Prevent falls! My interview with Kathleen Cameron

Balance for Fitness, Balance for LifeI recently had the privilege of interviewing Kathleen Cameron, MPH, Senior Director of the Center for Healthy Aging, part of the National Council on Aging (ncoa.org), about balance, falls, and health as we age.

Kathy told me that older Americans’ falling is one of the most significant public problems today. It’s estimated that 25 to 33 percent of people over the age of 65 fall every year. About 25% of those who fall are injured. Most common are broken wrists or hips. Femur breaks are also common, even though the femur is one of the biggest bones in the body.

Falls are also the leading cause of traumatic brain injury, and can also exacerbate other problems to the point where the person never recovers, and may even die.

Falls certainly account for many trips to the emergency room, hospital stays and courses of rehabilitation. It’s estimated that falls have cost $31 billion every year.

A descending spiral

The fear of falling alone can restrict activities, although most falls occur at home. People become more isolated and fearful of leaving home, which can lead to depression.Those who suffer from depression can fall even more.

You can see the spiral here. A self-fulfilling prophecy. People fear falling so they don’t do the things which can prevent falls, which causes an increased risk of falling.

Good news

The good news is that many falls can be prevented. Staying active, starting as early in life as possible, can prevent falls. Regular exercise, including strength and balance work, also can prevent falls. (And people give me funny looks when I tell them about my balance work…)

Kathy says even entirely healthy people aged 60 and older are more prone to falls than those 10 to 20 years younger. Changes occur to the body in aging that contribute to falls. As we age, we tend to lose muscle mass and strength decreases. To counteract the effect, it’s even more important to combine strength exercises with our cardio and balance!

Pre-existing conditions

Many older Americans also suffer from chronic conditions – heart disease, arthritis, and diabetes – which also contribute to the risk. And medications that are prescribed for these conditions may have side-effects such as dizziness and drowsiness, which contribute to falls.

Once again, though, there is good news. If a healthy and fit 60-year-old does suffer a fall, his or her recovery may be easier than others’. I told Kathy about a recent fall of my own. I stepped on a rock funny in the dark, fell and skinned my shin. 2 weeks later, it’s all better except for a little scab. Kathy said that it’s probably due to the strength and balance work I do that my injuries were not worse and my recovery was so fast.

Practice helps!

Practicing balance truly does help to reduce the risk of falling. But it needs to be practiced on a regular basis – in fact, daily! Tai Chi is one example of exercise that improves strength and balance, but it must be practiced for at least 50 hours before it produces any benefits. Starting early will help later, but it’s never too late to start!

Yoga has not been studied specifically for reducing falls, but if you’re physically able to do it, it certainly can’t hurt. Balance and strength, which yoga improves, reduce the risk of falls.

Balance is a combination of many factors

Kathy said that balance combines many sensory inputs. Input from the eyes, ears, and touch are all integrated through the brain and output through the muscles. All of your senses combine to affect your balance.

Balance also has a psychological component which may be even more difficult to overcome. Fear of falling is a real problem for many. There is an evidence-based program, “A Matter of Balance,” that the National Council on Aging encourages, helps to overcome the psychological effect of the fear of falling. If you or someone you know has a fear of falling, I urge you to contact your local area Agency on Aging and take advantage of this program. Everyone should be able to enjoy the world as much as they want to!

Shoes make the woman (or man)

shoes are important in balanceFootwear makes a difference in balance. According to Kathy, high heels significantly increase the risk of falling – no surprise there. But going barefoot or in socks at home also increase the risk, due to a higher risk of slipping. Low-heeled shoes with firm, slip-resistant soles like rubber are recommended. And be sure to wear your glasses, even at home!

Vision plays a very big role in balance. Everyone should have their vision checked every year, and have their corrective lenses adjusted. Your home should be properly lit. Don’t sit in the dark! If you can’t reach a burnt-out light bulb, ask for help. Don’t climb on things to change it! Have a clear, well-lit path from the bedroom to the bathroom. There are attractive modern switches that dim or light a path. Use one!

Weighty matters

The obesity epidemic in America is also a factor in falls. People who are obese may be less physically active, they may not be as strong and their balance may not be as good. Kathy said, many obese people who fall feel hopeless and helpless, feeling that nothing can be done for them. Again, increasing the risk of more falls.

Obese people suffer from diabetes and arthritis at a higher rate, which leads to more pain and discomfort, which limits their activity, and increases the number of prescription medicines they’re on, according to Kathy. Some of these medications’ side effects increase the risk of falling. Pain medicine, for example, produces side effects such as sleepiness and dizziness, leading to more falls. Obese people also tend to be more depressed. Anti-depressant medication also increases the risk of falls. More dark spirals.

Common medications may increase your risk

prescriptions may cause fallsMany older Americans are on some form of medication that contributes to falls. Kathy says that even some common prescriptions can increase your risk because they are psychoactive in nature and affect the central nervous system.

Many opioid pain medications increase the risk. So do insomnia medications such as benzodiazepines, and blood pressure medication. As we get older, our bodies don’t flush out medicines as quickly as when we’re young. Dosage could be a factor that increases our risk of falling. Get your medications checked on a regular basis.

Get your orthostatic blood pressure checked – sitting versus standing. If there’s a significant drop when you stand up, that could be a problem in your medications or their dosage. Our bodies’ response to medication changes as we age.

Even over-the-counter medications can also increase your risk of falling. The active ingredient in Benadryl and other antihistamines can lower your blood pressure, causing you to be dizzy and fall. It’s also found in sleep medicine that you can buy over the counter. Non-sedating allergy medicines are recommended, especially for people over 60 and those with a higher risk of falling.

What to do

In terms of exercise, walking alone doesn’t reduce falls, Kathy says. Walking is certainly important for cardiac benefits, but it should be done in conjunction with strength and balance work. The CDC recommends 20 minutes or so of vigorous activity 4-5 times a week, and moderate- or high-intensity strength work 2 days a week that involve all muscle groups.

Before anyone starts an exercise program they should check with their doctor and start slowly. Set realistic goals and build slowly. If you haven’t exercised in the past, the “Stay Active and Independent For Life” (SAIL) program is good for older adults. Then progress to “EnhanceFitness” and “A Matter of Balance.” These are evidence-based programs and are promoted by the National Council on Aging.

On a personal note, I add balance work to my regular exercise, which combines cardio and strength work.

Draft your doctor to help

If you’ve been to the doctor and had a bone density test, and you’re fine – Kathy says don’t be complacent! Falls are caused by many factors. At your next visit, ask your doctor for a falls-risk screening and assessment. Be pro-active and know your risks. Less than half of older Americans talk to their doctors about falls and their risks, not realizing their doctors can help.

What’s our take-away?

Be active and stay active! Be sure to follow the CDC’s guidelines on exercise, and add strength and balance work to your regimen. Contact me for suggestions!

If you’re overweight and fall into the “obese” category, get physical and psychological support. We want you to be healthy!

get your vision checkedTalk to your doctor about fall prevention, especially if you have fallen, have a fear of falling, or feel unsteady on your feet.

Have your prescriptions monitored for interactions and side-effects that contribute to falls.

Get your vision checked once a year and your corrective lenses adjusted accordingly.

And turn your lights on!

Wear safe shoes – there are some cute ones out there… I checked.

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Stay in control of your falls risk. You have the power to prevent a fall!

Stress – it’s not going away

Play with your dog to relieve stress!Stress, our old friend. It’s ever-present. And it’s not going away. Every day we hear on the news something that makes us gnash our teeth. And since social media makes everything immediate, even from the far-reaches of the globe. Former allies are now questionable, and we’re cozying up to former enemies. Your boss is asking for ridiculous deadlines. The talk-show host on your favorite radio program has gone insane. Even commercials are making us angry and on-edge.

And when we feel those stresses, they can manifest themselves in our behavior. Many people eat when they’re stressed. Some get cranky with those they love (because getting cranky with the boss can get you fired). Some people become ill. None of these are good things.

So, how can you keep your blood pressure (figuratively) under control?

Take a step back. Unplug for a while and turn off the TV.

Go for a hike in the woods. Or just a nap under a tree in the back yard. Enjoy some nature.

Close your eyes, clear your mind and breathe for a few minutes.

Talk to a friend about your dogs.

Play with your dogs.

Work in the garden.

Listen to music. Not on the radio.

Some people advocate meditation. I honestly do think it helps to ground me. I do a couple of minutes every day or so – without meditating for a bit my mind tends to take off into the “What if …” zone. And then it goes around in circles and spirals, and I get all hot and bothered. So I sit down, close my eyes and think about nothing.

Some people like listening to guided meditations. They’re good too – in fact, I’m developing a series of short guided meditations.

But, whatever you do, make sure the stresses of today’s world don’t affect you adversely.

One sure-fired way to stay sane

Google calendar to set my mind at easeLife is nuts. It’s just crazy, and getting crazier by the day. So many things to do, places to go, stuff to get done. It’s practically impossible to keep it all straight.

Dentist appointment. Hair appointment. Take the car in. Go grocery shopping (and where did I put that clean-eating shopping list?). Take the dogs to the vet. Buy that birthday card. Do laundry. Go to agility class once a week. Train the dogs. Work out. Answer emails. Write.

I know I can’t possibly remember all that. Something is sure to fall between the cracks.

I rely on Google Calendar. It’s my planner, my to-do list, my reminder. I can sync it to my pc and all my devices. I can color-code reminders and appointments. Whenever I think of something, I just open my Calendar and enter it. When I enter an appointment on my phone, it shows up on my pc. If I think of something I have to do on Monday, I can enter it on my tablet and I can see it on my phone when I’m running around.

And the calendar has a repeat function for appointments that repeat, like weekly classes.

I know that I haven’t even scratched the surface of all of its capabilities, but I’m getting good use from the Calendar, and it’s helping me to erase some worries. I worry that I’ll forget to do something, and being able to enter it the instant I think of it has eased my mind somewhat. I’ll probably have to use it more, and explore it to discover other ways to make life easier.

You can access holiday calendars that are formatted for the Google calendar. My dog Agility instructor even has our club calendar in the Google format. And I can even find out when the Cubs game is on my Google calendar!

If I don’t have to worry about things I have to remember to do and where I need to be, then I can focus on reaching my goals!

Enjoy every moment!

I know it’s trite. But lately every face I see walking down the street is glum. A restaurant is next door to our little shop, and people should be looking forward to a good meal, meeting with friends or family and having a good time. But many are frowning, having arguments with the people they’re with, or yelling on the phone.Enjoy every moment!

That doesn’t sound like a good time. It might even be bad for the digestion.

Yes, the world is upside-down in many ways these days. The country is divided and hardly anyone seems happy. Or even content. Traffic is a nightmare. Your boss is toxic.

So let’s make our own contentment. Take a look around. If the sky is blue, enjoy it! Or, if there are interesting cloud formations, enjoy that.

Appreciate the flower by the side of the road. Enjoy the cool feeling when you swallow a sip of water.

Look at that dolphin in the picture. He’s doing something he loves doing! Jumping! I took that photo the last time I was at Dolphin Research Center in Grassy Key, Florida. The overwhelming feeling I get every time I go there is joy. I must remember that feeling when I’m overwhelmed by other feelings. Remember that joy!

And I must look around and find something to enjoy! With a little practice you can do it too.

Balance – still important!

Torque

I almost took a tumble yesterday. We always take the dogs out, even though we have a fenced yard. There have been too many reports of hawks flying away with small dogs for us to be comfortable just letting the dogs out when they need to do their business. Plus, we don’t want them eating unidentified things that they find in the back yard. And, we don’t really want them catching stray rabbits that find their way under the gates.

Torque bounced, I flailed!

So, yesterday I followed the dogs into the back yard, when, sure enough, they all came racing back to the front, chasing a rabbit who was probably feasting on the herbicide-free grass and dandelions. (Yes, rabbits are stupid. We have four dogs, and rabbits can probably smell that. That’s probably why they reproduce in such quantities. And thinking about it, the bunnies probably were not munching on the dandelions – there are too many of them for the wildlife to be enjoying.)

Torque has absolutely no sense of personal space or staying out of anyone’s way. He will find the shortest path, even if it’s right into me and through my legs. He’s definitely adorable, but Torque needs to learn about going around obstacles.

Keeping my balance

Torque ran right into me, chasing after the stupid rabbit. He bounced, but I was flailing. I did not fall, though!

I credit my ability to stay on my feet to the balance exercises I do every day. As we age, we’re more susceptible to falls, so I’m doing everything I can to prevent it. There are a variety of exercises to strengthen that balance muscle, and it just takes a couple of minutes a day to do one. I lead others in my Facebook Balance Challenge – join us!

 

Is your head exploding?

Stress is bad in more ways than you know. It can also slow down your metabolism. Many people are stress-eaters. If you feel stress, every couple of hours, take 5 minutes and just breathe. Empty your brain and focus on your breathing. Close your eyes and think of water, mountains, flowers (like pansies), or whatever makes you happy. Not work. Not the kids. Not all the chores that aren’t getting done! Just the ocean or snow-capped mountains. Set a timer so you don’t worry about the time.

When the timer goes off and you open your eyes, you’ll be in a better frame of mind to tackle the work, the chores, and the kids.

If you’re not into meditating but still feel the stress. Go for a walk! Climb some stairs. If you have one, close your door and dance to a couple of your favorite songs. Bounce on the balls of your feet and get the blood moving. Sing along if you want to! (Off-key is fine!) Again, when you go back to your desk, you’ll be better able to manage the stress.

You won’t want that candy bar, but definitely have a drink of water! Your metabolism be chugging along, and you’ll feel much better.

Walk well to age well

runningman1We all want to get old, but we want the best quality of life as we age. We want to be able to do what we did when we were young (or as close to that as possible). What’s the secret?

Retired occupational therapist Barbara Knickerbocker Beskind suggests that good posture and a brisk 30-minute walk every day are the keys to aging well. In her article, “The Surprising Secret to Aging Well” in The Next Avenue, Beskind suggests that good posture and that walk from early childhood on will build bones and keep us young. It will build bone density and balance reflexes that will cut down on debilitating falls and injuries in later years.

Beskind states that walking has enormous benefits — emotionally and even creatively. This is in addition to the well-known benefits to the pulmonary and cardiovascular systems. A sturdy gait pattern with alternating arm/leg movement helps maintain balance reflexes and strength in lateral hip muscles. And going for a walk frees the mind for creative pursuits.

So you don’t have to go crazy – just a brisk walk (with your head held high and your arms swinging in opposition to your gait) will help you achieve the golden years of your dreams!

Unplug – for your sanity

Rest and unplug for sanityWe’re surrounded by our electronics and our devices. There is no escaping the fact that to live successfully in 2016, we need to be plugged into the world around us. It’s how we stay in touch with our friends, how we keep tabs on our kids, know if our flight is on time, how late the bus is going to be,  how we get our news.

But once in a while we just need to unplug. Stop the noise. Get some peace back into our lives. Turn off the computer. Turn the phone off. Turn the TV off.

And then we can go about regaining our peace and sanity. Just sit for a few minutes with your eyes closed. Let the thoughts zoom through your mind. Acknowledge them but don’t take any action at all. Then open your eyes and read a book for 15 minutes. Cook your favorite meal without the TV blaring. Play with the dog for a while, or go for a walk with him. Or by yourself. Look at the trees, at the bushes, at the houses. Or just think about the things and people that make you happy.

It’s easy to become immersed in our technological world, but once in a while it’s important to live in our own head and figure out who we are inside.

Incorporate exercise into your daily life

toe walkThe best way to exercise is to do it and not even realize you’re exercising! Many day-to-day activities can incorporate exercise. So you’ll get a double benefit. You’ll do the task you had to do, and you’ll exercise while doing it! This idea is especially useful when your schedule is so busy you can’t fit another thing in it!

For example – you have to walk to the garage to get in your car, right? Incorporate some toe-heel walking. Place the heel of your foot directly in front of and against the toe of your other foot. You’ve taken a step (okay, a small step) and you’ve exercised your balance. This is actually harder than it might seem, and it really does train your balance.

Another good functional exercise is to get up out of a chair without using your hands. Also harder than it might seem, and you’re strengthening your legs. Try it on one foot, and you’re doing all that and practicing your balance!

Try standing on your tip-toes and leaning to the side. Ever reach for something in a cabinet? That’s what you’re doing with this exercise.

Of course, no matter how you exercise, practice good posture – suck in your stomach and lengthen your spine!

How’s your balance?

bal_bathroom2How is your balance? No, really – how is it? Can you stand on one foot for 30 seconds? How about 15? No? Time to work on it.

As we get older, our balance can diminish. But as with most other things, we can improve our balance with practice. The more you test your balance, the better it gets! Just a couple of minutes practice a day will show remarkable improvement in just a week’s time.

Gradual changes linked to growing older—such as weak or inflexible muscles, slower reflexes, and worsening eyesight—affect the sense of balance. (Better Balance, Harvard Health Publications, Harvard Medical School) You’ve experienced this. When you’re young, you can run along a curb and not have to take a step in the street. Now, even walking slowly it’s difficult to keep to that curb and not step in the street or on the grass next to the curb. And in the winter, we’re all scared of losing our balance and slipping on the ice.

But, it’s been shown that balance training programs reduced falls that caused injuries by 37%, falls leading to serious injuries by 43%, and broken bones by 61% (published online in the BMJ). So, while it’s important to exercise vigorously to improve our cardiovascular system, it’s also important to work on our balance!

My favorite multi-tasking balance exercise is to stand on one foot while brushing my teeth – switching every 30 seconds. Or 15 seconds, or 10 seconds. Be safe, though – make sure the sink is handy for holding onto if you need it! (Canine supervision is optional!) Or just stand next to a chair on one foot for a couple of seconds and then switch. Just do something to improve your balance!