Who wants to be independent? I certainly do. To me, it means being healthy and able to do the things in life that give me pleasure. For many seniors, independence can also mean not depending on others for their care. A major cause for a loss of independence for them is falling.
While it’s true that most falls do not result in serious physical injury, there is a profound psychological impact. Once a person falls, they restrict their activities because of the fear of another fall. This action leads to greater risk of falling again, because inevitably they do less physical activity. This fear is very powerful, and negatively affects their lives. This fear is the greatest obstacle for re-establishing balance.
I’ve given several lectures on keeping seniors independent. Before each lecture, I pass around a sheet of paper for the audience to list the three most important areas of concern in their lives. At every lecture, staying independent and preventing falls is at the top of the list by a long shot. This is why I’ve devoted my practice to helping seniors with this issue. I will briefly cover these areas: eyesight, hearing, medications, and keeping one’s environment safe. I will cover proprioception in a subsequent article.
Balance tends to decline with age because it is dependent on three main factors which all interact with one another: vision, hearing, and proprioception. Proprioceptors are specialized sensory receptors on nerve endings found in muscles, tendons, joints, and the inner ear. Eyesight and hearing decline with age, and we may lose a great deal of our proprioception if we are less active and more sedentary. The majority of seniors are sedentary. For most of us, modern life consists of moving from one sitting position to another, leading to a lack of physical activity and strength. The lack of physical activity results in poor proprioception, decreased muscle strength (muscle strength is a major component of balance), and short, tight muscles in the hips and ankles, making balance, and even activities such as walking, a challenge. It also makes the daily tasks of getting up from a chair or toilet, lifting objects, and getting out to enjoy recreative activities difficult, if not impossible.
We all get old, so what can be done to prevent falls and retain independence.
The cerebellum is the area of the brain which coordinates vision, hearing, and proprioception. Like all body tissues, blood circulation is of utmost importance. There are certain foods which enhance circulation (vasodilation). Some of these are cayenne pepper, garlic, onions, rosemary, ginger, and foods containing magnesium. The best of these foods are dark, leafy greens, nuts, seeds, avocados, barley, and oats. Supplements include arginine, niacin or B3 (flush-free), and hawthorne. Please make sure that the supplements don’t interfere with any medications that you take. Extra help for eyes are a class of nutrients called carotenoids. Orange and red fruits and vegetables are rich in carotenoids; to a lesser extent in green, purple, and blue fruits. Zinc, vitamin C and E are also beneficial, but foods are by far the best.
Medications. All drugs carry side effects, even over-the-counter types. Some of the commonly prescribed medications that can affect balance (courtesy of Harvard Health Publications, Harvard Medical School, include: antidepressants, anti-anxiety drugs, antihistamines for allergies, blood pressure and other heart medications, pain relievers, and sleep aids. Many times, the combination of drugs can negatively affect balance. Have your doctor or pharmacist review all of the medications you take, even over-the-counter.
Make your home safer. At least one-third of all reported falls in the elderly involve environmental hazards in the home.It is useful to conduct a was-through of your home, both inside and out, to identify problems that may lead to falls.
Outdoors: repair cracks and abrupt edges of sidewalks and driveways. Trim shrubbery along the pathway to the home. Keep walk area clear of clutter, rocks, tools, and kid’s toys. Install adequate lighting by doorways and along walkways leading to doors.
For all living spaces: avoid using floor polish or wax. Remove small throw rugs or use double-sided tape to keep rugs from slipping. Remove things that you can trip over, like shoes, books, clothes, etc. from stairs and other walkways. Know where your pet is before stepping. If you have tiled or wood floors, watch for spilled water. Re-organize your pantry and cabinets so that you can easily reach the items you use frequently. Improve lighting in your home. Hang light-weight shades or curtains to reduce glare. Use a change of color to denote changes in surface types or levels. I use blue painters tape for this purpose. Have grab bars installed next to shower or tub and toilet. Use a flashlight or nightlight when getting up to use the bathroom at night. Finally, avoid over-reaching for objects. Many folks underestimate how far they reach and end up falling. Simply take another step to keep a leg underneath you for support.