Don't Break a Leg: How to Fall-Proof your Home for COPD
Fall injuries aren't something that most people think much about on a day-to-day basis, let alone take specific measures to avoid. But as people who have experienced a serious fall injury can attest to, falling is a very serious threat that many adults just can't afford to ignore.
Your risk of falling inevitably increases as you age, but your risk may be even higher if you have COPD. That's because, while COPD doesn't cause falls directly, it does cause a variety of physical effects that can significantly increase your risk of having a fall.
Studies show that people with COPD are both more likely to experience accidental falls and more likely to get severely injured from falling compared to similarly-aged adults without COPD. And this is no minor risk; according to the CDC, falls are the leading cause of injury-related and accidental death in adults over the age of 65.
Fortunately, many—if not most—falls are avoidable, and there are plenty of ways to reduce your risk of falling if you have COPD. And since the place that you're most likely to experience a fall is at home, thoroughly fall-proofing your house is one of the best things you can do to prevent accidental falls.
That's why we created this guide to explain everything you need to know to get started fall-proofing your home for COPD. In it, you'll learn how to identify common fall hazards and make a variety of practical safety improvements to fall-prone areas in your home.
We'll also take a closer look at the link between COPD and falling to help you better understand the magnitude of the risk. You'll learn about how COPD exacerbates fall risk factors, how it affects recovery from fall injuries, and how people with COPD can benefit from fall-proofing in a variety of different ways.
Our goal is to show you that fall-proofing is worth the effort and provide you with practical fall-proofing knowledge that you can put to use in your home right away. We hope that the strategies, tips, and resources in this guide will inspire you and empower you to make your home a safer environment for living with COPD.
COPD & Falling: What's the Risk?
Every year, more than one quarter of adults over the age of 65 have a fall. Among people with COPD, the rate is significantly higher: studies show that COPD patients are 55% more likely than non-COPD patients to have a history of falling, and that they have about 85% more falls, on average, compared to people without COPD.
While the association between COPD and falling might seem strange at first, it makes sense if you consider the multitude of ways that COPD can affect your balance and mobility. For example, COPD symptoms (like shortness of breath) can make you feel lightheaded and unsteady, while COPD-related health complications (like osteoporosis) can increase your risk of breaking a bone if you fall.
COPD is also associated with numerous well-known fall risk factors (PDF link), including muscle weakness, dizziness, lightheadedness, and fatigue. It's also associated with an increased risk of getting injured from falling, and a more difficult time recovering from injuries caused by falls
In the following sections, we're going to take a closer look at these and other COPD-related fall risk factors to better understand the relationship between falling and COPD. We'll also discuss how COPD impacts recovery, and why fall injuries tend to be more serious in people with COPD.
How does COPD make you more susceptible to falling?
It might seem surprising that COPD, as a respiratory condition, could affect your risk of falling. However, COPD is a complex disease that has a wide variety of effects on the body, many of which can affect your balance and susceptibility to falls.
If you or someone you love has COPD, understanding these effects can give you a better idea of what kinds of fall hazards you need to look out for. It can also help you focus your fall-prevention strategy on the things that are most likely to pose a danger to people with COPD.
COPD symptoms can make you feel dizzy, lightheaded, or even drowsy at times, which can easily throw off your balance and make you more likely to fall. This could happen during a bout of coughing or breathlessness for example, or when you're feeling fatigued.
Certain COPD medications can also make you dizzy or drowsy, which increases your risk of accidents, including falls. The risk might be even higher if you take other medications (e.g blood pressure medications) or take multiple medications (including over-the-counter medications) that interact with one another or have compounding side-effects.
Other Health Complications Caused by COPD
COPD can cause a variety of other health problems that can increase your risk of falling, usually because they affect your ability to balance or reduce your physical strength. For example, chronic hypoxemia (low blood oxygen levels) is a common COPD complication that can cause you to frequently feel lightheaded and unsteady on your feet.
COPD also increases your risk for a variety of cardiovascular problems (such as high blood pressure and right-sided heart failure) that can lower your blood oxygen levels and make you feel dizzy as well. The worst thing about dizziness from low oxygen levels is that it tends to strike during physical activities (e.g. walking, standing up, and climbing stairs), which is when you need your balance the most.
Having COPD can also interfere with your ability to do activities that help you maintain muscle strength and balance, including exercise, eating, and getting enough sleep. Many people with COPD also suffer from Vitamin D deficiency, which is another known risk factor for falls.
What's more, some research suggests that having COPD can reduce balance and stability irrespective of the factors mentioned above. While researchers are still unsure why that is, some believe it could be related to a kind of nerve damage (peripheral neuropathy) that is relatively common in people with COPD.
How Does COPD Increase Your Risk of Injury (from Falling)?
In addition to increasing your chances of falling, COPD also increases your chances of getting seriously injured when you fall. The main reasons for this are muscle weakness and osteoporosis, both of which are quite common in people with COPD.
COPD makes it difficult to exercise and stay active, which (in addition to other factors, like inflammation and malnutrition) often leads to physical decline. One of the biggest contributors to this decline is the loss of muscle mass and resulting muscle weakness, which is a major risk factor for falls.
Muscle strength is not only important for maintaining balance, but also for being able to “catch yourself” and avoid getting hurt when you fall. This can cause you to fall harder or land in a way that causes you to get injured; e.g. on top of a hard object or on a fragile bone or limb.
People with COPD also tend to have risk factors that make them more prone to osteoporosis; these risk factors include things like older age, poor nutrition, lack of exercise, and chronic inflammation (a common symptom of COPD). Some medications used to treat COPD symptoms—particularly steroid medications, including steroid inhalers—can also increase the risk of bone density loss and osteoporosis over time.
Osteoporosis weakens your bones and makes them more brittle, which can cause them to break from even little accidents like minor bumps and falls. One study found that COPD patients were 50% more likely to have osteoporosis than people without COPD and were 1.6 times as likely to have suffered a major osteoporosis-related bone fracture.
Unfortunately, people with very severe COPD symptoms often have trouble eating and exercising enough to keep their bones and bodies strong. Because of this, those with advanced COPD tend to have a higher risk for osteoporosis, muscle weakness, and getting severely injured from a fall compared to those with milder COPD symptoms.
To learn more about COPD and osteoporosis, check out our guide on that topic here.
How COPD Can Make Recovery Harder After a Fall
Having a chronic health condition like COPD can make recovering from injuries harder, even injuries that are completely unrelated to COPD. The opposite is true as well: unrelated injuries can make your COPD worse by making it harder to to take care of yourself and manage your COPD.
A fall injury that makes it difficult to walk or requires hospitalization, for example, could prevent you from exercising for weeks or even months at a time. In the time it takes to recover, you could lose much of your strength and endurance as well as the many other health benefits you get from regular exercise.
This alone can have far-reaching health consequences, including worsened COPD symptoms and an increased risk of developing other health problems like heart disease. Long periods of inactivity can also increase your risk of falling in the future due to decreased muscle strength, balance, and increased COPD symptoms like breathlessness and fatigue.
What's more, if you have a fall that requires you to be hospitalized, having COPD could complicate your treatment. It could make certain procedures like surgery more risky, for example, or limit the number of medications that doctors can safely prescribe you in addition to the medications you're already taking for COPD.
Being hospitalized can also be dangerous in and of itself because it can increase your risk of getting sick from certain types of infections (e.g. hospital-acquired pneumonia) that can be especially deadly for people with COPD. Unfortunately, because COPD weakens the lung's defenses against infection, COPD patients are particularly vulnerable to respiratory infections both in general and during prolonged hospital stays.
As you can see, falls can result in more than just a single injury; they can set off a chain of consequences that can affect your strength, your mobility, and your ability to manage your COPD long term. That's why avoiding accidental falls is vital for maintaining your physical independence and maintaining a good quality of life as you age.
The Benefits of Fall-Proofing: Why It's Worth the Hassle
Fall-proofing can do more than just prevent falls and fall injuries; it can make your home a more comfortable—and more accessible—place to live with COPD. It can help you conserve energy, stay independent, and even build up the confidence to do a wider range of activities around your home.
Now that you better understand how COPD can make you vulnerable to falling, you can hopefully see why fall prevention for COPD patients is such a serious concern. Now, let's take a look at what you can gain from fall-proofing, and why it's more than worth the time and effort it takes to fall-proof your home.
Reduced Risk of Injury and Hospitalization from Falls
It goes without saying that the main point of fall-proofing is to reduce the risk that you (or someone else in your household) will fall and get injured in your home. However, we do want to emphasize why preventing falls is so important by showing you how bad even a “minor” fall can be.
First, it's important to know that serious fall injuries among older adults are very common. CDC research shows that one-fifth of falls cause serious injury, and that 3 million older adults are admitted to the emergency room for fall injuries every year.
Second, you should know that even ground-level falls (falls from standing height or lower) can result in a wide range of serious injuries, including broken bones and head injuries. These injuries can require long recovery periods, long hospital stays, and sometimes even serious medical procedures like surgery before they can fully heal.
Unfortunately, recovering from fall injuries is often especially difficult—and particularly lengthy—for older adults and people with chronic diseases like COPD. Injuries in older adults are also more likely to result in permanent health problems, including muscle weakness, loss of physical mobility, and chronic pain.
The lasting effects from fall injuries can lead to further physical decline can make it difficult—or impossible—to return to the life you had before. In this way, fall injuries can have huge, long-term effects on your quality of life even long after they heal.
It's also important to acknowledge that some people never make it out of the hospital or home recovery because they die of their injuries or complications during recovery. In fact, studies show that deaths from falls in adults over the age of 65 have steadily increased in recent years.
Increased Confidence At Home
One of the more difficult parts of living with COPD is the gradual decline in physical ability, which can have a huge effect on just about every part of your life. Along with that often comes a sense of fear and vulnerability that can further restrict what kinds of activities you do.
Studies show that a large number of senior adults restrict their activities for fear of falling, and that this can have a significant negative effect on their quality of life. It's often not even a conscious decision; you just slowly start to limit yourself to the areas and activities that feel safest, not realizing what you've given up along the way.
You might be surprised at how much fall-proofing can improve your sense of safety and security at home. It can even boost your sense of confidence in your own abilities and help you feel less limited by COPD.
Increased Comfort & Convenience at Home
Making the effort to fall-proof your home will not only make it safer, but also much more functional and comfortable to use. That's because getting rid of fall hazards makes your home easier to navigate in general, which is a particularly important benefit for people with COPD.
This can make a huge difference during COPD exacerbations or anytime your feeling breathless and fatigued. It can also help reduce the stresses of daily life just a little by making it easier to get around when you're in a hurry or have your hands full.
More Energy and Independence
Fall-proofing can help you adapt your home environment to one that's much better suited to your mobility needs. In this way, fall-proofing can allow you to do more activities independently and generally expand the range of activities that you can do safely in your home.
For example, fall-proofing often involves adding practical tools (like shower chairs and handlebars by the toilet) that make it easier to do regular household tasks. This can allow you to live more independently and do more everyday things around the house on your own.
By making your home more accessible, fall-proofing can also help you conserve energy, which is often in short supply for people with COPD. Then, you can use that saved energy on other things, allowing you to do more and accomplish more throughout the day.
How to Fall-Proof Your Home For COPD
Now that we've covered the basics of why fall-proofing is important, it's time to learn exactly how to fall-proof your home for COPD. In the following sections, we'll go through all the major steps of fall-proofing, showing you plenty of practical strategies you can use to address a wide range of fall hazards in your own home.
But that's not all; toward the end of this guide, you'll find a curated list of expert resources and thorough fall-proofing checklists you can use. And in the very last section, we'll discuss a variety of other things (besides fall-proofing) that you can do to improve your balance and reduce your risk of falling if you have COPD.
How to Make Your Floors Fall-Proof: It's All About Where You Step
The surfaces you walk on have a major impact on your balance and fall risk, which is why the majority of fall-prevention strategies focus on floors. That includes the floors themselves as well as the obstacles that end up on them, such as furniture, doorway thresholds, power cords, and rugs.
Unfortunately, no matter what kinds of floors you have or how clean you keep them, walking on them will always carry some risk. However, you can reduce those risks substantially by eliminating trip hazards and making simple—yet effective—safety improvements to your floors.
Beware of Rugs
When you think about floor fall hazards, rugs probably aren't the first things that come to mind. But even though they might seem harmless, rugs are the most common—and possibly most dangerous—trip hazards in the home.
Studies show that rugs cause a significant number of fall injuries. In the US alone, nearly 17,400 adults over the age of 65 have to be treated for fall injuries associated with rugs every year.
However, not all rugs are created equal; some rugs are much more likely to cause falls than others, and—in some situations—certain types of rugs can actually help prevent falls. The difference comes down to a few different factors: what kind of rug you're using, where you place it, and what you're using it for.
Throw rugs, for example, are particularly easy to trip on, especially when their edges get curled up, folded, or frayed. Additionally, most throw rugs are not (or cannot be) secured in place properly, meaning they can easily shift, slip, and bunch up under your feet.
On the other hand, non-slip rugs can be safe to use on hard flooring, as long as they're properly designed and they firmly stay in place. In fact, non-slip rugs can actually help you avoid slipping on slick patches on floors that tend to get wet, like your entryway, bathroom, or in front of the kitchen sink.
Unfortunately, even non-slip rugs can be a trip hazard, especially if they're bulky, damaged, or poorly placed. That's why it's important to only use rugs where they're really needed, and to carefully consider whether a particular rug's potential safety benefits are worth its potential risks.
One thing that all fall-prevention experts agree on, however, is that getting rid of loose, decorative throw rugs should be a first priority when fall-proofing any home. When it comes to non-slip rugs, however, evidence is mixed, though many experts agree that non-slip rugs can be beneficial when used cautiously and sparingly on potentially-slippery floors.
Here are some basic rules and criteria for using non-slip rugs safely in your home:
- Only use non-slip rugs with rubber backing that firmly grips the floor.
- Choose thinner rugs over bulky ones; it's more of a trip hazard the farther it sticks up from the floor.
- Ideally, you should use non-slip rugs with tapered edges that sit flush (or as flush as possible) with the floor.
- Only use non-slip rugs on hard floor surfaces where they can get an adequate grip and stay in place (e.g. tile, hardwood, acrylic, smooth concrete, etc.)
- Consider placing non-slip rugs on hard-floored areas near places that get wet, which can include your entryway, bathrooms, any anywhere else that's near a water source like a shower, washer, or sink.
- Make sure the floor is completely dry before placing a rug; any moisture trapped underneath the rug (e.g. from water splashes or mopping) could cause the rug to slip.
Keep Up With Floor Maintenance & Repairs
Keeping your carpet and other flooring in good repair should always be a top home maintenance priority, especially for people with mobility-limiting conditions like COPD. Unfortunately, damaged flooring is one of those inconvenient problems that far too often get ignored.
People often put off floor repairs due to the expense and/or effort it takes to complete them, not realizing how big of a risk they are taking. In reality, floor damage