{
  "title": "Precautions for the Elderly's Home Safety",
  "content": "Preface\nThe elderly spend most of their time at home, but statistics show that the home is the most common place where accidents such as falls occur.\nIn addition to common abrasions and bruises, falls in the elderly are more likely to cause fractures. In particular, hip fractures not only lead to mobility impairment, but also bedsores may occur from prolonged bed rest. Once infected with bacteria, sepsis is easily triggered. Therefore, the mortality rate of patients one year later is as high as 20% to 30%.\n\n1. Precautions for a Safe Home Environment\n2. Precautions for Safe Living Behaviors\n3. Essentials for Using Mobility Aids\n\nPart 1: Precautions for a Safe Home Environment\nThe presence of any of the following characteristics indicates a fall risk, including:\n① Having fallen or nearly fallen twice or more in the past year.\n② Having sought medical treatment for injuries caused by a fall in the past year.\n③ Taking four or more types of medications daily.\n④ Taking sedative, sleeping or antidepressant medications.\n⑤ Unsteadiness when standing up from a sitting position, walking, turning around or climbing up and down stairs.\n⑥ Suffering from diseases that affect walking balance such as stroke, Parkinson's disease and dementia.\nIn addition to seeking medical treatment, the key to preventing falls for these high-risk groups lies in whether family members can create a safe home environment for the elderly. Even if the elderly can move freely now, they will inevitably find it increasingly difficult to walk with aging, or become people with walking difficulties due to falls, and the requirements for a safe environment will certainly be higher.\nThe \"Home Safety Manual for the Elderly with Walking Difficulties\" provides suggestions for creating a safe and comfortable home life for the elderly from the aspects of home safety environment, home safety living behaviors and essentials for using mobility aids.\n\n(1) Kitchen\nAvoid letting the elderly with walking difficulties walk alone in the kitchen; if unavoidable, a caregiver should accompany them.\nThe floor should be non-slip and kept dry, and avoid placing easy-to-slide floor mats.\n\n(2) Bathroom and Toilet\n① It is better to adopt a wet and dry separation design.\n② Install handrails beside the shower room, bathtub, toilet and sink for the elderly to support themselves.\n③ The floor of the shower room and the bottom of the bathtub should have anti-slip effect.\n④ The height of the sitting toilet should be suitable for the elderly; if it is too low, a toilet riser can be installed or a commode chair can be used instead for the elderly to use the toilet.\n⑤ Choose a gas water heater with an automatic temperature control device to avoid scalding the elderly with overheated hot water.\n⑥ Power sockets should have anti-leakage safety design to prevent the elderly from electric shock due to accidental contact with wet hands and feet.\n\n(3) Entrance Hall\n- Install a chair for the elderly to put on shoes while sitting.\n- If there are shoes or other items placed or scattered on the ground, they should be removed immediately to avoid affecting the elderly's passage.\n- There should be no threshold under the door to prevent the elderly from tripping; even if there is a drop from the ground, it should be within 0.5 centimeters. Otherwise, it is recommended to remove the threshold or install a non-slip ramp instead.\n\n(4) Living Room and Dining Room\n① If a tablecloth is to be laid on the table, it must be fixed with Velcro to avoid the sliding of the tablecloth causing items on the table to fall and possibly injuring the elderly by smashing.\n② Chairs or sofas should be stable, and the seat height should be such that the elderly's upper body and thighs can form a right angle. If the seat is too deep, it is recommended to place a cushion to improve it; in addition, there should be a backrest and armrests to assist the elderly in standing up.\n③ Install protective pads on the edges of furniture to prevent the elderly from colliding with protruding hard corners or sharp edges.\n④ The floor material should be non-reflective and achieve anti-slip effect. In addition to avoiding floor waxing, anti-slip strips can be pasted in the elderly's activity areas, pasted perpendicular to the elderly's walking direction with each strip spaced no more than 4 centimeters apart.\n\n(5) Balcony and Stairs\n- The height of railings or guardrails should exceed the waist position of the elderly when standing, and the spacing should not exceed 10 centimeters wide. A protective edge should be installed under the railings or stair handrails, with a height above the ankle, to prevent the elderly from accidentally placing the cane support point outside the railings and causing a fall.\n- Stairs should be equipped with bright and moderate lighting equipment. The edge of each step of the stairs should be clearly distinguishable; if there is no such design, anti-slip strips of a different color from the steps can be pasted on the step edges to distinguish them.\n- For houses with two or more floors such as single-family houses without special elevators installed, the elderly's activity areas should still be arranged on the same floor as much as possible to avoid the elderly climbing up and down stairs.\n\n(6) Bedroom\nThe position of the light switch control should be within the reach of the elderly to avoid letting the elderly climb up or bend down. If the switch position is not good, there are two improvement options: one is to place a night light beside the bed or move the bed position to be close to the switch; the other is to use an induction or remote control light switch.\nThe height of the bed should not be too high or too low, preferably 40 to 50 centimeters, to facilitate the elderly to get on and off the bed; for the elderly using wheelchairs, the bed surface height should be flush with the wheelchair seat height.\nThe mattress should not be too soft to avoid difficulty for the elderly to get up.\n\nPart 2: Precautions for Safe Living Behaviors\n\n(1) Clothing\nLet the elderly wear well-fitting shoes with anti-slip effect and non-slip socks.\nAvoid wearing clothes that are easy to be caught or with straps and ropes. The length of the trousers should not exceed the ankle to avoid tripping over them and falling.\n\n(2) Dining\nThe elderly should chew and swallow slowly when eating. Avoid letting the elderly eat food that can be taken in one bite or food that is not easy to chew and swallow, such as jelly, glutinous rice balls and rice cakes of one bite size.\nClean the refrigerator food regularly every two weeks to prevent the elderly from food poisoning caused by eating deteriorated food.\n\n(3) Medication\n- Chronic disease patients should take medicine regularly as advised by doctors.\n- Use a pill box to pack the medicines to be taken at different times of the day separately to prevent the elderly from forgetting to take medicine or taking the wrong medicine. To ensure the quality of medicines, the split packaging of medicines is limited to a single day, and the remaining medicines are placed in a moisture-proof bag first.\n- Some medicines may have side effects, and caregivers should pay attention to the elderly's condition after taking medicines. Since most side effects are dizziness, fatigue, etc., remind the elderly to slow down their movements to avoid falling due to unsteady center of gravity.\n\n(4) Showering\n- Let the elderly take a shower as much as possible and reduce taking a bath in a bathtub.\n- When using water, turn on the cold water first and then the hot water, and start rinsing only when the water reaches the appropriate temperature. The water temperature should be controlled at 37 to 39 degrees Celsius, as too cold or too hot water will cause physical discomfort.\n- If using a bathtub, the soaking time should not exceed 20 minutes to avoid physical discomfort.\n\nPart 3: Essentials for Using Mobility Aids\nMost elderly people \"refuse to accept old age and care about their face\", so many of them have no habit of using aids before falling. In fact, as long as the elderly feel a little powerless to walk and unsteady in center of gravity, they should use aids to help themselves.\nHowever, aids must be suitable for oneself to be useful. Just like checking and regular maintenance before driving on the road, these mobility aids should also be checked before use, and the correct essentials should be mastered when using them to ensure the walking safety of the elderly.\n\nWalking Stick\n- Check if the rubber pad at the end of the walking stick and walker is worn; if so, replace it immediately to avoid slipping during use.\n- When adjusting the height of the telescopic walking stick and walker, make sure that the spring buckle of the leg tube is locked in place.\n- The appropriate length of the walking stick and the appropriate height of the walker are the position where the grip is at the wrist when the elderly stand with shoes on and their hands hang down naturally.\n- For those using wheeled walkers, check if the braking function is correct. Hold the walking stick with the stronger hand.\n\nWalker\n- The elderly should slow down their walking speed.\n- Keep the eyes looking forward while walking, and do not stare at their feet while walking.\n- The leg tubes of the walker must land vertically on all four feet to avoid tipping over.\n\nWheelchair\n- Check the safety of the wheelchair such as braking performance, tire pressure, whether the foot pedals and seat belts are loose.\n- Regularly lubricate the wheelchair rotating shafts and remove foreign objects attached to the rotating shafts to avoid difficulty in pushing.\n- When the elderly sit in a wheelchair, their buttocks should be close to the back of the chair to avoid tipping over due to unsteady center of gravity.\n- Push the wheelchair at a stable speed and do not turn quickly; when the wheelchair stops, pull the hand brakes on both sides."
}