Addressing the problem of nighttime falls

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Michael Chotiner
Michael Chotiner

In August 2009, Eric Smith, a maintenance director at a skilled nursing facility, wrote in McKnight's about a costly, persistent problem in his sphere of responsibility that also threatened the residents' well-being: The problem was that the residents would tie the string that activated the light switch to their bed rails . . . or to anything they could reach easily. . . . Whenever these items were moved by the staff or sometimes by the residents themselves, they world inadvertently rip the string from the light switch, damaging the switch, making it inoperable. 

Smith tells us that management didn't want him to spend the time and money it took to replace the broken strings and damaged switches, and instead instructed him to remove the strings wherever he found them. "To this day," he writes, "it remains among one of the most difficult things I have had to do. Residents begged and pleaded to me, used vulgarity, cursed me and even tried to bribe me not to cut their strings loose." 

If we didn't know from experience, the introduction to a Lighting Research Center study on night lighting tells us why: ". . . most falls occur when residents are in their own rooms unattended, performing tasks such as getting in and out of bed. Hard-to-reach lighting controls . . . add to the difficulty seniors have getting up in the middle of the night." 

Smith's own solution was to design and fabricate "a bracket" that attached to a reading light. He installed ten of them in the facility where he worked. 

Although homemade fixes are always a potential solution, recent technological advances offer better ways to address the issue. Many manufacturers offer wireless lighting controls that enable users to turn lights on and off, and even dim or brighten lighting from anywhere in a room or hallway. Among the simplest and most affordable of these devices is the GE Home Control Series Indoor Light Switch. It comes in a kit (about $20) that includes a remote control switch that can be set on a table or mounted to a wall, and a plug-in receiver that can be inserted in any 120-volt outlet. A table or floor lamp plugged into the receiver can be turned on and off using the remote. The switch can actually be used to control up to eight lights or appliances plugged into compatible receivers. 

The Z-Wave Home Control Series Indoor Light Switch, left

comes in a kit that includes a remote light switch and a receiver that plugs in an ordinary wall outlet. A lamp plugged into the receiver can be operated by the switch from anywhere in a room. 

Facilities managers may also want to consider a more permanent, heavier-service solution in the form of lighting control duplex receptacles. The GE Z-Wave Lighting Control Receptacle, pictured right, enables wireless control from the receptacle itself and is compatible with incandescent, LED, halogen, Xenon, fluorescent and compact fluorescent bulbs.The Z-Wave Lighting Control Duplex Receptacle must be hardwired and can replace a conventional wall ou

tlet. It provides one plug-in point for a remote-controlled lamp and one for a conventional appliance.

In the same family of controls, the GE 45609 Z-Wave Wireless Lighting Control On/Off Wall Switch, pictured below,can be installed in place of a conventional wall switch to enable remote control of permanently mounted overhead lights. The rocker switch provides manual control, and with a compatible remote unit, wireless control of overhead fluorescent lights from anywhere within the room in which it's installed. The wall switch has an LED indicator light that enables it to be located easily in the dark. GE Z-Wave and other wireless lighting systems include wireless motion detectors and a wide array of compatible remote controls. 

Most systems include "keychain-style" designs that can easily be attached to a bedrail or worn around the neck on a lanyard. Motion detectors can be an important component in lighting control systems for seniors because they turn lights on and off automatically so the resident doesn't need to find a switch or remember to shut them off at night. 

Eric Smith's "bracket solution" notwithstanding, wireless lighting controls offer many practical options for improving safety and comfort in eldercare facilities. 

Michael Chotiner is a construction expert who writes on lighting, including wireless lighting controls, for Home Depot. Many of the lighting techniques Michael refers to can be used with lighting available from the Home Depot website, including Home Depot's bathroom lighting selection, as well as the company's ceiling lights options.

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