STOP HAVING FALLS

Falls are very serious: Having a fall is one of the worst things that can happen to us as we get older. The quality of our life for the rest of our life can be dramatically reduced. One statistic shows that if you are 75 or older and have a fall, you are 4 to 5 times more likely to have to spend at least a year in a nursing home. Falls are responsible for many having to move out of their own home and into a managed setting like an assisted living facility.
There are two things about falls that are important to understand:
  1. Falls happen without warning: We often have no idea we are going to fall. They happen so suddenly that we are, boom, down on the ground. Because of this we make an error in judgment: We think there is nothing we can do to prevent them. We think that falls are a natural part of aging. Neither of these statements are true. 
  2. Falls are a shock to our system: Every time we fall, we experience a strong psychological shock whether we get physically injured or not. We become afraid that we will fall again. In an attempt to be safe we restrict our activities but in doing so we actually instead dramatically increase the likelihood of falling. 

Understanding the effects of that shock:

Think of when you were young and you had an accident on your bicycle. Remember how shakey you were when you had to get back on the bike? And remember how quickly that nervousness left as you got used to riding again? Having a fall is a similar experience but the shock is more profound. The fear bullies us into rejecting the bike instead of facing the fear and getting back on.

An anecdote: A good friend who is a senior fell during his morning walk. He broke his wrist and healed completely from it. But the fear of falling again caused him to stop his daily walks. A year and a half later his balance is terrifyingly bad. His stability has greatly suffered and the likelihood of him having a devastating fall is very high. He is still afraid of walking. He cannot get back on the bicycle. His situation is not at all uncommon. 

Best of all is to not fall, whether you have before or not.
How can you prevent it?
Reduce your fall associated risk.

Fall Associated Risk, a very handy concept: Every choice, conscious or not, that we make all day long either increases the likelihood that we will fall or reduces it.

Examples of things that increase our fall associated risk:
  • Not looking where you are going.
  • Leaving water on the bathroom floor.
  • Wearing trousers that are too long.
  • Wearing improperly fitting shoes.
  • Skipping breakfast.
  • Having clutter on your closet floor.
  • Sitting for extended periods of time.

​Examples of things that reduce that risk:
  • Eating a healthier diet, reducing sugar, salt and processed foods.
  • Having your feet checked regularly by a podiatrist.
  • Increasing core strength, especially the abdominals.
  • Leaving yourself plenty of time to get ready.
  • Breathing consciously.
  • Drinking plenty of water.
  • Improving your posture.
  • Taking balance classes.
  • Exercising 30 minutes a day.

If we reduce our fall risk in different ways, we will make it substantially less likely that we will have a fall. If we modify behaviors that make falls more likely then our risk decreases even more. When we change some of the most influential factors we can make an even more significant difference.

Significant contributing factors: These elements are present in a large portion of falls. They might not always cause a fall directly, but they contributes greatly, making it far more likely that a fall will occur.

​Three contributing factors that cause significant harm:
  • Shuffling your feet: When we get older, we shuffle our feet more and more of the time, sometimes because we simply can't pick our feet up. Maybe we have lower back problems. Maybe we have had a fall and are being extra cautious by keeping our steps small and close to the ground. (Actually, this will make it much more likely we will fall.) To stop shuffling is a challenging endeavor. Luckily there is a wonderful technique that really works. Basically you push your feet off the ground as you walk. See the links below.
  • Rushing: Never rush unless it is out of a burning building. When we rush we make so many mistakes. We stop being aware of our surroundings. We trip. If we change this one thing we also make our lives so much more peaceful. 
  • Wearing backless shoes: According to one study, 50% of people who fell and broke a hip were wearing backless shoes at the time of the fall. It is very important to always wear shoes that hug your feet and do not allow for your foot slipping around if something sudden happens. 

There are many other significant contributing factors, some of which we have no control over, some of which we can train ourselves to ignore. Some examples:
  • Unfortunately many of our communities poorly maintain sidewalks and parking lots. Be aware of the hazards and prepare for them through practice walking in safe conditions.
  • Distraction is a huge issue for everyone, especially in the Internet age. Television in particular creates so much visual distraction that it can be difficult to train our brains to focus, something more and more important for us as we age.
  • Moving your head while talking when you have stability problems will make you dizzy. Some people express themselves with a lot of head movement. Learning to control head motion is a very helpful skill.

One common element of falls has startling consequences:

We can take all precautions. We can lower our fall associated risk substantially. We can become more educated about what actually causes falls so we can avoid those behaviors. In the end though, many falls happen because something sudden has occurred. Sudden noises, a sudden push from someone bumping into you, a car that comes from out of nowhere, a companion having a problem, someone calling your name when you don't expect it.

​Sudden occurrences are particularly dangerous for those older because we are so much less active. Being less active means being stiffer. This is where consistent exercise makes such a huge difference. If you are inactive, your body is less stable, especially side to side. We loose ability to adjust to changing conditions when we sit for extended periods of time. So if someone bumps you from the side, you are likely to topple over. If you are used to moving, even if its only for 30 minutes a day, then your body is more able to adjust to those sudden events. Falls are so much less likely.

Another characteristic challenges credibility:

Something else I have observed over the past 25 years, time and time again. People who I know who have had falls often were in the process of doing something they knew they shouldn't. A little voice in our head says: "That is not a smart thing to do. Don't do it." But we ignore it...unfortunately at our peril. So many falls happen because someone did something stupid. It is part of the human condition. Our job as we age is to become more aware of ourselves more of the time so that we can make better judgement calls.

If you have had a fall, figure out why it happened. Learn from your experience.

Because falls happen so suddenly, we often have no idea what caused them. Perhaps half of people I have spoken with do not know why they fell. It is very important to determine that because we want to prevent that kind of fall from happening again. For example:
  • If you fell because you lost your balance when you went to stand up, you can learn to stand up more slowly and to remain standing til your stability returns.
  • If you fell because someone called your name and you did not stop walking, turned your head and did not see an upcoming hazard, learn to stop moving if you have to turn your head for any reason. Do not walk and talk at the same time. Walk more consciously.
  • If you fell because you looked up in your closet to the top shelf, learn to always hold onto something stable when you are in your closet.
  • If you fell because you slipped on water in the bathroom, make sure to always mop it up.

SUMMARY:

Here are the most important things to do to stop having falls. Each makes it far less likely you will fall. Improve them all and falls will become a thing of the past.

  • Exercise 30 minutes a day.
  • If you have a fall, take a balance class instead of restricting future activities. Don't let fear cause you to backtrack. Get back on the bicycle.
  • Stop shuffling your feet. Learn to roll through your feet and push off to lift your feet up.
  • If you have a fall, figure out why you fell and do something about it so you no longer fall that way again.
  • Listen to the little voice in the back of your head. Don't do stupid things that you know are stupid.