very wobbly like that. Yeah. If I open it up in here but I can't in the hole. Gotcha. And then again I'm too weak to shut it and you might then I have to ram it against a piece of furniture to get it shut. It's big. Yeah. I'm just gonna... There's the bathroom. Okay. There's not a lot of room in there with water and dryer. No, it's a tight squeeze with your... I mean this is good that you have that on there, the bars to help you get up and down from the toilet. When I had to call an ambulance. Yeah, so that's good. That's a help. Oh, fantastic. So my next question is going to be how... it's a very tight squeeze in here. And my feet, like I would like a shower that goes straight down instead of that curve. My feet slide on

that curve of the bathtub. Oh this... you know the bottom there? This part? Yeah. That's why I would like a walk in. Yeah a lot of walk-in showers will be just be flat. Yeah. So when you're getting in you're telling me. That pillow is there for my cat. That's what he wants to sleep. So you're telling me right now you're grabbing onto this which is very wobbly. Yeah I it's wobbly because I raised it. The other one's not as wobbly. Well, I guess it is. These tend to be wobbly. Yeah, but that's alright. I can manage.

When you get out of the shower for now, always make sure you have something on the floor, like a rubber back mat, not a towel. Towels shimmy and slide too much. It's too easy to trip up on them. Can we take a peek at your bedroom, please? Yeah. See how you manage in there? Okay. I fell once here. So night light came in. Night lights are good but night lights won't work if the power goes out. Oh right. So I will give you a flashlight. I give flashlights out to everybody. Flashlight right here. Good. And that's about the best I can do. That's good you have no

area rugs you have no issues getting in and out of bed? No this is not this is my grandfather's bed and it's not high. Okay that's good. Yeah. Okay. Now you know my life story. All right how are you managing changing the litter box? Oh, it's a challenge. It's a challenge, eh? I love my cats and when they're gone, I'm gone too. They're the only things that are keeping me here, so don't suggest I get rid of them. Oh, no, no, I was curious about how you manage.

Oh, I would never. I'm an animal person. I would never tell you to get rid of your pets. Yeah, after you leave, I gotta go buy kitty litter. You're still driving? Yeah, I'm still driving. When I'm driving I feel like my old self. Oh, that's nice. I manage to do my groceries and then I come home and flake out. And then you've got to step up here to your kitchen but you have a railing? Okay. And the dishes are piling up and I can't stand there long enough to do those.

I fall into the sink. If you, we are able to get you a home making cleaning they might do the dishes when they're here for you. I just want it. Well let's see. Okay. Okay I'm going to take a peek luck. So you had said you wanted something here. What was it that you wanted on your step? I was wondering if a lift would fit there. Would let me stay here a heck of a lot longer. Yeah. I'm not going into a home. I've made that clear. I've made that clear. Okay, we can go in. I've been here 36 years and of course I was healthy when I bought it, but I've been living like this 20 years. Just gradually getting worse now.

Yeah. I never had asked for help before. Why don't you come and have a seat? Just take your time. I'm going to sleep good tonight, you guys. We're giving you a workout, aren't we? My spirits do lift up a bit when there are people come to visit me or come in here. That's funny, isn't it? How your spirits can lift. I have a couple of friends that do come over for a cup of tea and my sister-in-law likes to come over a lot. I like it in here. I feel safe in here.

Do you have any questions Linda? Oh, this is a lot of information. Well I've written most of it down. It means the world for me to have somebody help me. I'm very pleased. I hope I'll be able to get a few things anyway that'll help me out. And to be honest with you, I don't even know how much time is going to go by. You know, it's just something you don't know. So, just live every day best I can.

That's Linda Hawley. Lori Elliott Leach conducted that home safety visit, and she referred Linda to several services, including an occupational therapist and help with housekeeping and home improvements. On the Embedded Podcast. No, no. It's called denying us freedom of speech. It's misinformation. Like so many Americans,

my dad has gotten swept up in conspiracy theories. These are not conspiracy theories, these are reality. I spent the year following him down the rabbit hole, trying to get him back. Listen to alternate realities on the embedded podcast from NPR, all episodes available now. Nancy Edwards is a distinguished professor at the University of Ottawa, a retired nurse

with decades of experience in community health, including a focus on fall prevention for seniors. She's in our Ottawa studio. Nancy, good morning to you. Good morning, Matt. As you listen to that visit between Linda and Lori, what goes through your mind? Well, I think what she describes is pretty common actually, many facets of the interview rang bells with me. One was her reluctance, I guess, to ask for help,

her increasingly challenging mobility problems and the social isolation that she described, the fact that she's had a number of falls, she didn't disclose how many, but you know but as Lori speaks to her, Linda became more and more comfortable with the knowledge that something could be done and services could be offered, and good to hear that a referral was made

to an occupational therapist. Let me ask you about falls. Why is a fall such a serious risk, especially for somebody who's older? Well, as we get older, the likelihood of falling increases. We know that one in three seniors fall every year, and falls cost our health care system a lot of money, $10.3 billion. That's across all age groups,

but $5.6 billion of that is the cost of falls for seniors. As we age, of course, changes are taking place. In our bodies, we may have balance that's not as good as it was. Our strengths in our muscles is not as good, especially if we're not doing any regular physical activity. We may have vision changes associated with aging like cataracts. We may have more medications that we're taking for a variety of conditions. More and more people are living with chronic diseases. All of these start to build up the number of risk factors.

So you have an increased propensity to fall, and when you fall, you're more likely to injure yourself. And those injuries can be severe. They shake your confidence, even when the injury is a mild bruise, perhaps, that you get. But when you lose your confidence, then you may start to restrict your physical activity and it can become a downward spiral. Well, and the tricky thing, I mean, we heard that on that tour is that the risks are everywhere, right? I mean, she talked about how the bathroom scares her, but also in the tour,

we heard about concerns around carpets, what may or may not be in the bedroom, for example. Again, we got some evidence of that from the tour, but what are some of the things that people need to be looking out for in a home that could present a risk? Well, I was really glad that some of the environment issues were a focus of that interview because I think often those get overlooked. But the big ones in my mind are steps and stairs where we know that the results of falls can be very serious and the rate of injuries is higher. Lack of grab bars in bathrooms and in showers is another big one.

And then something that she also mentioned, which is in bedrooms, seniors who have to get up at night to go to the bathroom, they don't have a light that's handy. They're quickly trying to get to the bathroom and may fall in the process. So, stairs and bathrooms and bedrooms are the big places for falls. The night light was helpful, and flashlight as well. What about if you are adding a handrail or a grab bar, how effective can that be in preventing those falls?

Very effective. We know actually that grab bars in bathrooms can reduce falls by upwards of 40%. And handrails on stairs are probably the biggest improvement you can make on stairs. And not just one handrail, but two handrails. A lot of handrails in homes inside stairs are not very graspable. They're more decorative and you can hold on to them but you might be using a pincer grasp as opposed to having a round handrail that you can grasp firmly like a tennis grip. And lighting on stairs is often a big problem. People may not have a toggle

switch so they're turning on the lights after they go down the stairs in the basement and turn off the lights at the bottom of the basement stairs before they go back up. So essentially they're going up and down those stairs with no light. Outdoor stairs are also a big problem and unfortunately our building codes don't cover the construction of outdoor stairs which is why we see so many outdoor steps in Canadian homes that actually have no handrails. And I don't know the cost of this, but presumably if you are adding handrails and grab bars, that is an additional cost that perhaps at the best of times, let alone during a financial crisis, if

someone's living on a fixed income, can be almost prohibitive. They think it should be priced out, they might be important, but they might be priced out of somebody's ability. For sure. That's always a concern. There is some funding available in, I believe, most provinces that can be used for people

who are low income and need funds to actually support the installation of something like handrails and grab bars. It's also easier, I suppose, if you own the home, right? I mean, if you're renting, it's trickier to be drilling a hole in the wall and adding another railing. Yes, but I find often that people haven't actually asked the questions, but they're just assuming that the landlord will refuse to allow them to install a handrail or a grab bar when in fact they may allow it and they have a duty to

accommodate people who have accessibility problems. I'm very much one for thinking about universal design. What does that mean? So universal design is making things accessible everywhere for everyone essentially. And we see lots of examples of it in our environment. So think about a lever door handle versus a round knob. And no matter what age you are, it's easier to use the lever door. That's universal design.

For somebody who's got arthritis in their hands, it's particularly important, but it helps everybody. And the same with grab bars and the same with handrails. I actually think that grab bars should be standard equipment in every house. And with respect to cost, it's a very low cost item relative to your granite countertops and other things that you might choose, you know, $240 to install grab bars in your bathroom. That's prohibitive perhaps for somebody who's on a very low income like Linda, but there is some funding to help people who are in that situation. I want to play one more thing from the home safety check at Linda's house. Have a listen.

How are you managing to stand in the shower? Very scary. See, I was holding on to those ledgers and I cracked it. Yes. The bar there is probably not in the best spot. I know. But it might be the only spot he could have found a stud that's also possible. Have you ever considered putting a bar at this end? If they could put one in here, and again there has to be a stud in behind there. So if that can go there. Here's a stud finder. Try and find it. Try and use it. So if a bar could go in there at least for now until you figure

things out. So Nancy, talk a bit more about that. I mean one of the reasons you need the stud there so that if you put the railing in or the grab bar, it's actually going to be secure and not pull off if somebody grabs a hold of it. You're looking for changes to eliminate this problem of studs not always being where they need to be? Yes, there's a couple of things happening. So the Canadian commission on harmonized building, construction codes rather, is actually putting

together recommendations out of their current policy cycle right now. And I believe one of the recommendations will be universal backing in all bathrooms. So that affects new builds, new houses, apartments and so on, and also major renovations. And universal backing meaning that you could put that grab bar in anywhere.

That's right. The advantage of the universal backing is that you don't have to place the grab bar only where the stud is, which may work for the majority of people, but for somebody like Linda who's got mobility problems, it may not be the optimal placement for her. The challenge with universal backing is that the resident still has to install the grab bar, and the universal backing by itself will not prevent any falls. That grab bar has to be there and I'm of the opinion that the grab bar installation needs to be part of the codes coming forward so that we actually get grab bars in bathrooms and prevent falls.

One of the reasons why you could imagine, aside from cost for example, one of the reasons why you could imagine somebody pushing back on that is they might say, I don't need this. I'm not old enough now. And maybe that's denial, or maybe it's the fact that they don't think that this is going to be something that they need now. They might need it in future, but they don't need it now. How do you get around that?

And that's a very common statement I hear, I don't need it yet. My neighbor down the street who has mobility problems, she needs a grab bar, but I don't need one yet. But I'm still able to get around just fine. That's right. There's ageism related to that. There's a stigma of grab bars.

There's the feeling perhaps that if you put in grab bars that people will think you're too old to live by yourself. Most people want to age independently in their own homes, 90% of seniors do. But we know from some recent studies that have been done in Canada that actually grab bars are more acceptable than we

might have thought. A study done by Ivor Levine at University Health Network in Toronto, they found that 65% of those, this was age 18 and above up to over 80 had no grab bar, but 88% would allow grab bars to be installed if there was no cost, and only 11% would object to grab bar installation because it was mandatory in new buildings. And most thought that they would use a grab bar if installed.

And we know from research that if a grab bar is there, people will use it. I think what's happened along the way is that we've had an enormous amount of work, still lots to do around accessibility for people living with disabilities. And that's really important and we have much to thank that community for. However, I think because we see versions of accessible bathrooms, for example, in public spaces that have a bit of an institutional look to them, people are thinking that that's the only option for what a bathroom would look like in your own home.

That they don't want their house to look like a hospital. Exactly. And yet there are actually a lot of different products out there now which are safe to use and which meet code standards, but in fact look quite luxurious and don't look institutional at all. And aesthetics is in the eye of the beholder. Platform shoes, one year look atrocious, then another year they look great. I remember seat belts coming in in the 60s, and at first we thought that they really ruined the look of a car, you know, with leather seats. Now you get into a car and you wouldn't even let the driver turn the key for the engine unless you have your seatbelt on. So things change.

And we need to make, in my view, grab bars and outdoor handrails part of a new normative standard and that will encourage consumers to demand more of them. Part of this is also about the conversation that we ourselves have about getting older, right? And we heard that there with Linda, she's not going to leave her home, that that's her home. She doesn't want to leave. This is about independence. This is about dignity in many ways as well. How do you go about having conversations with somebody

about something that they don't want to talk about, which is that they're getting older and maybe the grab bar or the extra railing is something that's actually going to help them and help them stay in that home. Well, I think when you can frame it the way you just have, which is let's think about the ways that you can actually maintain your independence and feel safer for personal hygiene needs and so on, turning it on its head, I guess, in terms of the argument and that you are there, as Laurie said, to try and help the person find ways to maintain their independence and not to end up with a serious fall that may result in long-term hospitalization,

perhaps even having to go into long-term care if they're not able to manage at home anymore. And the other aspect of this is whether one has mobility or problems or not, thinking about how to make our homes more visitable. And this is something that's relatively new, but getting a lot of attention with the development of new building codes. How can we make all of our homes visitable? Because social isolation is a big problem. I have heard many people say, you know, my mom and dad used to come and visit us in our house to see the grandkids, we'd love to have them, but now mom actually cannot make it up the front steps of our home.

Or she's worried that the bathroom is upstairs and that the stairs may be tricky to get up and get down. Absolutely. And so the visits slow down and maybe even stop. But if that home was visitable, it would actually be more accessible for the grandparents. It would be more accessible for the little ones too, who have their own challenges with getting upstairs and getting into a bath tub safely. It works for everybody, so we're about, you know, circled back to universal design,

can make our homes more visitable and help people live independently. Just before I let you go, I mean, you're the expert here in this conversation, but you're also a human being. Do you think about this yourself in terms of your own living situation in the future? Oh, absolutely. I actually chose to move into a bungalow about 10 years ago as my retirement home, which was built for somebody who was accessible, who was in a wheelchair. So I've got wide hallways and I have grab bars and I have all sorts of features

that make it more accessible. So I thought about it a lot. And I guess in part because of what I saw with my parents, especially my dad who had mobility problems and they had to move out of an assisted living retirement home situation because they didn't have the right shower for him and it was expensive to make the change so they moved into housing that was more suitable. And that influenced your decision to move into the bungalow? Oh absolutely and I wanted to do it proactively before I you know absolutely needed that and I think that would be my message for many people. Think about this proactively and we can all benefit.

So let's go the more accessible route and encourage our MPPs and others who are working on building code regulations in our provinces and territories to go the accessibility route as well. There's a lot to think about here. Nancy, I really appreciate speaking with you. Thank you very much.

Thank you very much. Nancy Edwards is a retired nurse and a distinguished professor at the University of Ottawa. This is an ongoing conversation we're going to be having on this program about getting older, the conversations that that spurs, but also the conversations we aren't having about what happens as we get older. And we're curious as to how you're thinking about your own situation.

Is this something that you want to talk with your parents about, is this something that people have spoken to you about? In the coming weeks, we're also going to be looking at some of the things we have to navigate as we get older. Independently, perhaps as part of a family or a community, we're looking at stories on caregiving, dementia care, aging on your own,

divorce after the age of 65. There's a lot to talk about here. And so if there are things that you think we should be speaking about or there are things that you want to talk about, get in touch. You can email us, thecurrentatcbc.ca. For more CBC podcasts, go to cbc.ca slash podcasts.