Aging Parents: Does Fear of Falling Undermine Confidence to Walk?

Two Suggestions Can Help Aging Parents Walk With Confidence

“If you don’t use it, you lose it.” Sound familiar? When fear of falling undermines parents’ confidence to walk…. what happens?  Less exercise. Muscles weaken. Potential weight gain. Basically nothing good–as we know.  And the problem is compounded when vanity prevents an aging parent from using a recommended cane or walker.

We can, however, provide opportunities for aging parents get out and walk with confidence.

1.  Find stores where shoppers use shopping carts. The weight of the cart adds enormous stability, which promotes confidence to walk around like everyone else, minus the pervasive fear of falling that accompanies so many older people when they walk.

Shopper (with cane in shopping cart)

I noticed a shopper with her cane in the shopping cart at the grocery store the other day.

I thought about my mother whose tia’s and falls made her walk with uncertainty, except when she went grocery shopping and could push a shopping cart like everybody else. When adult children can take parents grocery shopping, it’s a win-win. Everyone gets needed groceries and children can rest assured that parents have ample, healthy food.

While the grocery store is the most obvious place shopping carts are used, check out–to name a few– Target, Costco, Home Depot, TJ Max, Marshalls, many major pet supply stores, some toy stores… Once accustomed to looking, we notice more opportunities; and taking parents can make for a fun outing.

2. Think twice before using aging parents’ handicapped parking permits when going out with them. When parents can walk and need exercise, it might not be in their best interest to use the handicapped parking space.

Why? Because there are ways to have them walk with you that instill confidence, while giving them opportunities to walk further and feel “normal.”

  • Walk arm-in-arm: Marie, a sturdy-on-her-feet octogenarian, was heard offering her less-sturdy-on-her-feet friend her arm, saying “Do you like chicken? Grab a wing.” Walking arm-in-arm shouldn’t be a big deal.  It happens naturally with men and women all the time.
  • For extra support: with your parent’s arm in yours, move your elbow in towards your hipbone so your arm hugs your parent’s arm against your body and your hipbone provides additional support. Done correctly the extra bracing adds to your strength should your parent begin to lose balance, and gives your parent an added feeling of stability.

This latter suggestion has the stamp of approval from a highly respected nurse-author-geriatric care manager to whom I demonstrated this method.  She likes it because she says you aren’t pulling or leading your parent (which is usually the case). As we look for ways to help parents age well, check it out.  Go for a walk with your parent.

For additional information go to the National Institutes of Health link, found above on the “Sites and Blogs I Like” tab, and click “F” for “Falls and Older Adults .” And to http://newoldage.blogs.nytimes.com/2008/09/16/everything-you-need-to-know-about-preventing-falls/.

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

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. Thus, take steps to “use it”…or them.

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.”


 

 

A SAD STORY (begun 12/17; finished Sat. 12/19)

This situation may not be all that uncommon, although I hope I’m wrong. It involves a retired, respected professional in the health care field; his independence; his capable, caring adult daughter with an extraordinarily busy life; And stuff that can happen, but shouldn’t.
*             *          *
     Rodney, divorced, was in his early 80’s living happily by himself in a condo in a very nice southern California suburb. Because of his profession he had many friends who valued his wisdom and kind ways. But he was increasingly seeming “spacey”– “dementia-like” to those who knew him well. He appeared unsteady on his feet at times. Close friends obviously noticed this and may have attributed it to his age. (But maybe people simply hesitated to “rock the boat” as discussed in a previous post.) Clearly the reasons for no one questioning Rodney’s physical and mental change could be many.
     One day Rodney took a bad fall in his apartment. A neighbor heard his call for help and phoned 911. At the local hospital where supposedly they did a full evaluation to determine the cause of his fall, his daughter was told he needed assisted living.
     She quickly and efficiently made arrangements for assisted living, but it was soon evident that Rodney needed even more help so a private aide was hired to be with him. More falls, more trips in and out of the hospital. No one understood the cause, only the effect as Rodney became more and more frustrated and, at times, unruly. Assisted living could not provide the care Rodney required.

     So his daughter located a group home with adequate staff to watch him and prevent more falls. The supervisor of the home, a thorough person, had a hunch… that medication could be causing Rodney’s problems. It then surfaced that Rodney (who could legally write prescriptions), prescribed and used a common sleep aid. Rodney had no primary care doctor (unrelated specialists treated him). And evidently prior to the “hunch” no one was aware Rodney was taking this medication, which could produce the side effects Rodney was experiencing.

     The good news: the group home’s supervisor put Rodney on a new medication. He’s himself again; he’s much steadier on his feet. The bad news: he has nothing in common with the residents at this group home. He doesn’t like living there. But during these many months his efficient daughter quickly sold his condo because, she was told, he could no longer live alone and because funds were–and would be–needed for his care. Rodney has no condo to return to.

Initially his daughter was glad to see him cared for, didn’t wanted another upheaval, and thought she would have peace of mind. But with new medication, Rodney made it clear he had no reason to stay in the group home.

     A bad start, lack of information, incomplete knowledge, inaccurate assumptions, and a busy, caring daughter’s well-meaning quick fixes.

1.  When making important decisions, think: is it better/easier for my parents or better/easier for me?
2.  Having a current list of parents’ medications may avoid problems and be helpful.
3.  Getting help from an experienced geriatric social worker would most likely have reduced the busy daughter’s stress and led to well-thought-out changes with a quicker, better outcome.
* * * * *
Eventually Rodney did move from the group home, but much time had passed and other problems arose; so he moved to an assisted living facility–much better suited to his needs.

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.