Winter brings the joys (and stressors) of the holiday season—and it’s also a really cozy time. Think twinkling lights, candles, lots of throw blankets and an excuse to stay home (if that’s your thing). Depending on where you live, it can get mighty cold outside. And lest we forget, some of the coldest days of the year are also the darkest. And you might start to worry about older family members when it gets colder and darker earlier—geriatricians say that’s understandable.
Dr. Owen Deland, MD, a geriatrician at Hackensack University Medical Center, tells Parade that winter comes with a storm of stressors for older adults that affect their physical and mental well-being.
“As the days get shorter and the weather gets colder, seniors often spend more time indoors, which can lead to severe social isolation and trigger seasonal affective disorder (SAD) or clinical depression,” he says.
Dr. Deland adds that aging bodies regulate temperature less efficiently, straining the cardiovascular system and increasing the risk of hypothermia in older adults. On top of all of that, winter is peak sick season—and older adults are more likely to become severely ill (and even die) from the flu, RSV and COVID-19.
But there’s a lot you can do to prepare older family members for late fall and winter.
“Getting ready now, with vaccines, medications, working heat and a plan for who to call, is much easier than doing it in the middle of a storm or an illness,” Dr. Lourdes Adame, MD, a board-certified family medicine physician who practices geriatrics at AltaMed Program of All-Inclusive Care for the Elderly (PACE) Huntington Park, Calif.
Geriatricians urge families to do one more thing as the days get darker earlier to keep their older loved ones healthy. They revealed it below and offered tips to make life safer for older adults.
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Do This as It Gets Dark Earlier, Geriatricians Beg
Geriatricians say it’s crucial to assess an older adult’s fall risk, especially as it gets dark earlier. “Assessing fall risk proactively is essential because meaningful interventions take time to implement, and you want preventative measures fully in place before environmental hazards peak,” Dr. Deland says.
He points out that more than 1 in 4 older adults (or about 3 million people) fall each year. Unfortunately, just one fall doubles a person’s risk of falling again, which Dr. Deland describes as a “dangerous cycle that is easily ignored without proper medical intervention.”
Darkness can also increase a person’s risk of falling.
“Falls are one of the biggest threats to an older person’s health and independence, and the risk increases when daylight shrinks,” Dr. Adame says. “With age, the eyes take in less light, adjust more slowly when moving between bright and dark spaces, and have a harder time judging depth and spotting edges. In dim light, a step, a curb, a pet or a cord can seem to disappear.”
So, Dr. Adame points out that a hallway or porch that felt fine during the summer months can become a hazard by 5 p.m. in November.
“Earlier sunsets also mean more evening trips outside or through the house, like errands, walks to the car and bathroom visits at night, all in low light,” Dr. Adame adds. “Wet leaves, rain, and ice make it even harder to see where to step, and common eye conditions like cataracts and glaucoma make it worse.”
Eyesight is only part of the equation when it comes to older relatives’ risk of falls in fall and winter.
“As the light starts to dim earlier and the cooler weather starts to make joints stiffer, it’s always a good idea to engage older people regarding safety,” says Dr. Sonal Patel, MD, a board-certified internal medicine doctor specializing in geriatrics. “Water or melting ice can create slippery situations that slower and stiffer joints may not be able to respond to well enough.”
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What Can Happen To Older Adults if They Fall
The American Geriatrics Society (AGS) reports that falls are the No. 1 reason for hospital admissions in older adults, who may not be “good as new” at discharge.
“The physical and lifestyle repercussions of these recurring falls are devastating,” Dr. Deland says.
Dr. Adame agrees. “A fall can do much more than cause a bruise or some pain,” she says.
Here is what Dr. Adame says geriatricians worry about:
- Broken bones. Falls commonly affect the hip, wrist and spine. “A hip fracture often means surgery and a long recovery, and some people never get back to their previous level of independence,” Dr. Adame says.
- Bleeding. Dr. Adame is especially concerned about bleeding that occurs in the head. “This is more dangerous for people on blood thinners, and even a minor bump can cause bleeding that shows up hours, days or even weeks later,” Dr. Adame notes.
- Worsening of other health conditions. “A fall and the hospital stay that follows can flare up heart disease, diabetes, lung disease or memory problems,” Dr. Adame says.
- Loss of strength and function. Dr. Adame says falls can severely limit an older person’s ability to care for themselves and enjoy life independently. “Even a short time in bed can cause fast muscle loss, making it harder to walk, bathe or dress without help,” Dr. Adame says.
- Lying on the floor for too long. Dr. Adame says seniors can become dehydrated, develop pressure sores or get dangerously cold if no one finds them for a while.
- Fear of falling again. This one can also prevent older people from living independently and hurt their mental well-being. “Many people start avoiding walking, going out and seeing friends,” Dr. Adame says. “That makes them weaker and more isolated, which raises the risk of another fall.”
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How To Lower Fall Risk in Older Adults Before It Gets Darker Earlier
The CDC’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative can help you address the risks of seasonal darkness and poor lighting at night.
Dr. Patel says that, ideally, you’ll start before it gets dark, not as it gets dark. But it’s not too late to take steps to lower the risk. She shared a few tips for keeping older loved ones safe from falls as the days get shorter.
1. Annual wellness visits with primary physician and vision exams
Dr. Patel says these visits will let you know if you need to make any necessary improvements, like optimizing glasses or attending physical therapy to improve gait stability and strength.
“There are other concerns, such as medication-related dizziness, that can cause falls,” Dr. Patel adds. “Medication reviews with a primary care physician [before the] winter months to prevent low blood pressure upon standing would be extremely beneficial.”
2. Make home improvements
A Journal of Safety Research study suggests falls and injuries happen more often during trips and slips right outside the home. Dr. Patel suggests improving lighting in common areas, creating slip-resistant flooring before the fall/winter months, and using dimmer lighting.
It helps family members, neighbors, and friends who are aging have someone check the lighting inside and outside their home during dark summer hours,” Dr. Patel says. “Installing motion lights outdoors along walkways and the patio and porch can improve visibility considerably.”
Inside, Dr. Patel suggests keeping lighting “bright” to reduce tripping.
“Motion lights are easily accessible nowadays and can be installed along the path from the bed to the bathroom as well, where many falls do happen overnight,” Dr. Patel says.
3. Get the right shoes
This one isn’t about style. Dr. Patel explains that it’s crucial to ensure older relatives have the right footwear for the colder, darker months. “The right footwear can prevent many falls,” she says.
She advises people to make sure their older relatives wear closed-toe shoes that support their arches. She adds that the footwear should have good grip or a textured sole. Low heels and a wide base provide better ankle support.
“It’s essential that the shoes fit around the foot firmly with laces, straps or Velcro,” Dr. Patel states.
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Sources:
- Dr. Owen Deland, MD, a geriatrician at Hackensack University Medical Center
- Dr. Lourdes Adame, MD, a board-certified family medicine physician who practices geriatrics at AltaMed Program of All-Inclusive Care for the Elderly (PACE) Huntington Park, Calif
- Dr. Sonal Patel, MD, a board-certified internal medicine doctor specializing in geriatrics
- People at Increased Risk for Severe Respiratory Illnesses. CDC.
- Facts About Older Adult Falls. CDC.
- American Geriatrics Society response to the World Falls Guidelines. Journal of the American Geriatrics Society.
- STEADI – Older Adult Fall Prevention. CDC.
- Seasonal variation in fall-related emergency department visits by location of fall – United States, 2015. Journal of Safety Research.