'The pain was excruciating': A friend in her 80s fell down her basement stairs. Could it have been avoided?

By Quentin Fottrell

'She developed pleural effusion - fluid between the lungs and ribs - compressing her lungs and making it hard for her to breathe'

"My aunt had a stairlift installed when severe arthritis made the stairs dangerous." (Photo subject is a model.)

Dear Quentin,

I read the letter from the 80-year-old reader who wondered whether he should renovate or downsize ('I have $400,000 in equity': I'm 80. Should I sell my house because of dangerous stairs - or spend thousands renovating?).

Here's a cautionary tale, which your readers may find of interest in light of that story. A friend in her 80s slipped on the stairs to her flooded basement and fell, breaking two posterior ribs and injuring her shoulder.

The pain was excruciating. She developed pleural effusion - fluid between the lungs and ribs - compressing her lungs and making it hard for her to breathe. A chest tube was inserted to drain the fluid.

Her sister traveled from out of state to help, and once my friend can travel, she will convalesce with her family in another state. She faces months of healing and rehabilitation to get back to full health.

My aunt had a stairlift installed for her steep staircase when severe arthritis made the stairs dangerous for her. There are many options for the person in question to consider. It's wise to take dangerous stairs seriously.

Forevery Wary About Stairs

You can email The Moneyist with any financial and ethical questions at qfottrell@marketwatch.com. The Moneyist regrets he cannot reply to questions individually.

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People do put stairlifts into basement stairwells, but when cost is an issue, choices need to be made.

Dear Wary,

A stairlift can be a lifesaver for millions of older adults. It can also be expensive.

People do put stairlifts into basement stairwells, but the steeper and narrower space can make them trickier and possibly more expensive to install. Depending on the configuration of the stairs, it may be more practical to install a stairlift on the main staircase, which is often the most heavily used set of stairs in the house. Your friend was unlucky that she took a tumble on those basement stairs. If in doubt about stairs, older people should wait for a friend or family member, but it's also easier to lecture people after the fact.

If you have reduced mobility, stairlifts are an effective way to remain in your house. Government grants, veterans' benefits and local programs can help with the cost. What happened to your friend is an all-too-common occurrence, and Medicare can foot the cost for necessary inpatient rehab, as long as its eligibility requirements are met. A fall can lead to broken bones, and remaining sedentary for weeks or months while recovering can have a domino effect on a senior's health.

There are a couple of understandable reasons older people put off installing a stairlift. They might also hesitate to install a shower chair or add handrails at the front door for all the neighbors to see. These things are an acknowledgement to others and to yourself that you're getting older. And stairlifts, notwithstanding any grants, are not cheap. They can cost anywhere from $5,000 to $15,000 to install, depending on the brand and the stairwell.

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Falls can be traumatic and even fatal

For anyone in a similar situation, before deciding to sell a house you love, consider whether relatively modest changes can make it safe enough to remain there - and whether the house can continue to work for you if your mobility declines further. Such changes will vary in cost and might mean adding a stairlift, better lighting, handrails, nonslip surfaces, a safer bathroom or even relocating a bedroom to the main floor.

The Centers for Disease Control and Prevention has some startling statistics. Every year, there are roughly 4.5 million visits to emergency rooms due to elderly people falling, resulting in 3.1 million treated and released and 1.4 million hospitalizations (falls account for 88% of emergency-room visits for hip fractures among older adults). Falls are the most common cause of traumatic brain injuries for older adults and result in around 43,000 fatalities every year.

Falls are the most common cause of traumatic brain injuries for older adults.

Staircases are a flashpoint for accidents in general. More than 1 million people visit ERs each year for stair-related injuries, with young children and older adults more likely to injure themselves this way, according to a study published in the American Journal of Emergency Medicine. Women are injured more often than men. Older adults are also more likely to suffer fractures, while younger children are more likely to sustain head and neck injuries.

As well as broken or uneven steps, weak ankles or knees and inappropriate footwear, a variety of other factors can lead to falls, the CDC says. Those include lower-body weakness; vitamin D deficiency; age-related balance and mobility issues (especially after a period of illness or, say, a pandemic); side effects of prescription drugs like tranquilizers, sedatives or antidepressants; and even some over-the-counter medicines such as antihistamines and sleep aids.

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Psychological and physical independence

And, yes, the desire to do things yourself is understandable, if sometimes regrettable. Why wait for the housekeeper to make that trip to the garden shed for hedge clippers? Why ask someone else to climb a stepladder to reach a cobweb? We all take chances, sometimes without thinking about the cumulative risk. A fall can rob older people of the very independence that they are trying to preserve by carrying out those tasks.

As your friend's experience illustrates, when an older person falls, the effects can be long-lasting, and not just physically. I recently saw an elderly woman fall at a book signing. She tripped backwards over a wooden platform, and I was surprised that she was able to get up, but the biggest surprise was how it affected her emotionally. She had had a fright and could not even deal with the concern and empathy of onlookers.

In addition to the complications your friend endured, a bad fall can lead to loss of mobility and even a possible withdrawal from social situations due to fear of falling again. You may endure a period of time where you cannot put your own clothes, bathe, or even cook or feed yourself. With or without other age-related medical conditions like heart disease, hypertension, frailty or Parkinson's disease, you may experience a psychological as well as a physical spiral.

A stairlift can help preserve your independence, but it's only one part of the solution.

By emailing your questions to The Moneyist or posting your dilemmas on The Moneyist Facebook group, you agree to have them published anonymously on MarketWatch.

More columns from Quentin Fottrell:

'I'd rather be on a beach in Bali': My husband resents my $8 million net worth. Should I pay for his retirement?

My doctor friend objected to his hospital's fundraising tactics. Did management go too far?

I'm 77, pay rent and live off Social Security, but I help homeless people. Why are so many people going hungry?

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-Quentin Fottrell

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10-05-26 1900ET