Seniors and Falling Are All To Common

Do you remember your parents telling you to stand up straight, don’t slouch at the dinner table, balance a book on your head while walking? Did they also send you out to play at the first sign of light with a reminder to get yourself home by dinner?  If so, you, like many in the Baby Boomer group is no stranger to realizing now why that advice was important and why we need to continue to impart the same to our children and grandchildren. Fitness and good posture are preventative measures to falling. 

Every day hundreds of seniors over the age of 65 fall down and cannot get themselves up. They end up with serious or at least temporary injuries from these falls.

The main reason seniors fall is a loss of balance, changes and shifts in the body’s center of gravity and the loss of bone density and muscles happening at the same time make these ‘changes’ ones that need our full attention.

Falls can and do decrease mobility and many times cause seniors to reduce their activity. They may become less independent and less socially active. In essence, the fall changes their lifestyle.  Compounding the problem is the fact that many seniors do not ‘share their fall’ with their doctor or family members because they fear losing their independence. Unfortunately, that is exactly what happens, because they stifle the chance for rehabilitative care and/or supportive preventive measures. So in the long run they actually hasten the loss of their independence. 

Everyone’s situation is different. Suffice it to say that seniors (other than the aging process itself) may have multiple conditions or symptoms that make them more prone to falls. In some cases, an inner ear disorder or cognitive problems from dementia and Alzheimer’s can cause the brain to read balance differently, and many times it’s a lack of fitness in combination with medication confusion and some or all of the above.

Excessive medications are a leading cause of falls.  Multiple doctors often prescribe medications and if a breakdown or lack of communication between the doctors, the patient and or family members occur the awareness of the combined effects of the drugs is unknown. Seniors and their families need to know and discuss what medications (and what dose) are being taken. Old medications lying around need to be discarded.

Customized exercise program.  Exercise, in the form of resistance (strength) training and balance, gait, coordination training and cardiovascular training is effective in reducing falls.  Physical exercise, including tai chi is proven to help with balance and water aerobics are also great for improving strength. 

Vision impairment. Aging is the number one culprit for changes in visual acuity, development of cataracts, macular degeneration, glaucoma, etc., and all can have a direct affect on stability and in essence be the cause of falling.

Dizziness. Did you know that shifting positions, or getting up from a seated position can cause your blood pressure to drop, causing dizziness and disorientation…most times caused, or worsened, by dehydration and medications…hence increasing the possibility of a fall?

Vitamin D. Vitamin D supplementation at appropriate levels should be considered for all older adults, especially those living in areas with low seasonal sunlight (that’s us here in the Northeast). 

Footwear. Use common sense when it comes to shoes. Well-fitting, comfortable shoes with non-skid soles are best. 

Age-friendly homes.  Falls can be avoided with a little bit of prevention. De-cluttering is one option and there are additional programs and agencies that will recommend or provide home screening services to identify any problems and recommend needed modifications. This may give a senior more confidence to get up and move around if the home is free of unnecessary obstacles.

I have known seniors that have fallen in housing, in their homes and in nursing homes and these falls take their toll. Once having fallen (in some cases several falls), seniors can become fearful of another fall and so they self-limit their potential to fall again - they stop moving. This in turn causes a weakening of muscles. Weak muscles cause shuffling and loss of balance is a recipe for another fall or a complete loss of ability to walk. 

Encouraging a senior and/or loved one to attend "Balance & Strength Exercise Classes" will help to re-build their confidence. These classes put them at ease because they are with others that have experienced similar situations.  Medicare A or B pays for this with a doctor's order and an RN involved.

Look, clearly, falling can be a life-changing event. Preventive measures such as exercise are key and it would be advisable to consider the use of a cane or walker, guardrails in the shower, a bar by the bed if you are noticing any signs of weakness in this area.  Of course common sense works too. No more climbing on a ladder or chair to clean the ceiling fan (I’ve been guilty of this). Be conscious for potholes and or impediments in parking lots, clutter on stairs, rain slicked walkways etc and if you suffer from a condition which effects your balance, weakness in limbs, pain etc then take extra care towards better and stronger muscle mobility as it is crucial to staying upright.

If you you begin to recognize that you are at risk of falling, it is time to be pro-active - denial is not helpful.  Do not let someone insist you are ‘just getting old’. Go for a ‘fall risk assessment’ at your local Physical Therapist office. Learn what they have to offer. They will help correct your posture and strengthen (with proper therapy) your muscles in no time.  Frailty is not your friend.  If you are living alone, (or know of someone who is) and find yourself or them being inactive know that inactivity DOES accelerate the loss of muscle, strength and balance and you will be at a higher risk for a fracture if you do fall...which equals possible nursing home care. 

I understand that the body does not do what it used to (mine doesn’t either). I understand being on a fixed budget. I understand not wanting to exercise. However, we have to keep moving. And although canes are good to pirouette around and a walker is a good assistive device, it is important to realize that physical activity is the “key” to maintaining or restoring our bodies to an improved physical state which in turn will stimulate our brains and restore our confidence and desire to get out and live a more active and productive life for the time available to us.

Sara-Lynn Reynolds has a Degree in Health Education from UMASS, Amherst and is currently the Community and Education Liaison for Home Instead Senior Care Northern Bristol County, office located in Attleboro, MA. Her columns will offer advice, articles, stories and pertinent information regarding health, wellness and fitness.