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Falling – the Beginning of the End

A major fear shared by many seniors is the fear of falling. They fear that a trip or stumble will result in a broken hip and it will be “the beginning of the end.” In fact, brain injuries account for more than half of the deaths from falls. Breaking bones and brain injuries can be prevented by taking precautions to avoid falling.

The risk of falling increases as we age, largely as a result of deteriorating vision and poor balance. The side effect of many medications can cause dizziness. Decreased strength from inactivity and reduction of muscle mass make it harder to withstand trip hazards in the environment.

The good news is that falls can be prevented.

Vision can be improved by having an eye doctor revise the prescription for glasses. Just a simple thing like keeping your lenses clean will help you see more clearly. Removal of cataracts produces a remarkable improvement  in vision, often limiting the need to wear glasses only when reading.

Most falls occur in the home.  The biggest threat is in your bathroom. Install grab bars in the shower or tub. Use a textured bath mat to minimize slippery surfaces. Consider the use of a shower chair. Place non-skid bath rugs in the areas where the floor might get wet.

Rearrange the storage areas in your kitchen so that you don’t have to reach for things you need most often. Use a sturdy footstool or get a reaching device that will grab onto anything you need that is out of reach.

Use bright lights throughout the house and plug in night lights in strategic areas to prevent tripping in the dark. Place  contrasting colors on steps and thresholds to define changes in elevation and reduce the risk of falling.

Look around your house to see if you can minimize clutter and organize placement of furniture. The more stuff you have in your home, the easier it is to get in the way and trip you up.

Throw rugs are notorious for contributing to trips and falls. The safest thing to do is to get rid of them. If you can’t part with your throw rugs, make sure they are firmly attached to the floor with carpet tape.

Balance can be improved through exercise. Balance can be re-learned through practice. Exercise will also strengthen muscles to improve mobility and the flexibility to catch yourself when thrown off balance. Physical therapy can also improve balance and mobility.

Review your medications with your doctor to see if there are alternates which do not cause dizziness. Ask for suggestions from your doctor to cope with side effects which may contribute to feeling off balance.

Pay attention to your surroundings, especially when carrying things. Carrying a bag, tray or plate in front of you will obscure your view of what is immediately on the ground.

Wear non skid shoes. Leather soles don’t stick to carpet. Athletic shoes have grooves which can catch on carpet keeping your feet stuck while the rest of your body pitches forward.

It is amazing to realize that something as devastating as a fall can be prevented by paying attention and taking the steps to compensate for physical limitations and hazards in your environment.

 

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Masking Memory Loss

As children grow up and leave the nest, they often spread out to different cities and even states. Career opportunities, a desire to live in a different environment, or the location of spouse’s family are just some of the reasons for moving away from their home town. Sometimes, they just need a little breathing room from their siblings or an overbearing parent. Family relations don’t ease with distance but may possibly soften over time. That is until, family members are confronted with a difficult situation.

Let’s say for example Joe, the oldest son, moved to the East Coast shortly after graduating from college. He made a point to visit twice a year, until the demands of his own family and job prevented him from making regular trips back to California. The youngest daughter Julia became a nurse and remained close to her parents in their home town. She and Joe had opposite temperaments and often did not get along. Julia is a natural caregiver and realizes how much she needs to compensate for her mom’s lapses in memory and ability to complete complex tasks. This has been taking its toll on her energy and is affecting her relationship with her own husband and kids. When Joe comes to visit, Mom is on her best behavior.  He doesn’t understand why Julia is so concerned about their mom’s decline. He resists any notion that mom has slipped.  Julia accuses him of being in denial. She becomes angry with Joe because he doesn’t see the sacrifices Julia is making for their mom.

Often times, those who are closest to the person experiencing memory loss are more likely to accurately assess the situation. Family members who are more remote, either physically and/or emotionally don’t seem to accept that there is a problem.

Those in the earlier stages of memory loss often practice a phenomenon I like to call “performing.” They realize they are expected to respond in a certain way while in a familiar situation. In the example above, Mom seems perfectly fine because she is performing. Conversations seem to flow easily because she is in complete agreement with Joe’s comments. She may not be able to articulate that it is hot outside, so she replies “Isn’t that the case.” when Joe remarks on the summertime. She will cover up the fact that she shoes are on the wrong feet because they are so comfortable that she didn’t even notice. She will ask Joe to set the table because he is so good at it, rather than reveal she can’t remember which side to place the fork.

The best way to get a remote sibling to see the real behavior of their parent is to identify the times when, in Joe’s case, mom is performing. He could make a statement that is clearly nonsensical and listen to mom agree. By gently challenging mom to do something spontaneously,  Joe could observe that lost look in her eyes, and perhaps frozen body language. When mom doesn’t know that he is watching, she is likely to reveal herself the way Julia sees her.

When family members can work together to accurately assess memory loss in a parent, they are in the best position to seek the appropriate level of care. Denying or delaying medical treatment for the parent and support for the caregiver is an injustice to the entire family.

 

 

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