Changes in medications, worsening of existing conditions, and new medical diagnoses all contribute to an increase in falls. However, a central cause right under our noses (and something that we can IMPROVE), is poor muscle strength. Lower extremity and core weakness increase vulnerability in everyone, especially elders, making them more prone to poor balance and falls.
An assessment by Mom’s primary care physician to rule out any medical source of the presenting problem is the first place to start. It's key to report the falls, where they occur, and suspicions of the cause and frequency, as honestly and accurately as possible. Balance may be affected by blood pressure, heart rate changes, blood count abnormalities, and visual or inner ear issues. And as we know, poor balance is a precursor to falls. Dehydration (prevalent with elders) can lead to an electrolyte imbalance, which in turn can cause muscle weakness.
Staying active!Activity level varies for every person. Seniors may consider themselves active based on previous life experience, which may not accurately reflect their activity level today. "I raised six children, grew all our vegetables, canned them for winter, and had a part-time job. I have been VERY active." Active, indeed, but what is going on… now?
Grab your pen and paper, and take an inventory:
What does Mom's day look like?
Is she principally indoors, moving around her home in spurts?
Does she have intentional exercise?
Is she taking a real "walk" outside or at the mall?
Does she garden or work in the yard?
Does she play with the grandchildren at the park?
Consider the use of physical therapy (PT) to reduce or even better yet prevent the fall that could be a life-changing event.Professional physical therapy provides:
An assessment of strength, endurance, coordination, ability, and areas of vulnerability
A customized plan based on the individual's ability and goals, taking personal limitations into account, maximizing ability, and solving problems (not creating new ones!)
A supportive individual to assist, accompany, and encourage the program
Introducing movement and exercise into the life of someone who has been without it needs a strategy. Several factors could contribute to a lack of "buy-in" and become a complicated obstacle. A good plan takes a thoughtful inventory and identifies and addresses the barrier issues. If there is a barrier, what is it, and why? Could it be:
Fear of falling/anxiety/lack of energy?
Dizziness/weakness/lack of confidence?
Pain/shortness of breath?
Ultimately, staying independent. If asked, most of our seniors would want to remain at home, meet their own needs, and participate in activities with family and friends fully. An independent, home-based program of exercise and movement may be the best program to accomplish their individual goals. Programs like these include an in-home 1:1 PT evaluation, assistance, support, and a specialty gym, private studio, or center for balance and mobility.
Change in physical activity has to “feel good” and be achievable to be sustainable. Goals need to be specific and measurable. Helping your elder to feel accomplished will be reinforcement to keep going. You can be an active cheerleader.
Increasing safety, reducing falls, and retaining independence will be accomplished by improving balance and increasing core and leg strength to yield more energy. You will see your senior's overall mood improve, as well as their quality of life; a win-win.
Joanne MacInnis, RN, is the founder and president of Aberdeen Home Care, Inc., of Danvers, a concierge private duty home care agency in business since 2001. With 35 years of nursing practice, management and administration experience focused on home care and hospice, Joanne and her team specialize in advising and supporting families addressing the elders in their lives retain dignity and quality of life.
