Aging Parents: Falls and Fall Prevention-Part 2

Older people and the increased likelihood of their falling has been a major concern--no doubt for decades. The drug industry has come forth with medications to improve bone density. More recently gyms and senior centers offer programs aimed at improving balance, flexibility, muscle strength, and bone strength, among other things. And in the last 10 years or so--probably because people are living longer and the likelihood of falling increases the older one gets--the subject of older people falling has spawned considerable literature with ideas for prevention.

To say that older women suffer more fractures than older men probably comes as no surprise. But the statistics may surprise. After age 50--and increasing with age as just indicated-- up to one out of four women and one out of fifteen men can anticipate breaking a bone. Is this because: a) women outlive men; b) their bones are less strong; c) all of the preceding? No matter. If we have aging mothers we must be proactive (if they aren't) in our quest to help them age well. And let's not slight aging fathers. Bone density is also a problem for some men, so it may bear checking out in older men with slight frames.

It seems obvious that there is proactive prevention--to ward off problems before they become problems ; and reactive prevention--to deal with immediate problems. Of course, the proactive is easier. The reactive is difficult to begin with, but is made more difficult because many parents don't tell when they fall (see October post).

Starting with the proactive: When aging parents aren't already taking measures to ensure--to the extent possible--that they will not fall, what can be done that is effective, respectful, and supports self-esteem and competence. Note: I didn't write "confidence." Parents may think they have will never sustain a fall, or may be in denial, because they consider themselves healthy (they are) and "in charge."

It's best to begin this conversation before it's needed. Don't put it off if you think your parent is presently at risk of falling. If a friend should fall, this news usually travels quickly among older people and is sobering. It also provides a natural opening to suggest certain check-ups and provide some information--"some" information because we don't want to sound like "know-it-alls" (even when we think we do) or cause overload. 

The following are often associated with risk of falling, so check-ups to rule them out or identify them before they become problems makes sense.

Vision--Natural aging may cause problems distinguishing shades of dark colors that could result in missing a step at, for example, a curb or on uneven pavement on cloudy days or at night. (A small flashlight is a good gift.) Cataracts at a certain point may make night driving NOT advisable, but shouldn't affect daytime driving, until they worsen. And outdated prescription-glasses pose obvious risks.

Hearing--if balance seems to be a problem, rule out inner ear problems.

Balance, dizziness, falling asleep at the wheel (yes, it happens). Check with pharmacist to rule out medication reactions and/or contact doctor. An exam may be in order.

Proactive prevention:

Bones weaken, which makes falls more dangerous, thus becoming familiar with bone density medication, vitamins, and certain kinds of exercise (ie. walking, dancing, tai chi) to strengthen bones makes sense.

Muscles weaken, flexibility lessens, and reflexes can slow down. While this occurs naturally to some degree with aging, these changes become more pronounced for inactive people because of the "If you don't use it, you lose it" truism. 

An awareness of the above has led to fall-prevention offerings at senior centers and gyms.  Example: tai chi, a gentle but proven effective exercise for balance.  No doubt this is why these classes are popular and offered at senior centers, as are yoga and chair yoga (the latter for the less physically able). Check out "Silver Sneakers" (www.silversneakers.com), a nationally-offered exercise program designed for seniors, given at fitness centers, and covered by insurance companies (which vary by state).

Lastly, one of my two fall-prevention tips (tip 2 next post). An octogenarian tells me, that--at least with women-- vanity enters into the falls and fractures discussion. How? By the shoes women wear, that can make good balance very "ify" and perhaps even more worrisome if it's your aging mother who is teetering in them. This fall prevention "head's up" will probably be met with resistance. Indeed, this kind of discussion may be better coming from a physician. I'm not ready to give up my shoes yet and perhaps will never think I should. What about you?

"Fall Prevention" continues on Tuesday.  In the meantime, you might want to order a free copy of "Taking Steps to Prevent Falling Head Over Heels" using AARP's "Home and Community Booklets Online Order Form."