Falls can pose major problem


My grandmother and I were coming back from our weekly walk together to the grocery store, having scoured the free samples and bought some of the cookies I liked, when she had her first bad fall. It happened more quickly than I could watch it, and ten-year-old me was terrified. Does this mean no more walks to feed the ducks? Does this mean my grandmother is going to stop coming on adventures?

In previous columns, I’ve tried to encourage readers to see retirement as a beginning instead of an end. But for this series to be useful, it needs to be frank. And the plain truth is that there are some things about the facts of aging that make staying active a challenge. In this week’s Senior Scene, I look at falls.

Falling is one of great challenges of getting older. It looms large both in the psyche of seniors and among the day-to-day challenges they face. Many seniors see a fall as signaling the end of their independence. They know that fractures, especially if they happen in the hips or pelvis, can cause hospitalizations that drag on at great cost. Falls are associated with a number of cycles that can entrap a senior, if he or she doesn’t get proper care. A French study published in the academic journal “Gerentology” studied a group of older people who had fallen, finding that those who were depressed were more likely to have low scores on a test of balance and motor skills. This suggests that depression, which often follows a fall, can itself create a lifestyle that may lead to another fall. In my personal experience, I’ve seen seniors (my own grandmother included) become more concerned about going out or even performing routine tasks after falling — fear of falling can be a condition even more crippling than the physical aftermath of a fall.

One group of medical authorities on falling are physical therapists. Physical therapists are specialists who typically get referrals from primary care physicians. They deal with problems related to the skeletal and muscular systems, including rehab. To find out what practical information seniors need about falls, I talked to one of the rehabilitation department physical therapists at Montgomery Place. Rebecca Feehan, who has a master’s degree in physical therapy, says that balance issues are one of the most common complaints which bring patients in. Problems with falling can be caused by a number of systems in the body — poor eyesight, muscular weakness and cognitive issues are three triggers which Feehan mentioned.

Improving home safety is the one step seniors can take to address all of those potential contributors. Feehan mentioned the usual: throw away your throw rugs, get night lights and, especially if you have impaired vision, make sure lighting is appropriately bright. Installing (sturdy) rails in your shower and bathroom is also a frequently recommended step. 

As for physical fitness, if you can walk for recreation, Feehan says you should – just make sure the route is doable and has the right number of benches for your ability before you go out. Strength is important for seniors because it helps them to maintain balance even in “extreme positions” – that is, leaning back or side to side. Seniors who want to start a strength-building routine should, Feehan says, consult their primary-care physician. (The Village drop-in program also hosts gentle exercise sessions designed for seniors with appropriately credentialed instructors; call my hotline for more information.) 

Seniors need to know that balance issues are a normal part of aging. As Feehan said, “it happens to everyone.” If you’re concerned and feel you need a closer evaluation of what might be contributing to the problem, consult with your primary care physician, who will look at possible factors and consider referral to a physical therapist. About $2,000 for therapy is the minimum covered under Medicare Part B. Before choosing a therapist, Feehan said you should be sure to do an interview, making sure that there’s a solid personal match.

If you have questions or comments related to aging and life as a senior or this column, call Andrew’s Senior Scene Hotline at 508-397-0321.