Ergonomics for the Elderly Population

International Day of Older Persons – October 1, 2022

Let’s start with a question: In which place do injuries in elderly people occur frequently?

  • Worship places
  • Parks or walking area
  • Home
  • Shopping malls

We believe most of you have got the correct answer. Surprisingly, most of the injuries in elderly population happen at home, the most familiar place to them than at unfamiliar places. Because in unacquainted places, they are more cautious about the floor, their steps and surroundings, whereas at home they are relatively careless; after all, that’s how a home should be – comfortable and relaxed. Hence, it is of utmost importance to keep the house safe and elder-friendly to avoid falls and resultant injuries.

To improve safety, one must know the risks in relation to place and time. The bathroom and bedroom floor are the two most common places of falls and often happen at night. The temporal correlation can be explained by multiple drugs taken by elderly people at night, sleepy state of mind and poor muscle coordination. Their weak muscles and bones are at a further disadvantage due to impaired reflex movements and altered sensation from age-related peripheral neuropathy. Hence, in a simple slippery situation where a young person can balance oneself easily, an elderly person is more prone to fall.

‘Fall’ in the elderly population is a major health hazard as it can lead to major complications including head injuries and complex fractures which can even be fatal in some cases. Prevention is the key and it can be intrinsic or extrinsic. Intrinsic factors include improving the individual’s health with periodic health check-ups, proper eyeglasses, drug-monitoring, osteoporosis management and regular physical therapy. Extrinsic factors are about the living environment and caregiver. If an elderly person is dependent on aid for indoor mobility or is bed-ridden or wheelchair bound, it is advisable to have a dedicated caregiver during day time and to use a bed-pan or diaper at night time to avoid walking to the restroom alone at night. This is easier said than done and it’s quite difficult to convince the aged person as most of them are not willing to accept using even a walking stick (dignity issue). Home modification is vital in preventing all these issues and these are a few suggestions.

  • Keep Things Bright – Rooms should be illuminated with high-wattage lights. Contrasting paint colours on the wall and white roof improve illumination.
  • Be Smart – Automation of switches (motion sensing or voice activated) in the bedroom help in the nighttime. It avoids walking in the dark toward the switchboard which is unsafe. Smartwatches can detect falls and alert the caregiver.
  • Maintain the Routine – Always keep the furniture and other things in the same place, so they develop muscle memory and subconsciously avoid bumping into things.
  • Avoid Slippery Floors – If altering the floor is not feasible, consider using anti-slip rubber mats at fall-prone places like kitchen sinks, wash-basins and rest-rooms. Avoid rugs and mats which are slippery and can easily crumble.
  • Always Keep an Eye – CCTV cameras installed at strategic places help in early detection of inadvertent events like falls and they also feel safer.
  • Untangle – Avoid multiple wires and cables on the floor or close to tables. Concealed wiring and pipelines are much safer.
  • Supporting Rails – Most important in bathrooms and stairs. Even if a seat raise is used in the lavatory, it is wise to install hand rails nearby to enable getting up safely.
  • Consider wheelchair and walker access in the door entries and restrooms.
  • Although most of these things are simple and can be done by ourselves depending on the current demands, it is better to engage an occupational or physical therapist experienced in elder-friendly home modification as they can suggest changes considering future demands also.

Dr. P. Keerthivasan
Consultant Orthopaedic Spine Surgeon
Kauvery Hospital Chennai