A Question of Organ Recitals
INTERESTING STUFF – 23 September 2017

Too Old to Fall

Are you age 65 or older and live at home? If so, in any given year, you have almost a one in three chance of falling. If you live in a care home, you have a 50 percent chance.

This is not to be taken lightly. Little kids fall all the time and bounce right up - their bones are still pliable. Old people's? Not so much and a broken bone, even a bad bruise, can lead to disability. Here are some statistics about elders and falls (emphasis is mine):

Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall

Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths

Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults

Today, the first day of autumn, is the annual Falls Prevention Awareness Day and as we do here every year at this time, we remind ourselves to take stock of how to protect ourselves from this particular danger.

For elders who live independently, most falls happen at home.

Before I get rolling on this topic, here is a short video from the National Council on Aging about preventing falls. It's a little too cutesy for me, but it has the basic information you need to keep in mind to help you stay safe from falls:

For such a short piece, that video covers the preventable causes of falls quite well and the beginning of this new season is a good reminder to correct the problems in your home that might trip you up.

Two unexpected things changed after my Whipple procedure surgery in June: I lost my taste for sweet things (not that I don't eat them but they are no longer something I crave) and my balance, which had always been good, has become shakier.

For the first time, I now have a mat in the tub so not to slip while showering and I have taught myself, especially when I get up from a chair or bed, to hang on to something for a few moments until I feel steady on my feet.

You might like to take a mental inventory to see if such things may have changed for you.

Here is a list of websites about most of the hazards and preventions we should check for and correct once a year:

National Institute on Aging

AARP – Preventing Fall in the Elderly

Mayo Clinic

WebMD

National Institute on Aging

Few of these and other well-meaning instructions mention an important hazard we discussed in August – running children.

”Suddenly, two boys – maybe seven, eight or nine – ran full tilt down the hallway, brushing the old man's cane arm as they scooted by and then, making a course correction, nearly bumped into my wheelchair.

“I don't recall any previous time when I was frightened in just that way. I immediately pictured myself and the wheelchair tipped over on the floor of the hallway, my incision ripped open with blood pouring forth.”

This post drew a lot of comment and several of you mentioned the additional problem of adults looking at cell phones while walking and bumping into people. Here's my free advice about that:

If you use a cane, a walker or a quarterstaff, take it with you every time you leave the house. One reader commented in August that they also work well as defensive devices when out and about.

Another useful device is a medical alert system that will notify a response team if you have fallen and can't get up. (Yes, I agree, those TV commercials are awful.) There are many different systems to choose from and some may not be as reliable as anyone would want or need.

One place you can check is the reviews.com page about these devices. They say they have carefully checked and tested many systems and give reasons for their recommendations so you might want to consult them. Just so you know, their About page notes:

"If you buy our picks, we'll often make money on that purchase. That is how we can stay in business...We pledge that we'll never name a top pick that's not truly great even it'd mean a bigger payout for us."

As always, be careful where you shop online.

Most of us at this blog are too old to risk falling so let's all be safe out there, just as Sergeant Phil Esterhaus (Michael Conrad) used to say every week on Hill Street Blues.

Comments

A new TaiChi class has multiple benefits to help with balancing and stabilizing. Of course the physical strengthening and stances are of enormous value, but the mindfulness (go very slow, with attentiveness, awareness) is what I've found most helpful.

With time and constantly reminding myself to practice, I expect this body and mind training to become automatic, perhaps to the point of being mindfully inattentive. Whatever keeps the boat upright.

Also reorganized my bedroom so there's an easy (flash)light near the bed, the bed linens aren't too big and bulky, as I move a good amount during the sleep hours and end up in all sorts of contortions and bunched-up linens, a pottery dish to hold only my glasses, phone, small light.

Every evening and morning my calendar is reviewed, then I'm aware of what has to be done so I'm not overly rushed, either going somewhere or to gather information or belongings needed for some reason. Otherwise I'm leaving myself open to frantic, accident-prone rushing.

And regarding the "being on time," if I'm going to be late, so be it. No longer do I fret over this, as was the case when younger. Cell phones always help with informing others of lateness.

Lastly, I put personal safety atop the fray of life's comings and goings, by giving it priority over everything else and no longer needing my once, so-called valued shortcuts for accomplishing anything and everything, to save time.

Last of lastly, every room, possessions and thoughts are being simplified.

I took a fall last November while out walking with my husband. stepped on a small branch, it rolled and I lost my balance. Hurt both arms, banged my head and as it turned out broke my left wrist. I always thought I was careful when I walked, now I'm double careful, at home and when out walking.

T his is me, 3 falls in last 3 years, nothing broken just bruised and sore
Every precaution you can take
I am taking.
Did not want it, but since solo, outside a lot now have a device that I wear around my
neck. Love it feel as though someone is with me
With escalating arthritis, exercise daily, yoga, meditate, good diet, 106 lbs, wonderful family but no one near, now some help, this is new and I carry onward.
Cane always near and no the fear of falling.
Share a lot of this on my blog My Journey To Mindfulness.
Now 82 and told I may live a long time with my good health other then arthritis :(

Sometimes it is difficult for someone to accept changes in their ability. My 95 year old mother fell and landed in the hospital but still refuses to use any walking aids. I realized at 70 that I needed to work on my balance and have been doing Tai Chi. It does help and it is easy on the body.

I like to hold my elbows out just a little bit to claim more space for my body when traversing my way through a group of people or on a crowded sidewalk. By holding my elbows out I claim more personal space, and it gives me a feeling of having good balance. It may keep people from knocking into me and maybe causing me to get off balance, trip, or fall.

When I worked in healthcare I was told many times that older people do not fall and break their hip(s), but that the hip breaks and then they fall. I suppose that's based on osteoporosis -- I'll bet that it happens both ways.

I do know that my grandpa fell and had a broken hip, but the worst of it was that he became demented from the incident and that's the most feared outcome. My father had an operation for bladder/prostate cancer and then became demented, whether it was because he didn't get enough oxygen during the surgery or from the shock of the operation. It is something I fear more than death...

I long been aware of fall hazards. Several family members have fallen and broken bones, and worse, sometimes alone or abroad. So far I've been very lucky and am almost paranoid. My doctor is helping (?). Every time I check in, they ask if I've fallen. I always take my phone when away from home and have for several years considered the various medic alert systems. I may start carrying a walking staff (or one of the much lighter weight poles that hikers use) when I go walking, not yet for balance but to ward off loose dogs. To date my balance seems fine, but I know my stride has changed -- slightly wider stance, shorter strides. The walk of someone afraid of falling.

Here at the ALF, falls are not just a daily occurrence,but on some days, an hourly one. The policy here is if a person cannot get up on their own, the staff must call EMS for assistance. The resident is checked for breaks or bruises, blood pressure and any pain before the EMS guys will help them to their feet. And, if need be, take them to the ER. Many of the falls happen in the resident's rooms when they don't use their walkers or canes, become dizzy and lose their balance. Fortunately, most of the injuries are minor.

Thank you, Ronni, for this post. I was someone who rushed, rushed, rushed, energizer bunny. After several falls over the past year with, thankfully, no major injury,, I have slowed myself down and proceed much more carefully. As I am presently living on a boat, this has been easy to accomplish. But I still need to remind myself. It requires more vigilance, as, do I dare say it....does our being aware of what is going on in the political world of our country these days!

Here in the Minneapolis area, until his death at 90 or so a couple years ago, a man named Elliot Royce taught classes in falling to elders. He deliberately fell a number of times every day in order to practice how to fall without injury. This, in addition to a good Tai Chi class, would benefit us as we age.

For those who do not have conditions that would prevent such trainings, these are excellent additions to the above strategies for avoiding falls.

I recently dropped 40 lbs after getting the correct medication for a thyroid problem. While strength and stamina have returned with a regular fitness routine, balance requires extra effort. One teacher suggests viewing balance as a kind of muscle that requires its own daily workout.

Thanks for posting this, Ronnie.

Totally worthless observation: the sling switches from the guy's right arm to his left in the video. (Thought I wasn't paying attention, didn't ya?)

I am 72 yr old. On July 25 I fell and broke my hip because I tripped on a tree stump while I was walking backwards to water a row of potted plants. I know, I know: Backwards! As a geologist, I fell hundreds of times without serious consequences. I felt immune to serious consequences from falling: that was for 'other people'. But here I am retired and I wreck my hip while gardening. I have pretty severe arthritis and have to work to maintain flexibility and strength. At some point, it looks like I will have to have a hip replacement for my 'pinned' hip. I'm now extra careful.
Shockingly, my wife and I learned yesterday that a high school classmate of ours, whom we had visited with at our August high school reunion (Lake Oswego High), fell and died. He reportedly fainted, fell and hit his head on a rock in his small backyard pond. He didn't suffer, but his death from a fall has hit us pretty hard.

I fell slipping in the bathtub about four years ago and totally rearranged my lower spine. It looks like an upside down question mark on x-rays now. Miraculously nothing broke but I can no longer just stand in place for more than 7-8 minutes at a time. Last autumn while rushing around I fell over my feet and hit my head on the dining room table. My kids are helping me declutter my condo. Too much furniture in a small place. Got rid of my throw rugs, bought socks with anti-slip on the bottom to wear around the house instead of slippers. No more tub. I moved into a one floor ground level condo with a step-in (2") shower with grab bars. But since I can be unpredictably unsteady on my feet (arthritis and inactivity) I've signed up for Tai Chi and am shopping for a walking staff. Move it or lose it I guess, and I've been very, very lucky so far.

The bit about mindfulness... I think of that as a new rule: "One thing at a time." Even as recently as a couple of years ago I used to think nothing of walking briskly while fishing in my purse for my transit pass. Now I make a point to stop walking before transferring my attention away from staying balanced.

My falls have usually happened because of defective neural feedback. After my last fall, I finally saw the pattern: My foot just doesn't lift as high as I think it has lifted, so I trip over an obstacle I think I am going to step over easily. Now that I know, I can take precautions -- namely, just stop trying to step over things! Go around. Or if I do have to, stop first. Do it slowly, with awareness, one foot at a time. If possible, have one hand somewhere I can hang on if necessary.

I have both vision and hearing issues, and they do cause minor difficulties with balance. Plus, being short of breath results in being a bit low on brain oxygen, which again affects balance. On the other hand, I am grateful not to have the joint or bone fragility problems so many have to deal with. So far!

They say youth is wasted on the young... I hope I am old enough by now to spare a thankful thought for those remnants of youth that are still left to me.

As someone who just recovered from two foot surgeries, I would like to add that the new "knee walkers" or "knee scooters" are MUCH safer to use than crutches. It makes me mad that Medicare won't cover them and neither will my other insurance! They prevent falls and getting knocked over accidentally while you are on crutches, so ultimately they save money and are only around $100 to rent or buy for 4-6 weeks.

Suggestion: read reviews and compare a few types of scooters in your foot surgeon's office or a medical supply store before renting or purchasing. Some are much more stable than others and have better turning radii, which becomes important in a small hallway, kitchen or bathroom! Try a 6 point turn a few times and you will see what I mean!

Our doctors advice to us: "feet on the floor".

The major problem for me that was only mentioned on the WebMD website is animals.
My dog and cat are forever crossing in front of me when I am walking in the house. I cannot begin to count how many times I have almost tripped over one or both of them. A couple of years ago while attempting to step over my dog that was laying across the kitchen doorway, (I knew better but stupidly did it anyway) the dog stood up at that exact moment, hit me just right and I flew across the room. I was lucky; I only sprained two fingers when I slid into a chair leg. I might mention the dog is a really gentle German Shepherd who would take a bullet for me.

To add to Class of 65 ‘s comment, some falls are caused by heart or blood pressure problems. Some patients questioned the need for a cardiogram after a fall but it is important to rule out medical reasons that may precede or contribute to a fall.

This post and comments are really scary. I have a Collie about a year old and whenever I turn around, there she is! She follows me everywhere and I am afraid I might fall over her one day. I try to be careful but sometimes I,m just in a rush and this whole conversation has me re-thinking the way I do things. Thanks and ladies, be careful.

Love and light

I have two cats sleeping around. My answer is to somewhat shuffle so I don't step on or fall over them. Not rushing is the big thing.

Slammed my arthritic big toe hard against a van bumper in Cork, Ireland.

Face planted like a bag of boulders.

Damn that hurt like a B----!

It was dark, the parking lot was on an steep angle.

Shocked the H out of my husband.

My entire body hurt.

I used to laugh my butt off after falling.

Now I bend a nail back and howl like a lonesome coyote.

Times change..

The best thing I have found for balance is my yoga class (1 or 2 X weekly) and walking as many days a week as I can manage.....for 30 mins. I like to walk outside and live where it is enjoyable year around so lucky that way. It helps my arthritis, my depression, my weight, my cholesterol and my sleep.

Five years ago I was rushing after a hike with my husband and tripped on a speed bump....that bruised my entire left side. It took a year for the awful pain to subside and to get some semblance of balance once again when walking down 2 steps to the yard or the laundry room in the garage. I am now 77.

I am very careful now, and as many have commented, I no longer rush around like I used to....also use a mat in the tub after I fell there. Have osteoporosis but have never broken a bone although I have caught myself with my hands many times.

A friend's mother had too much alcohol, fell down her condo stairs, hit her head, was in a coma for a few days and pronounced brain dead...she was only about 73 years old !
That shook me up - not good to have a 2 story place even if you don't drink.

I read this earlier and thought that, as an expert who has fallen more times than I can remember, I should have something worthwhile to contribute. I don't.

I will just tell you of the stupid things I did that contributed to my most serious falls. My first broken bone was due to being very careless and leaning too far to paint the fascia on our house that was being built. I fell into the pile of rocks in the trench of the basement that had not been filled in yet. I only broke a finger that time.

Had I leaned my lesson yet? No, not a chance. My next fall some years later happened when we had just moved into another new house we had built and had just planted sods of grass to start a lawn. The ground was a sea of mud with clumps of grass peeking above it. I had new shoes on and didn't want to get them dirty so was jumping from one clump of grass to the next when I slipped, instinctively reaching for the side of the house to break my fall. I broke my shoulder that time.

You would think I had learned my lesson by this time. You would be wrong.
Some people are slow learners and some never learn. I fall into the latter category. I was on a high ladder trimming tree branches when a branch I had been hanging onto for balance broke throwing me backward and my head hit the steel post holding the laundry lines. I had a concussion that time and had been unconscious on the ground before calling for help.

I was visiting my daughter and her family in California and their house had a very steep drive to the garage. It was Thanksgiving day and I went out to get the paper. If any of you live in the L.A. area you know that the L. A. Times weighs a ton with all of the ads the paper has. Of course, the paper was at the bottom of the drive. Did I mention that their house was on a hill with a steep drive? About half way up I lost my balance and started doing dance steps backward to try to stay upright. I knew I was going to fall so when my feet hit the dirt I thought "Oh good, I won't hit concrete." Then I went down and my head hit the corner of a post holding their "for sale" sign. Do you know how a head wound bleeds profusely? A trip to urgent care to have 20 stitches taken in the top of my noggin that time.

My next fall was the one that was most catastrophic one for me. I simply got up from my chair to go to bed, lost my balance and did my dance steps trying to keep from falling again. I failed and broke my hip.

Falls since then have been one in my living room decorating for Christmas. I was carrying a heavy wooden Santa and lost my balance again. I put my hand on the top of my heavy glass coffee table to break my fall and ended p on my face with the top of the coffee table pinning me to the ground. Thank god for my medical alert.

The next fall happened because, still not having learned a thing, I was carrying couple of trays of appetizers to the living room and lost my balance, falling backward and breaking my vertebrae. This led to being hospitalized.

The next December I fell again by losing my balance and falling backward. I was not being careless this time, but it caused me to spend another night in the hospital and Christmas and New Years in re-hab.

There were other falls that were not serious, but were there nonethless.

I really think I have learned my lesson this time, because the doctor indicated that the next fall would be my last.

My cousin's daughter read this and reminded me of another fall I took that resulted in 2 broken ribs. It occurred between the concussion and the California fall.

I was getting in bed and put my knee on the edge of the bed and it slipped off twisting me and my back hit the sharp corner of my end table. I pulled myself up and sat on the edge of the bed waiting for the pain to go away. It didn't and after 15 minutes I decided that I should probably call the ER guys. Yep, more broken bones.

I am beginning to feel like a patchwork quilt.

Lots of effective tools for avoiding falls offered in this post -- only have to remember and practice them -- that's the hard part. I try to remember to practice a "stage fall" if I'm going down -- learned it in drama class in my young adult theatre "ham" years. Just complete body relaxation and folding down.

Don't want to let our head hit a hard surface, even the ground. People worry about broken bones, hip fractures and replacements, but "breaking" our mind should be a concern also.

By all means, protect the head when falling as the consequence of a head hitting the ground or other hard surface can result in closed head trauma -- no external bleeding. The effects can be subtle cognitive ones in various areas including judgment problems resulting in their engaging in unsafe actions, becoming impulsive, lacking inhibitory control, even memory deficits (especially immediate or short term), slight personality changes.

I'm reminded of an active late sixties-in-age retired woman who prided herself in all she was able to do herself, caring for her house and gardening. She ceased appearing at an informal group, initially strangers to each other, that used to occasionally encounter each other for coffee at a local shop. Eventually we learned she had been up just a few steps on a ladder leaned against her house trimming shrubs and the ladder had tipped backward causing her to fall with the back of her head hitting the ground though she didn't lose consciousness. I don't know what subsequently happened or when it was finally determined she could no longer live independently and house was sold, but I learned she had to move where she could be supervised. She appeared okay, could walk fine and do for herself but might not be appropriate -- her safety became a concern.

A few years later, coincidentally, she came in the beauty shop where I was -- recognized and greeted me -- she suddenly said, "You've put on weight!" She immediately put her hand over her mouth and with alarm said, "Oh, I shouldn't have said that." I smiled and reassured her, ""That's okay -- I have added a few pounds since you saw me." The point is, her speech showed she was impulsive, lacked inhibitory control. It also showed she was aware of her socially inappropriate behavior as our previous relationship had been so limited, brief infrequent contact only a couple times to say hello, she never would have said that.

She'd probably had a lot of therapy to get to the point she could try to reestablish self-control and judgement, so it was good she caught herself. That was a very minor speech incident, but indicative of what were likely far more serious judgment behaviors with impulsiveness that could result in her bringing harm to herself. Speech judgment errors are one thing, but the safety problems would occur in actions she might take such as deciding to do some physical thing with no thought to the consequences. Short term memory problems could mean she'd have a hard time remembering from one time to the next what to do or not do.

Very determined men or women or anyone of any age for that matter with closed head trauma can be a challenge to help. They look okay, often believe they are and even family may assume so, too, initially. Isn't much fun having that problem either -- I don't want it.

Oh yes,oh yes. Never broke a bone until I was 80. Then in three years, I broke my shoulder and my pelvis in two place (right after getting a heart valve replaced.) sigh.
. If you want I could send you my article (made it to the front page of the local rag) on tripping...or rather not tripping. I walk SO carefully now.

My dog is always underfoot, so I shuffle...when I remember to do it!
But I NEVER go up or down stairs without holding firmly to the handrail.
I've been doing it ever since I moved to this house, 33 years ago (I'm 71). And I do it everywhere. When I don't want to touch the handrail in public places, I just keep my hand a few centimeters above it so I can hold on if I slip . It has worked, so far!

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