I have lost two people whom I loved because of falls. Both men were old but very viable. My grandfather still worked full time in his grocery store and my friend retired from teaching but still worked seven days a week in his office. Their falls, each resulting in a fracture, didn’t kill them directly, but the days in a rehabilitation clinic followed by weeks of recovery led them on a slow downward spiral of dysfunction until they died. For many elderly, a fall and subsequent injury is the catalyst, the trauma that breaks them.
Most people over 65 fall once a year, but everyone falls. A misstep on a dog chew toy can end up with anyone face down on a coffee table. Even the fittest lose balance and strength as we age. Fortunately, we have some control. We can maintain or improve our physicality, not only to prevent falling but also to enhance life in general. Improving strength and balance reduces the incidence of falling about 50%. We need to accept the position that falling is a possibility and choose behaviors that reduce risk. Since most falls occur in the home, we can improve our environment to avoid unnecessary hazards.
Regarding strength, your primary focus should be the lower body. Good leg strength is one key to fall prevention. Squats require no equipment and are easy to do in your home. Put your hands on a table or sturdy chair, squat down, keeping your heels on the floor, back straight, until your thighs are parallel with the floor. Do around ten squats, rest, then repeat. A reasonable goal is about 30 squats done 3-5 days a week.
Take the stairs; if you can, occasionally try to take two at a time, keeping your hand on the railing. Walking is an excellent and common exercise, but most people only walk on flat surfaces. Try walking on uneven surfaces such as lawns or fields. I highly recommend walking up and down on trails. Trail walking involves an unconscious adjustment of our neuromuscular system to maintain balance. Falls happen quickly, so try to do some quick exercises like skipping and jumping. Playing games that require quick movements is great.
Balance training requires that you put yourself in an unbalanced position. Simply try to balance on one leg. Place your hand on a sturdy table or chair and lift one leg off the floor. Remove your hand and try to slowly increase the duration. Make sure to use both legs. As you get better, try different positions. Keep your eyes open.
Winter is here so keep a pair of shoes with spikes next to the door. Wear them every time the sidewalks are slippery. Use a hiking pole. When carrying objects downstairs, leave one hand on the railing. When getting out of bed, sit up and wait to adjust to the new position. You may love your old worn shoes, but throw them away. Don’t even give yourself the option of wearing them.
Analyze your environment. Keep clutter off the floor, especially in the bedroom. Many people love throw rugs; throw them away. Bathrooms are prime areas for falling so keep non-slipping mats for shower and floor. Carpet the bathroom. Stairs should have banisters on both sides. Many homes have 2-3 stairs to change levels; put handholds on the wall. Good lighting is critical throughout the home. Use nightlights in bedroom, lamps next to bed, and a flashlight next to the bed. Maintain a good and ready supply of salt and sand leading outside.
My last fall was when walking my son’s dog. It was just a flat road but he ran around my leg, tripping me flat on my face when his leash caught. I see many dog walkers go by my house. The trick is for you to walk your dog, not the reverse. I often see people being dragged by their dog, like it’s the Iditarod. Make your dog obey; only walking on the left side and next to you, never pulling. Get help with training if necessary.
When you fall you have to get up. Roll over on your stomach, then onto your knees. Place your hands on a solid table or chair, bring your better leg forward under your chest, push down and stand up. In fact, just doing this is an excellent exercise. Practice it. Get your legs fit, improve your balance, avoid risky behaviors, and develop a safe environment. Don’t fall.
Jim Johnson is a retired professor of exercise and sport science after teaching 52 years at Smith College and Washington University in St. Louis. He comments about sport, exercise, and sports medicine. He can be reached at jjohnson@smith.edu