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Tag: Balance

  • How to prevent falls and their sometimes horrific consequences

    How to prevent falls and their sometimes horrific consequences

    According to the National Institutes of Health (NIH), more than one in four people over 65 fall each year, and around three million end up in the emergency room or as a hospital inpatient. Falls are increasing, even though they are preventable. Falls are also costly. In the period between 2016 and 2018, the average annual cost of falls among older adults was $80 billion.

    For older adults, the consequences of a fall can be particularly horrific, restricting people’s activities, if not robbing them of their independence. According to the CDC, falls are the leading cause of injury and injury death among people 65 and older.

    How to prevent falls?

    1. Talk to your doctor about the side effects of the medications you’re taking, both prescription and over-the-counter drugs. Some medicines can make you dizzy and more prone to falls.
    2. Make your home safer. Remove any loose rugs or tack them to the floor. Install grab bars in the bathroom. Use night lights.
    3. Stand up slowly after sitting to avoid light-headedness.
    4. Have your eyesight and hearing checked each year.
    5. Use a cane or walker for stability.
    6. Do balance and strength exercises.
     Here are five exercises to improve balance that the NIH recommends: (more…)
  • Five exercises to improve balance for safety and health

    Five exercises to improve balance for safety and health

    As we age, it becomes more likely that we will fall and break a hip or a shoulder. The Centers for Disease Control (CDC) reports that falls are the top cause of injury and death from injury for older adults. Exercise can improve your balance, reducing your risk of falls and promoting your safety and your health.
    According to the National Institutes of Health (NIH), one in three people over 65 fall each year, and more than two million end up in the emergency room. In 2014, older adults experienced 29 million falls, resulting in seven million injuries and costing Medicare about $31 billion.
    The consequences of a fall can be horrific, restricting your activities if not robbing you of your independence. So, it’s important to do balance and strength exercises to help prevent falls. Here are five exercises to improve balance that the NIH recommends: (more…)
  • Five ways to ensure the people you love are safe and healthy 

    Five ways to ensure the people you love are safe and healthy 

    At least once a year, every caregiver should engage the older people they love in what can be difficult conversations. No child looks forward to being a parent to her mom or dad; no one wants to have to speak with a spouse about exercising more, rethinking a medication regimen or considering stopping driving.  But, that’s often what needs to happen. Here are five ways you can help ensure the people you love are safe and healthy.

    1. Make sure they get an annual flu shot.  This should be easy since often the local pharmacy will administer the shot.  The shot minimizes the risk that older adults will develop flu-related health problems, including pneumonia and worsening chronic conditions. [Editor’s note: Also make sure they get their Covid-19 vaccine and booster shots.]
    1. Check out what drugs they are taking.  And, make a list of them, along with the names and phone numbers of their doctors, both for yourself and for their wallets.  If they keep the list on them, and you have a backup copy, it will help ensure their doctors are best prepared to treat them.
    1. Ask them about painkiller prescriptions they take as well as over the counter drugs, like Tylenol.  Too much acetaminophen can be dangerous. Prescription painkillers, such as Percocet or Vicodin, can be even more dangerous, particularly if mixed with alcohol, tranquilizers or other drugs.
    1. Try to nudge them to exercise. A brisk walk can reduce the likelihood of stroke and help prolong their lives. If they are not inclined to move, ask them what might get them out of the house.  Sometimes, a companion can make all the difference.  Anything they can do to move their bodies is great, including in hospital. Sometimes, showing them some easy exercises can work.  You can find simple balance exercises that the National Institutes on Health recommends here. For information about free and low-cost exercise programs in your community, visit the eldercare locator.
    1. Talk to them about driving if they are still driving. Many people can drive all their lives.  But, both mental and physical reflexes can weaken as you age.  The National Institute on Aging offers great advice on when and how you can help someone you love decide to stop driving.

    And, if you need help motivating them to change an unhealthy behavior, here are six tips that could help.

    Of course, there’s more you can do, including making their homes easier and safer to live in: for example, make sure floor surfaces are smooth to reduce the likelihood of tripping, install ramps and  raise toilet seats. More on that in a separate post.

    (This post was originally published on April 10, 2015.)

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  • Caregiving: How to prepare for a visit to aging loved ones

    Caregiving: How to prepare for a visit to aging loved ones

    Now that the pandemic is somewhat behind us, we are reconnecting in person with older friends and family members. If you’d like to help them with the to-do list they were forced to put on hold for so many months, here are some suggestions from the New York Times and elsewhere.

    Start by asking them to put together a list of the things they would like help with when you see them. If possible, have them let you know what’s on the list before your visit. If you want to help with the list, here are the items you might want to cover.

    Before your visit:

    1. Doctors’ appointments: Most people skipped preventive care visits during the pandemic. Are there doctors’ appointments that are overdue? If so, schedule those.
    2. Home maintenance: Most likely some appliances are no longer working and need fixing. Other items around the house might also need attention. If so, arrange for service people to come to the house.
    3. Legal matters: Do the people you love have a healthy care proxy, someone they’ve named to speak for them if they can’t speak for themselves and that it is documented in an advance directive legal document? If so, you should find out who that person is and, if possible, get a copy of the document. Someone also should have durable power of attorney to take care of financial matters if they are unable to do so.

    During your visit:

      1. Time your activities around your loved ones’ schedules. Try to engage them when they are most alert, in the morning or after a nap. And, try to meet all the people in their circle, including caregivers, neighbors and others who they spend time with. Having contact information for those people could be invaluable over time.
      2. Assess how your loved ones faring mentally and physically. How independent are they? Are they able to cook for themselves? Are they taking their medicines? Check the dates on any prescription pill bottles to see whether their prescriptions are up to date. If not, ask whether they would like a pharmacy to deliver medications to them.
      3. Talk to them about their hearing. Can they hear the phone, the doorbell and the TV? Explore with them whether they would like a hearing aid.
      4. Discuss the location of various items in the house. How easy is it for them to access what they need? Find out whether they think it would be helpful to rearrange items for easier access. Offer up your muscle to move items inside or outside the house.
      5. There could be tripping hazards in the house. Steps, throw rugs, wires. Would they like some nightlights? Do they still want the throw rugs or are they more of a nuisance that could lead them to fall? Would it be good to have an electrician come in to put in electric outlets in more convenient places and to reduce the possibility of tripping over electric cords?
      6. Confirm that their balance is good. If not, discuss what you might do to help them from falling. Are guardrails needed in the bathroom? Talk to them about doing balance exercises and other exercise for mental and physical health.
      7. Draw up a plan for caregivers if there isn’t one. Talk with your loved ones about what their ideal weekly schedule looks like, in terms of outings, meals, exercise and social and cultural events. Include contact information for the most trusted people in their circle.
      8. Make sure there’s a file that contains all the basic information needed to care for them if needed.

    Here’s more from Just Care:

  • How to avoid unintentional injuries

    How to avoid unintentional injuries

    As we age, the risk of unintentional injuries rises. A new Centers for Disease Control study looks specifically at unintentional injuries among older adults. Older people can and should take precautions to help prevent avoidable injuries.

    Each year, about 60,000 older adults die from unintentional injuries. In 2019, the majority of them, 34,000, died from falls. About 8,000, 13 percent, died from motor vehicle accidents. A tiny fraction, 3,000, died from accidental drug overdose or poisoning.

    On top of that, an even larger number of older adults experience unintentional non-deadly injuries, with grave health consequences.  They might experience severe brain injury and inability to care for themselves.

    In 2018, 2.4 million older adults visited the emergency room. More than 700,000 of them ended up hospitalized. More than 90 percent of those visits were caused by falls.

    Women are more prone than men to experience an unintentional injury. They are more likely to end up in the emergency department and to be hospitalized for a fall than men. But, men are more likely to die from an unintentional fall.

    The likelihood of falling increases with age, with one in four older adults falling each year. But, the likelihood of being in a motor-vehicle crash declines. The researchers posit that people tend to drive less as they age.

    You can prevent these unintentional injuries. Falls do not have to be part of aging. Talk to your doctor.

    Sometimes, exercise to improve balance and strengthen muscles can make all the difference between suffering from an unintentional injury and not. Physical therapy visits can also help; Medicare covers medically necessary physical therapy. Eye exams, which Medicare generally does not cover, can detect and correct poor vision. Good vision can help in preventing avoidable injuries.

    Your doctor should also check your feet at least once a year to ensure you have the right footwear to minimize your risk of falling. Medication reductions can also help, particularly reducing use of  benzodiazepines, opioids and anti-depressants.

    Visit this Just Care post to learn how to make your home safer.

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  • Coronavirus: Consider learning tai chi

    Coronavirus: Consider learning tai chi

    While socially isolating during this coronavirus pandemic, people are trying all sorts of new activities. I’ve finally mastered the art of making sourdough bread! For your mental and physical health, it’s important to be moving as much as possible. You might consider learning tai chi, a safe and beneficial form of exercise.

    Harvard Health explains that tai chi helps you maintain and improve strength and flexibility, as well as balance. It can improve both your upper and lower-body strength. It also strengthens back and abdominal muscles.

    Tai chi is a low-impact martial art that can treat or prevent an array of health conditions. It can reduce your risk of falling. Tai chi is done in slow motion.

    With tai chi, you are focused on your breath and your body. Your muscles are always relaxed. You might be standing, sitting or lying down. Some times you’ll do breath work to calm your mind and activate the energy in your body.

    If you’re looking for a way to exercise at home, I hope you’ll consider trying it. People who do tai chi generally feel better physically and mentally. There are scores of tai chi classes on youtube. Find one with an experienced instructor. Harvard Health recommends taichihealth.com. It has videos on tai chi fundamentals, including basic moves and a form demonstration. Here’s an instructional video for beginners that is extremely popular, with more than 400,000 views.

    N.B. Before you start doing tai chi, if you have balance issues or a medical condition that makes it difficult for you to move or puts you at risk of falling, speak with your doctor.

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  • How your doctor can help you age in place

    How your doctor can help you age in place

    We all know the expression, “If you don’t ask, you don’t get.” It is as true in the health care realm as everywhere else. Even I, a health care advocate, who thought I was on top of my dad’s health care issues, have just relearned that lesson. Here’s how your doctor can help you or someone you love age in place . . . if you ask.

    Until last week, I had never asked my 96-year old dad’s doctor about either his need for a physical therapist or how he might get additional companionship. My dad has had balance issues for some time now. But he walks quite well, with neither a cane nor a walker, so I had not taken them as seriously as I should have. And, while I see my dad and speak with him as much as I can, I knew he would benefit from engaging more with others–buddies are important.

    Luckily, I do know the value of accompanying my dad to his doctor’s appointments. He likes me to be his buddy at the doctor’s office because I speak up about health issues that might skip his mind or that he thinks are too minor to raise himself, such as a growth on his arm or pain in his feet. I like it because I can make sure that his doctor knows about health issues my dad might not be aware of–such as his periodic inability to remember where he is or his declining handle on numbers.

    At my dad’s recent appointment, I expressly asked whether the doctor might prescribe him physical therapy because of the difficulty my dad was having raising his right arm. I mistakenly was only thinking about this acute issue. That said, he has taken mild falls multiple times and lives in a home where he is required to walk a flight of stairs to get to his bedroom. While we modified his home in several ways and installed chair lifts where possible, one curving flight of stairs could not accommodate a stair lift.

    As soon as I asked–but only because I asked–the doctor made arrangements. As it turned out, my dad wanted the physical therapy and companionship way more than he had ever expressed or I had ever imagined. The physical therapist immediately prioritized improving his balance over addressing his arm because of his risk of falling. The physical therapist also suggested that an occupational therapist visit his home to see how he manages on a daily basis and what additional home modifications would make his life easier. And, the hospital social worker, where his doctor works, arranged for a volunteer to visit my dad in his home weekly. My dad (and I) could not have been happier.

    I remain surprised that my dad’s cracker jack doctor did not suggest these services on her own and mortified that I waited so long to ask for them.

    Lessons learned: A health care buddy should explore ways to minimize a loved one’s risk of falling and to ensure the loved one is as socially engaged as possible. As a buddy, you should speak up about these issues early and often.

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  • Five ways to ease your fear of falling

    Five ways to ease your fear of falling

    Editor’s note: According to the National Institutes of Health, more than one in three older adults falls each year and the likelihood of falling increases with age. More than 1.6 million of them end up in the emergency room, with bone fractures and other serious injuries. Dianne Lange of Senior Planet offers this advice to help prevent falls:
    Having a fear of falling is a slippery slope. It turns out that being afraid you’re going to fall increases the risk that you will take a tumble, even when you’ve never fallen before. Whether your fear of falling is due to physical or medical issues, or you’re just anxious, there are things you can do to help yourself stay upright:

    1. Do exercises for balance and strength. You want to make your legs stronger, improve your balance and raise your confidence level.

    • Tai Chi is a good example of a practice that does all three.
    • Yoga is strengthening and has many poses that improve balance, some of which you can do seated.
    • There are also balance exercises that you can do almost any where — including while you’re standing in line at the grocery store.

    2. If you’re taking medications, have your health care provider or pharmacist review them so you’ll know if any cause dizziness, make you sleepy or might cause you fall for any other reason.

    3. Have your vision checked.

    4. At home, put away anything you could trip over on stairs and paths that you often walk, so you won’t have to worry. You can find tips on making your home safe on the CDC website.

    5. Check out your shoes. The American Podiatric Association has a 1-2-3 test that can help you evaluate whether your shoes are optimal for balance.

    This post is excerpted from “5 Ways to Ease Your Fear of Falling” on Senior Planet. To read the entire article, click here.

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  • Can Parkinson’s disease be treated?

    Can Parkinson’s disease be treated?

    Parkinson’s disease is a type of movement disorder affecting about 1 million people who are typically 60 and older. Parkinson’s causes people to have difficulty keeping their bodies still. It is a chronic condition, staying with people over time, generally with worsening symptoms. Some people become severely disabled, but it is not possible to predict the course of the disease for a particular person. There are four signs of Parkinson’s disease:

    1. Tremor
    2. Trembling in the hands, arms, legs, jaw or face
    3. Stiffness in the legs or trunk
    4. Balance problems

    Over time, people with Parkinson’s may have trouble walking or talking or otherwise performing daily activities such as bathing, dressing or eating.  Chewing and swallowing and even speaking  can be a problem as well. Sometimes, people with Parkinson’s also experience depression or mood swings,

    Doctors generally diagnose Parkinson’s based on a neurological exam and medical history, Blood and lab tests cannot diagnose Parkinson’s.

    While there is no cure for Parkinson’s, several medications can relieve the symptoms, including tremors.  People whose symptoms are not relieved can have Deep Brain Stimulation, recently approved by the Food and Drug Administration.

  • Watch your feet: Foot care is critical and pain is treatable

    Watch your feet: Foot care is critical and pain is treatable

    You’ve heard the expression, “watch your back.” When it comes to older adults, you might say “watch your feet.” Caring for an older adult means checking vision, gait, hearing and balance on a regular basis.  It also should mean checking feet.  Feet are a window into whether an older adult is able to care for himself or herself.

    When it comes to feet, older people have lots of issues. Your primary care doctor or geriatrician should be sure to check your feet regularly. Here are seven things to watch out for and talk to your doctor about:

    1. Foot pain: People are more likely to have foot pain in later life as the skin becomes thinner and less elastic. Painful feet can usually be treated.
    2. Fungal infections between the toes causing redness, blisters or itching: Use an over-the- counter fungal spray or cream. And, talk to your doctor. Make sure your feet, including the area between the toes, are dry to prevent infections.
    3. Corns and calluses: Make sure your shoes fit well, and your feet are not rubbing up against them. Use a pumice stone or foot file to remove hard or calloused skin. You also can rub the corns or calluses gently with a washcloth but do not shave them. Moisturize dry and rough skin on your feet to prevent cracks.
    4. Ingrown toenails: Cut toenails regularly to avoid ingrown toenails caused by the nail growing too long and cutting into the skin. Keep in mind that many older adults can’t bend down to cut their own toenails.
    5. Tissue build up in the ball of the foot or toes causing pain. This could make it harder to balance. Make sure your shoes are wide enough.
    6. Toes that are pulled back: This can affect balance. Make sure shoes have enough space in them.
    7. Swelling.  See a doctor if your feet are swollen.

    If you have diabetes, you may have poor blood flow in your feet. And, you are more prone to scrapes, bruises and infections. You should check your feet every day for red patches. If you have sores or blisters or cracks in your skin, see a foot doctor. You want to avoid getting infections.

    And, regardless of your health status, exercise your feet to increase blood flow and improve the health of your feet. You can also do foot exercises.  For more information, check out this pamphlet from the National Institute on Aging.