Every Sunday America’s Funniest Home Videos gets uproarious laughter with videos of people falling. But for many seniors, including me, falling is not a laughing matter. According to the CDC, “more than 1 in 4 older adults report falling each year—that’s about 36 million falls." (1)
I fear falling. Like others of my age, I’ve seen that one fall can change your life forever.
Six of my friends have fallen this year resulting in two pelvis fractures, two broken hips, a broken wrist, and a broken arm and collar bone. In 2018 I fell and broke my right wrist.
The same year two other women on my block also broke a wrist. All but one of these falls were caused by a loss of balance. Fortunately, everyone recovered from these falls.
None of us fit the image of a tottering old lady. All of us are active. And, with one exception, none of us fell as a result of the usual suspects listed on why older people fall: ear problems, medications, chronic medical problems or tripping hazards. The exception tripped over a power cord.
Most of our falls were the result of a brief moment of distraction or a loss of balance and the inability to recover our balance.(2) When I googled falling in seniors, I was shocked that most of web advice on falling never mentioned balance. They prescribed walkers and removing throw rugs.
Even talking to friends while walking can cause you to miss a step
I finally found a website that explained why a lack of balance can cause older people tend to fall. Dawn Skelton, Professor in Ageing and Health, Glasgow Caledonian University, says “Our bodies are inherently unstable… Maintaining an upright position and moving from place to place while staying balanced is a continual challenge for our bodies. Our success depends on the well-being and integration of many different systems within our bodies (eyes, ears, and recognition of body sensation) … Our brains must rapidly and continuously integrate and then process this sensory information … and this integration is often worse in older people...”
According to Skelton, when people feel unstable when walking they can “descend into a vicious spiral of inactivity: many of these aging changes to the body are accelerated by sedentary behavior, which in turn leads to a greater reduction in strength and balance, loss of bone and an increased risk of falls”.(3) Another issue is that people who are unsure of their balance start shortening their stride, and that actually makes us more unstable.
It is unfortunate that many of the websites and professionals offering advice to prevent falling jump to remedies such as using walking aids instead of emphasizing balance and physical therapy. These remedies lead people to decreased reliance on their muscle strength and fewer opportunities to use their internal balance systems. That descent into the vicious cycle of inactivity.
There is hope. We tend to become more sedentary as we age because our bodies aren’t as forgiving as they used to be.(4) Feet swell, muscles ache and we injure more easily. It takes us longer to loosen up and feel good when we start to walk or do other forms of exercise. Yet studies have shown that if we do some form of aerobic exercise combined with balance exercises, fall rates in seniors can decrease.(5)
Lately I’ve been on a campaign to improve my balance. I’m taking balance classes and I tried to use the balance machine in our fitness center. I started with TuxRacer, a game of shifting your balance to guide a penguin sliding down a ski slope to catch fish and not hit the sideline poles. On my first try, even on the bunny (easy) slope I didn’t catch any fish and hit a lot of poles. I skidded off the slope into the trees and ended up in the gravel patch. Ugh. It was so bad, I read the instructions. Instead of leaning my body left or right, I should just shift the pressure on my foot. And as a bonus, if I put the pressure on my heels, it slowed the penguin down. I spent the second round on my heels with the penguin inching its way down the slope. I caught 20 fish and stayed inside the flags, most of the time.
In the second game you are supposed to move a foot on the screen to tap on a star. I didn’t hit any stars. Sometimes I kept stomping like I was squashing a bug, but I still didn’t get the star. I was glad the fitness director didn’t kick me out for machine abuse and that my stomping didn’t break the machine.
On the last game I tried, a snake head is supposed to slither to an apple and bite it. I tried that game three times, read the instructions twice, and still didn’t come anywhere close to the apple. The snake slithered in directions that didn’t seem to have any correlation to how I shifted my body or my foot pressure. Bad snake!
The snake heads to the corner away from the apple
It’s hard to stay motivated when I’m a klutz on the machines. And many times the classes seem boring. I am motivated by seeing how hard my fellow balance class students, many of them a lot older than I, work to restore their balance and by seeing people improve. Also, seeing people who have lost their mobility reminds me of what’s at stake if I don’t go to that boring class or take a daily walk. I want to keep my mobility as long as I can.
I leave you with one of my favorite poems which is more relevant to me now than it was when I first loved it in my 20s:
“Do not go gentle into that good night.
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.” Dylan Thomas
Does burning and raging at the machine snake count?
References
CDC, Still Going Strong, May 21, 2021
Distracted Walking, OrthoInfo (the American Academy of Orthopedic Surgeons), November 11, 2015
Dawn Skelton, Explainer: why does our balance get worse as we grow older?, The Conversation, October 8, 2015
Leandro Fornias Machado de Rezende, et al Sedentary behavior and health outcomes among older adults: a systematic review, NIH: National Library of Medicine, April 9, 2014
S F M Chastin, et al, Associations between objectively-measured sedentary behaviour and physical activity with bone mineral density in adults and older adults, the NHANES study, NIH: National Library of Medicine, April 13, 2014
Dawn Skelton, et al, Tailored group exercise (Falls Management Exercise — FaME) reduces falls in community-dwelling older frequent fallers, Oxford Academic; Age and Aging, November 2005
Bonus article added Sept 20:
Wong, Grace, Fall Prevention Tips for You and Your Loved Ones, health enews (Advocate Healthcare - Chicago area), September 20, 2022
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