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Articles - Body Business

No Risky Business

Sally Castell - Monday, July 18, 2016
No Risky Business
Plan, Be Prepared and Take Your Time to Ensure You Make Safe and Sensible Moves - Watch Your Step and Pick Up Your Feet!
Sally Castell - Movement Matters
Safety and Falls Reduction Considerations
 Stay Alert and Active in Your Environment
Everyone wants to live an active and independent life - no matter how old!  However, there are many hazards and situations which can become a challenge and so require a bit more effort (physically and mentally) especially where there is reduced activity or ability.
We all need to be able to manage the environment we live in.  But as we age, it can become more difficult and thus our safety can be challenged on some occasions. Age diminishes our ability to move as efficiently and effectively as we used to.  We can become more vulnerable and “at risk” in certain situations. In the increasingly ageing population, there is a trend towards maintaining the ability to live independently in the community as long as possible. Consequently more people are likely to be travelling as pedestrians. This means an increase in exposure and potential for greater risk of accidents.
There is a need to consider the environment
Inside 
It has been estimated that just under 50% falls occur in or around the home.  Factors that may contribute to a fall include:
• poor lighting – (areas that are not easily visible or have excessive glare),
• different surfaces e.g. slippery and wet floors due to liquid, powder and food spills,
• uneven ground, or even obstacles in the way e.g. clutter, furniture etc.
Even so, most falls occur on level surfaces within commonly used rooms such as the bedroom, living room or kitchen.
Falls also occur in the bathroom, stairs or from ladders and stools (but not so frequently).
The location of falls is related to age, sex and frailty.
Understandably, with increased age the number of falls at home increases correspondingly.
Fewer men fall in the house but they are more likely to fall in the garden.
The frailer group with limited mobility suffer most falls in their own home - these occur during periods of maximum activity in the morning and afternoon.
The main causes of falls
Trip -40%;  Poor balance- 21%;  Unsure -14%;   Slip-13%;  Weak legs -6%;  Dizzy - 5%;   Faint- 1%
Indoor Falls Location According To Age 
    Age                     85+          75- 84           65- 74
Chair / Ladder   -                      5%           4%
On stairs                 13%           7%          5 %
Getting out of bed  3%             5%          2%
Shower /bath          4%             5%          6%
Level surface         35%          25%        24%
Adapted from:  Lord SR., Ward J., Williams P., Anstey KJ  An epidemiological study of falls in older community dwelling women: The Randwick Falls and Fracture study Australian Journal of Public health 1993; 17 (3): 240 –5
Outside 
Walking is one of the least strenuous, safest types of activity even  though we can still be vulnerable in some circumstances. It is particularly risky when we are not fully in control of our movements and also not fully aware of what’s happening around us. There are lots of environmental hazards which can cause one to slip, trip or fall. So we need careful planning when moving around open spaces. Consideration is needed of problems in the terrain which can include uneven footpaths, steps, stairs and ramps as well as surfaces that may be wet and/or slippery.  Shopping centres and malls can present unexpected hazards including entrance-way steps, stairs, ramps, lighting, uneven or slippery surfaces, furniture and fittings, lifts etc.
NB. With some chronic conditions movement becomes harder and walking is affected – this increases the risk of falls and injuries. It is important for everyone, whatever age, to live an active life so please undertake some daily appropriate exercise to maintain your movements.
Pedestrian Safety issues
Activities can be more challenging, such as crossing the road or using public transport where many elements of balance, speed and co-ordination are required. To manage activities safely, good vision and mental processing skills are all needed at the same time.  Bearing this in mind, it is very important to be aware and to be as prepared as possible to manage these situations.
In NSW between 2006 and 2010 people 60 years and over accounted for only 19% of the population, yet 39% of the fatalities and 18% of the injuries were aged 60 years and over. (NSW centre for road safety 2010 crash stat data).  People 70 years and over age group accounted for only 10% of the population, yet 29% of pedestrian fatalities and 11% of the injuries were in this age group. (NSW centre for road safety 2010 crash stat data). One of the reasons older pedestrians are over represented in fatalities is frailty, meaning that any crash could have a serious outcome.
Research has identified certain behaviours which put older pedestrians at risk.  These include the following;
• Walking more slowly across the road
• Taking longer to leave the kerb
• Having difficulty determining a ‘safe gap’ distance
• Failing to make eye contact with the nearside driver to make sure the car will stop
• Failing to look at vehicles travelling towards them on the far side of the road
• Failing to check and re-check for traffic prior to and while crossing the road
• Becoming confused in a complicated road environment –e.g. at an intersection
• Being slower to react to approaching traffic
• Losing confidence of their ability to cross the road safely
Move Safely and Remain Alert
For your safety, when undertaking any activity, think through the many factors that will allow you to make appropriate adaptations and application. When crossing the road, getting on and off a bus, getting in and out of cars, moving around shopping areas consider the following points:
• Your physical and mental abilities and limitations for performing the activity such as your strength, mobility, stamina, and vision
• What is needed to do the activity
• The environment inside and out (e.g. surfaces and wet conditions)
• Your equipment (e.g. clothing and walking aids) 
Pedestrian Safety Tips
In order to help minimise the risks as a pedestrian, please consider the following points;
• Try to always plan your trip – create either a mental map of your route or write it down
• Where possible cross at crossings with a signal
• Where possible cross on a pedestrian crossing
• Wait for vehicles to stop – some drivers will not stop for pedestrians, so wait until all vehicles have stopped before you start to cross
• Look both ways before you cross and while you are crossing. You should be sure that the driver, rider or cyclist has seen you and is going to stop
• Wear bright or light coloured clothes. This helps make you visible to drivers, rider or cyclist
• Utilise ‘traffic facilities’ that have been installed to assist pedestrians cross the road safely.
Shared paths across NSW can be used by both pedestrians and bicycle riders, as a pedestrian on a shared path, make sure you, keep to the left, move off the path to the left if you want to stop, keep any animals on short leads and under control   
Acknowledgement RMS  Walking Safely –Presenters guide
Final words of wisdom....
Plan, Be Prepared and Take Your Time to Ensure You Make Safe and Sensible Moves - Watch Your Step and Pick Up Your Feet!
Sally Castell - Movement Matters
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