Saturday, April 2, 2011

Aging Parents and The New American/ British Geriatric Societies' Updated Elderly Fall Prevention Guidelines

I was invited to write a guest blog for EPOCH Senior Living (EPOCH offers levels of living and care for seniors); and while I write few guest blogs, I liked the idea of this one. It was interesting to relate the new guidelines--which make sense in theory--to practice (the experience of a few older people I know).  What follows comes  from my blog post for EPOCH's blog.
AGS/BGS Guidelines should lessen falls among the elderly. Yet they wouldn’t have helped my husband’s “with-it,” 97-year-old mother, R, (the subject of my January "falling, broken hip, complete recovery" posts).
When R fell, her health was very good (no heart, high blood pressure, etc. problems). She ate healthy, took calcium citrate+D, exercised and walked daily on a non-electric 1960’s treadmill, powered by her feet.
Guideline’s-recommended Tai chi--confirmed in countless reputable studies to improve balance and help prevent falls, and now offered at many senior centers--may have prevented R’s fall.
I attended a class at our local senior center several years ago. Coincidently, the abrupt twist that caused R’s fall was one focus of that class--practicing a gentle turn of legs and body, as opposed to twisting part of the body, which disturbs balance. (Isn’t that what we instinctively do, for instance, when a phone or doorbell rings unexpectedly?)
That said, driving to regular exercise classes is impossible for non-driving seniors like R.  Obviously many needy seniors without transportation miss out on tai chi and other exercise classes.
Because faulty vision can cause falls, in addition to regular vision check-ups
, at least one New York U. Medical School faculty doctor recommends that his elderly patients have a night--light in their bedroom, especially if they read/work in bed and throw those materials on the floor before going to sleep. “I warn older patients they can easily slip and break a bone (as some have) if they get up in the middle of the night and don't see them.”
One sensible Guideline--“Evaluation for gait and balance” by doctor after one fall—may be easier said than done. Falls are often kept secret. An 87-year-old had many falls before one caused a broken hip. Her doctors discovered an imbalance that a simple device in one shoe remedied. Had she not been so secretive, after the first fall, her broken hip could have been prevented. The new assessment “examination of feet and footwear” didn’t exist then. It might have prevented her falls in the first place.
An alert pendant/bracelet, while not preventing falls, would have saved R additional pain, from pulling her body 30 yards over 3 hours to a phone.  Her badly bruised knees healed more slowly than her hip. How many seniors have, but don’t wear, those pendants? R never thought she’d need one because she took such good care of herself. Doesn’t it make sense for elderly people, living alone, to have one? (Click link for some researched options.)
Denial, keeping falls secret, and transportation difficulties can undermine even the best fall prevention efforts. We have the Guidelines, we know some of the problems, now it would seem that the challenge is for seniors’ doctors, rational older people and their children to embrace them.

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