Balance and Falls: Overcoming Fear
A preventable epidemic currently affects millions of people aged 65 and older and causes upwards of $20 billion in direct medical costs every year.
That expensive and prominent outbreak is falls, which remain the leading cause of injury deaths and hospitalizations among seniors. In fact, 1 in 3 older adults have fallen, according to the Center for Disease Control.
"It's a huge problem," says Linda Baldwin, a Matter of Balance trainer and Community Health Educator in Salem, Oregon.
The growing issue of falls has led to better prevention and education funding recently. As of January 1, 2012, physicians are required to administer a balance assessment to their Medicare/Medicaid patients. Those deemed to be at risk of falling are referred to a local health education resource, like the national Master of Balance program.
While cases continue to increase, there are simple ways to prevent falls. Baldwin says most falls can be attributed to a lack of exercise and low muscle tone. She focuses half of the eight-week Matter of Balance course on simple, yet effective, exercises to increase leg strength and improve balance. Tai Chi and Yoga programs are also effective ways to achieve strength and balance.
Poor vision or hearing and medication can also result in balance issues. Seniors should ask their physician to review medication and have their eyes and ears checked at least once every year.
Simple modifications can also make your living space safer. Baldwin spends part of the course addressing common hazards that lead to falls.
Typical household risks include throw rugs, furniture placement, loose cords from phones or other electronics, and pet toys among others.
"A lot of things people haven"t really thought about," Baldwin says. "As a group, we identify the markers, and it's something they can change. Participants feel empowered because they are making the decisions themselves."
A routine balance screening, conducted by your physician or other health expert, can also reveal your risk of falling.
A cycle of fear
Too often, older adults limit physical activity due to a fear of falling. The cruel irony is that inactivity actually increases fall risk due to low muscle tone.
"What we find is a lot of seniors who have had a fall, or once someone they know has had a fall, fear tends to start transforming their decision-making process, and they begin to limit certain activities," Baldwin says. "Once they limit activity, the risk of falling actually increases."
She adds: "Because of the fear cycle, many older adults start to do a style of walking that's more like a shuffle and the muscle gets no development," Baldwin says. "It's a big vicious cycle."
Common exercises in the Master of Balance program include foot circles, seated knee raises, standing from the seated position, heel raises, and marching in place. "These are just very functional exercises that can really make a difference by developing leg muscles, which are the primary movers when walking," Baldwin says.
Another startling reality is that less than half of older adults who experience a fall will talk to their healthcare provider or loved ones about it, according to the CDC. Seniors often avoid these discussions out of fear of losing their independence and being moved to an assisted living or nursing home.
"Providers have no desire to take people’s independence," Baldwin says. "Seniors must go in with the mindset that this person is working with me to keep me healthy and functioning as best as possible."
Loved ones may compound the problem based on their fears. For instance, if a son or daughter lives two states away and can’t be around mom, they may be concerned for her well-being and encourage her not to be active.
Having informed and open conversations, without the control of fear, is the best approach, Baldwin says.
"We work on restructuring the thought process and get them to realize what their own perceptions of falls are," Baldwin said. "We also cover external situations. Seniors are often scared of going to big events because of the large crowds or perhaps stairs and access to seating. These opportunities are still available, but they may just need to plan a little better in advance."
For balance resources, videos and a toolkit, visit the U.S. Center for Disease Control.