I was proud and shocked when my 77 year old mother hired a personal trainer. I was proud because she was taking care of herself. I was shocked because she actually took my advice. Her trainer was a classmate of mine from grammar school. You can hire a trainer, too. Ask about their experience with fragile older bodies If that’s not an option, you can still teach yourself some fall-prevention skills. It’s all about balance, strength, and de-cluttering.
To prevent falls, de-clutter the home to avoid tripping. Re-arrange the furniture to make wide paths. Use assistive devices to stay upright. Do balance and strength training to keep healthy. Do eye exercises, flexibility training, and strength training to hold yourself upright. Improve posture to stay balanced.
“Falls are a threat to the health of older adults and can reduce their ability to remain independent,” says the CDC. “However, falls aren’t something that just happens when you age, there are proven ways to reduce falls.” We want to help our moms and dad remain independent. We want to remain independent ourselves. To stay out of assisted living and the nursing home , we have to do everything we can to avoid that last insult to injury.
Shuffle a Few Feet in their Slippers
As a caregiver, you can look at the patient’s home with an eye toward making it safer. How does your patient experience the home? “Shuffle a few feet in their slippers,” says Paul Furtaw, author of The Family Guide to Trip and Fall Prevention.
Does the furniture need to be re-positioned? What does your patient find it difficult to do that might end up causing a fall?
Th impulse to stay independent might be the culprit in your patient’s next fall. Refusing to ask for help is one of the many reasons seniors fall. The desire for independence is completely understandable. We get it, that’s why we aren’t insisting mom or dad go to the assisted living facility. But that independence we honor and respect is self-defeating if it leads to an emergency trip to the hospital.
Fixing and removing rugs can be one of the greatest acts you take against unnecessary falls. Rugs are often implicated in the last falls people make before we lose them. Both living room and bathroom rugs are involved in many of these falls.
Don’t assume your patient can see wires lying in their path. Lamp wires don’t need to be run across a room. Run extension cords along the wall to prevent this trip hazard.
Add lights throughout the house. If your patient is unsteady, add hand rails to hallway walls. Put grab bars in the bathroom. And if you haven’t done it already? Remove the bathroom rugs.
Walking Faster Saves Lives
“Did you know that a person’s’ risk for falls increases as their walking speed decreases?” asks Jeff Bowers, author of Exercises to regain balance and avoid falls.
“Increasing an older person’s walking speed by 0.1 meter per second over a one-year period has been shown to increase that person’s life expectancy by 8 years in 58% of the older population.”
Beyond decluttering and assistive devices. Beyond strength training, flexibility and balance. Increasing walking speed 0.1 meter per second over a one year period increases life expectancy by 8 years!
Bowers suggests improving nutrition, keeping hydrated, and stretching. I have to agree with him about PNF (Proprioceptive Neuromuscular Facilitation) stretching. It’s a superior method to getting muscles to relax. See p. 76 of his book for instructions. Pages 79-89 contain pictures and instructions to help your patient stretch and exercise to avoid falls.
The vestibular system keeps us balanced, and the eyes are part of that feedback loop. “Eyeball exercises increase balance stability by making sure that the image of an object can be projected onto the best portion of the retina through visual control.” There are five eyeball exercises included to help strengthen the Vestibulo-Ocular Reflect, which in turns, helps to prevent falls.
If you’re wondering how to get better balance, this book contains about 100 pages of balance exercises and self-evaluation tests. There are descriptions and pictures of each activity. The guide helps you work your way from easy to more difficult stances. The standing static balance exercises start with feet together (mildly difficult); then one foot somewhat behind the other (semi-tandem); then the foot all the way behind the other (tandem) and then single leg. The more balance your patient attains, the less likely she is to fall.
Even 90 Year Olds Avoid Hip Fractures with Exercise
Preventing falls saves lives. “Falls are the leading cause of death from injury in people age 65 or over,” says Gail Davies and Fran Scully. The physical therapists wrote Fall Prevention: Stay on your own two feet.
Davies and Scully recommend balance training, strength training, and Tai Chi.
You can increase muscle mass at any age. But the fear of falling creates muscle atrophy.
First you avoid walking for fear of falling. Then your muscles get weak because you never use them. Then when you do walk with weak muscles, you’re more likely to fall.
Fall Prevention includes a good home safety checklist toward the back of the book. Use the list to help you think about the trip hazards in your home. Fix the problems that cause falls.
What do you do to prevent falls?
- Don’t be afraid to move. The less you move, the weaker you get. Weakness is a fall waiting to happening.
- Stand tall. Good posture improves balance. Good balance prevents falls.
- Exercise. The stronger you are, the less you fall. And strong people can recover from “almost falls” much better than weak people.
- Walk. Every step improves your ability to stay upright.
- Keep vision in mind. Recognize visual limitations. Move furniture out of the way. Never assume your patient can see a hazard.
- Recognize that prescriptions contribute to falls. They create cognitive weakness and tiredness.
- Talk to your doctor. A detail left out might be the difference between bad and good care.
- Pay attention to footwear. Good shoes promote healthy activities.
- Watch for hazardous clothing. Don’t trip on your clothes.
- Be aware of the cats and dogs. My cat loves to trip us. He thinks he’s begging for food. He just doesn’t realize that he’ll eat less if he trips us into the hospital.
- What if you do fall? Take inventory before taking action.
- Fix the household arrangement. The strongest, most balanced person with great eyesight will still be more likely to trip if the house is cluttered.
Furtaw offers good advice on assistive devices. And he lists organizations to ask for help if you’re not sure about how to help your patient from falling.
After the Fall
Balance is the second key to fall prevention, says Lex Gonzales, author of The Book of Balance: Rehab Secrets to Improve Your Balance and Decrease Your Risk of Falling.
The first key is to remove the obstacles that you trip over. Fix uneven walkways. Be aware of raised thresholds. Secure handrails.
Gonzales lists obstacles to fix on the outside of the house, in the bathroom, and stairways. He suggests increasing the light both inside and out. Use chairs that allow you to push yourself up. Fasten carpets and runners.
After you’ve fixed the items on the checklist, start a balance and strength program. There’s a very good set of exercises in The Book of Balance. Each exercise has a drawing showing how to do it.
Gonzales tells you why you’re doing the exercise too. Don’t you find that knowing something will work helps motivate you to do it? I know that when I trust the outcome, I’m more likely to engage in the behavior.
For instance, you might ask, “Why should I do the segmental neck and trunk rotation exercise?” Gonzales answer, ” “This exercise will improve your ability to look over your shoulder without losing your balance.”
We don’t often think of “looking over our shoulders” as a life-threatening activity. The fact is, anything that makes us more likely to fall is also more likely to kill us. Falling down is often the last insult to injury before we make our final trip to the hospital.
The Book of Balance exercises are relatively easy. They’re designed for older people with physical issues to work around. Gonzales rightly points out that you should exercising stop if you feel pain.
The exercise chapters include:
- Build Your Balance on a Strong Foundation
- Let’s Get Up to Sitting
- Time to Stand Up
- How Good is Your Standing Balance?
- Let’s Get Moving
- Time to Break Free!
Do bed alarms prevent falls? Yes, bed alarms prevent falls as long as the caregiver responds to the alarm to help the patient. Bed exit alarms trigger when the patient moves away from the bed, or completely gets off the bed. She is already in motion when the alarm goes off. The alarm alerts the caregiver that the patient is in the process of doing something dangerous. When the caregiver responds to the patient and assists her, the bed exit alarm has accomplished its mission of preventing a fall. Read more about bed exit alarms here.