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Chapter 16

Environmental Safety

and Security

Feeling Secure as One Ages

Involves sensing an identity with one’s personally significant space, whether at home or a care facility
Depends on perceived familiarity and predictability of life-space in which one moves or interacts

Feeling Secure as One Ages

Perceptions of security and feeling safe strongly influenced by cognitive capabilities and ability to problem solve
Nurses can encourage older persons to participate in steps to organize environment
Use reminders and calendars to gain greater control over time
Create simple maps to outline “territory” in which they expect to move

Feeling Secure as One Ages

Healthy People 2000/2010
More than 400 Americans die each day from injuries
Motor vehicle accidents, firearms, falls, and fires responsible for many of these deaths
Violent crime also a concern

Influences of Changing Health and Disability on Safety and Security

Physical Vulnerability
Vulnerability to environmental risks and mistreatment by others increases as people become less physically or cognitively able to recognize or cope with real or potential hazards
Important to emphasize strong influence of stress, whether it is physical, emotional, mental, or spiritual in nature

Influences of Changing Health and Disability on Safety and Security

Vulnerability to Environmental Temperatures
Many older adults exposed to temperature extremes in own dwellings
Preventive measures require attentiveness to impending climate changes, as well as protective alternatives

Influences of Changing Health and Disability on Safety and Security

Hyperthermia
Body temperature increases above normal ranges because of environmental or metabolic heat loads
Body temperature above 38° C (100.4° F)

Interventions to Prevent Hyperthermia

Drink 2 to 3 L of cool fluid daily
Minimize exertion, especially during heat of day
Stay in air-conditioned places, or use fans when possible
Wear hats and loose clothing of natural fibers when outside; remove most clothing when indoors

Interventions to Prevent Hyperthermia

Take tepid baths or showers
Apply cold, wet compresses, or immerse hands and feet in cool water
Evaluate medications for risk of hyperthermia
Avoid alcohol

Influences of Changing Health and Disability on Safety and Security

Hypothermia
Medical emergency requiring comprehensive assessment of neurological activity, oxygenation, renal function, fluid and electrolyte balance
Core temperatures below 35° C (95° F)

Influences of Changing Health and Disability on Safety and Security

Factors Associated with Low Body Temperatures in Elderly
Aging
Low environmental temperature
Thinness and malnutrition
Poverty
Living alone
Nocturia/night rising
Orthostatic hypotension

Influences of Changing Health and Disability on Safety and Security

Factors Increasing Risk of Hypothermia in Elderly
Thermoregulatory impairment
Conditions that decrease heat production
Conditions that increase heat loss
Conditions that impair central or peripheral control of thermoregulation
Drugs that interfere with thermoregulation

Influences of Changing Health and Disability on Safety and Security

Vulnerability to Natural Disasters
Older people are at great risk during and after disasters
Nurses must participate in disaster planning to support older people during these times
Older people may be less likely to seek formal or informal help than younger people during disasters and may not get as much assistance as younger individuals

Effects of Changing
Life Situations

Change is usually stressful, regardless of whether change is perceived as positive or negative
Changing life situations for older adults can affect safety and security by posing unfamiliar routes, routines, and persons in the environment

Effects of Changing
Life Situations

Auto Safety
Factor often contributing to feelings of isolation for older adults is decision, sometimes imposed by others, to give up one’s driver’s license and no longer drive

Safe Driving Tips

Plan travel route in advance; carry map of area
Wear seat belt
Keep eyes on road
Avoid distractions. If necessary to use cell phone, first pull over at convenient place
Follow 4-second rule when following another vehicle

Safe Driving Tips

Obey traffic and motor vehicle laws, signs, signals
Adjust speed to road and weather conditions
Drive with doors locked, windows rolled up
Park car in visible, well-lighted area
Expect the unexpected and always drive defensively

Effects of Changing
Life Situations

Neighborhood Security
Significant contributor to fear of crime among elderly is socioeconomic deterioration of neighborhood and loss of neighbors

Crimes Against Older Adults

Risks and Vulnerability
Living alone, memory impairments, loneliness may make elders more susceptible to crime
Older people are more likely to be victims of consumer fraud and scams that include telemarketing fraud, e-mail scams, undelivered services

Crimes Against Older Adults

Fraudulent Schemes Against Elders
Trusting elderly persons may be duped into giving money to pen pals, Internet acquaintances, phony religious causes, new acquaintances who “need help”
Door-to-door contractors
IRS Impersonators
Medical fraud

Fire Safety for Elders

Risk Factors for Elders
Economic or climatic conditions may promote use of ill-kept heating devices
Attempts to cook over open flame while wearing loose-fitting clothing
Inability to manage spattering grease from frying pan can often start fire from which elder cannot escape

Fire Safety for Elders

Reducing Fire Risks in Group Residential Settings
Noncombustible building materials
Sprinkler systems
Smoke detectors
Closed air spaces
Written fire procedures
Orientation of personnel
Assessment of environment by fire prevention officials

Fire Safety for Elders

Reducing Fire Risks in Group Residential Settings
Personnel protocols should address these issues:
Predetermined staff members should be given specific duties and posts
Notification procedures for fire department and personnel should be clearly described
Management of exit maneuvers should be assigned and specifically described

Measures to Prevent
Fires and Burns

Do not smoke in bed or when sleepy
When cooking, do not wear loose-fitting clothing
Set thermostats for water heater or faucets so that water does not become too hot
Install portable hand fire extinguisher in kitchen
Keep access to outside door(s) unobstructed
Identify emergency exits in public buildings

Measures to Prevent
Fires and Burns

If you consider entering boarding or foster home, check to see that it has smoke detectors, sprinkler system, fire extinguishers
Wear clothing that is nonflammable or treated with permanent fire-retardant finish
Fabrics of animal hair, wool, and silk are less flammable
Use several electrical outlets rather than overloading one outlet

Fire Safety for Elders

Reducing Fire Risks at Home
Potentially hazardous substances are found in most homes and should be surveyed regularly
If substance is rarely or never used, eliminate it from the home

Fire Hazards in the Home

Flammable liquids (e.g., gasoline, acetone, lacquer thinner)
Combustible liquids (e.g., lighter fluid, kerosene, turpentine)
Gas leaks
Rubbish and trash stored near stove, water heater, furnace

Fire Hazards in the Home

Christmas trees and lights that are frayed or poorly insulated
Smoking in bed or discarding burning cigarettes
Overloaded or worn electrical systems

Role of Assistive Technology

Decreasing need for personal care
Enhancing independence and ability to live safely at home

Role of Assistive Technology

Arizona Technology Access Program
Controller woven into fabric of clothes or worn as pin that will turn lights on and off, open doors, control thermostat
Controller operated by hand or voice that will operate any household appliance
Voice recognition computers
Body monitors that automatically call an emergency number when person falls
Laser-guided canes for the blind