Drago - Living safely, aging well: a guide to preventing injuries at home

LIVING SAFELY, AGING WELL

A Guide to Preventing Injuries at Home

DOROTHY A. DRAGO, M.P.H.

Note to readers

This book provides information to help older people and their spouses and children and other caregivers keep older people safe from injury. The information is as reliable and up-to-date as possible, but neither the author nor the publisher bears responsibility for the safety of an individual person. That responsibility lies with the person and with anyone providing care for that person.

This book is not intended to provide medical or legal advice. The services of a competent professional should be obtained whenever medical, legal, or other specific advice is needed. The publisher and the author make no warranty, either express or implied, regarding the recommendations offered or the practices described, nor does the publisher or the author assume liability for any consequences arising from the use of the content of this book.

2013 Johns Hopkins University Press
All rights reserved. Published 2013
Printed in the United States of America on acid-free paper
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Library of Congress Cataloging-in-Publication Data

Drago, Dorothy A., 1946
Living safely, aging well : a guide to preventing injuries at home / Dorothy A.
Drago, M.P.H.
pages cm
Includes bibliographical references and index.
ISBN 978-1-4214-1151-4 (hardcover : alk. paper)ISBN 978-1-4214-1152-1
(pbk. : alk. paper) ISBN 1-4214-1151-2 (hardcover : alk. paper) ISBN 1-4214-1152-0
(pbk. : alk. paper) ISBN 1-4214-1153-9 ISBN 978-1-4214-1153-8 (electronic)
1. Older peopleHealth and hygiene. 2. Older peopleWounds and injuries
Prevention. 3. AccidentsPrevention. 4. Aging. 5. Self care, Health. I. Title.
RA777.6.D73 2013
613.0438dc23 2013010979

A catalog record for this book is available from the British Library.

With the following exceptions, all illustrations are by Loel Barr: Figures 1.1, 1.2, 1.3, and 1.4 are courtesy of the National Eye Institute.

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Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible.

CONTENTS

LIVING SAFELY, AGING WELL

Our definition of old changes over time. When we were children, we may have thought that 30 was old. In our thirties we probably thought that 50 was over the hill. As we age, we push old into the futureto 65, say, the age long viewed by Social Security as normal retirement age. But as we approach 65, our concept of old age may drift to 75 or 80 or even older. Regardless of our personal perspectives on age, old today is older than it was a generation ago.

Part of the reason for this revised image of old age is that people are living longer. According to the U.S. Census Bureau, the population of Americans age 65 or older grew rapidly for most of the twentieth century, from 3.1 million in 1900 to 35.0 million in 2000. In April 2010, there were 40.3 million people 65 or older, constituting 13 percent of the total U.S. population. And the older population is on the threshold of a boom. The Census Bureau projects a substantial increase in the number of older people from 2010 to 2030; after all, the first Baby Boomers turned 65 in 2011. The older population in 2030 is projected to be twice as large as it was in 2000, growing from 35 million to 72 million. This group of people will represent nearly 20 percent of the U.S. population.

So, no matter how you define old, there will soon be lots of old peopleand these will be old people who will do what it takes to defend their independence and lifestyles. To maintain ones independence and lifestyle, however, one must age well; to age well, one must remain healthy; and to stay healthy, one must avoid injury. Whether you are an older person looking out for your own safety, an adult child taking care of parents, or a caregiver helping someone stay safe from injury in the home, this book should provide much helpfulindeed criticalinformation.

If there were no increased risk of injury for older people compared to younger people, the rates of injury to people of different ages from the same cause would be the same, but they certainly are not. The U.S. Consumer Product Safety Commission has found that about three times as many adults 75 or older as one would expect are treated in hospital emergency rooms each year for injuries associated with consumer products. When older people are injured, their injuries are often more serious than a similar injury in a younger person, they may need to be hospitalized, they take longer to recuperate, they are at higher risk for infections and complications, and they are more vulnerable to repeat injuries. In short, people over age 75 are a fragile population when it comes to injuries. Since most accidentsincluding the majority among people 75 or olderhappen at home, taking steps to be safe at home is essential.

What makes older persons so much more vulnerable to injury? While there is much individual variation in the aging process, age-related changes affect most older people. They include deterioration in the senses (vision, hearing, smell, taste, and touch) and an array of possible physical, cognitive, and health-related changes. Any of these alterations can make a person more susceptible to injurywhether its the ability to recognize a hazard, the ability to react to it in time, or the greater likelihood of getting hurt than a younger person might under the same circumstances. Whether you are engaged in an everyday activity like walking or are using a harmless-seeming product like a vacuum cleaner or an obviously dangerous one like a car, your safety depends on the extent to which you have the abilities to meet the demands of the activity.

The rest of this chapter describes natural age-related changes and illustrates how they can contribute to increased risk of injury. No one can predict exactly when or to what degree these changes will begin to occur in any particular person. They may be so gradual that they arent even noticed. Aging is highly personal! I will occasionally illustrate a point with examples from real life of people I have known.

If we try to list the physical changes that go along with aging, we naturally think first of the most visible oneswrinkles, graying hair, baldness, sagging skin, and so onbut these features are not important for safety. How safe a person is depends on how he or she functions in and interacts with the immediate environmentthe activities and products involved in everyday life.

We spend our childhoods growing taller and stronger, and then most people plateau in height and strength as teenagers or young adults. Later, we realize that our youthful strength and stature do not endure. In general, people tend to get shorter and weaker as they age. These changes are related to natural alterations in bone and muscle structure. The amount of bone mass we have is greatest when we are about 30 years old; after that, bone loss continues faster than bone growth, resulting in ever-decreasing bone density. Loss of bone mass, called osteoporosis, is assumed to be one reason for the increase in bone fractures among older adults. It is also thought to be a factor in the flattening of the spinal vertebrae and the discs between them, as well as in the spontaneous fracture of vertebrae that some people experienceall of which contribute to making us shorter as we age. By some point between 65 and 79 years of age, most adults have lost about 3 to 6 percent of their peak height. At the same time that our bones are getting more fragile, our muscles are on the decline, too.