Falling and the Fear of It

Finding the line between prudent precaution and over-the-top anxiety

You may be too young to be concerned about falling. I also may be too young, but I am a klutz.  I stumble, trip, and occasionally faceplant on a regular basis. At this point in my life, I’m fortunate that I can get back up.

But I don’t know how long I can depend on my resiliency to counteract my klutziness. I strongly suspect it will be like rapid metabolism – you have it, you depend on it, you don’t think about it, until suddenly you’re 20 pounds heavier and realize it left you without a forwarding address.

So ready or not, I have started to read up on falls. We all know of older people for whom a nasty fall began a downward spiral – first a broken wrist or elbow or hip, which led to a chain of other disabilities, until one day recovery was impossible.

The statistics are sobering. Each year, more than one in four older adults has a fall (although less than half tell their doctor). Even so, in 2019 falls accounted for 3 million emergency room visits. At least 300,000 older adults are hospitalized for hip fractures (95% of which are caused by falling).

Complex Factors

It is humbling, if not humiliating, to realize that the complex, coordinated internal systems that allow you to walk upright – something you have done successfully since you were in diapers – have fallen out of alignment. Because it is a complex system with many moving parts, it just takes one slip-up – in balance, in muscle mechanics, in eyesight – to throw the body askew. There are multiple risk factors, and the more you have, the more likely that you your internal gyroscope is going to flake on you. Among them:

·         Muscle weakness in the lower body

·         Difficulties with balance

·         Prescription or over-the-counter medicines that affect balance and steadiness.

·         Vitamin D deficiency

·         Vision problems (including issues with bifocals or progressive lenses, and poor lighting)

·         Foot pain or poor footwear

·         Home hazards – throw rugs, clutter, kids’ toys, broken or uneven steps

·         After-effects of Covid – fatigue, weakness, difficulty walking – one more outcome from the gift that keeps on giving.

Many of these risk factors are within our control. Exercises can strengthen weak muscles. Vitamin supplements can address deficiencies. Doctors can correct medications that are hindering mobility.

And of course, as you would expect in our culture, fall prevention and fall mediation have created bountiful business opportunities. There are devices to help adults recover from falls – for instance, the full body patient lift, a crane-like machine that elevates a person off the floor and deposits then in a chair or bed; medical alert devices to call for help after a fall; and skills training for learning how to recover from falls.  

When it comes to the prevention arena, it occurs to me that the ultimate safeguard is to emulate the  Michelin Man, whose inflatable protective layers have helped him live to be 128. 

Fear Itself

But that leads us to a paradox. It seems there is something even more hazardous to older adults than falling. And that is… (wait for it) Fear of Falling.

When people are constantly afraid of falling, their central nervous systems make them more cautious. And guess what? That anxiety may ultimately increase their risk of falling.

Here’s why: If your anxiety about hurting yourself in a fall goes over the top, your fear may lead you to cut back on physical activities. But the fear of falling, according to a 2020 study, limits older adults’ daily activities as much as experiencing a fall itself. Fear can lead to functional decline, reduced mobility, and ultimately, a weakened physical condition that leads to more falls.

The goal, I believe, is to strike a balance between common-sense precautions and anxiety run amok. Although I believe we should banish the phrase “I’m too old for this” from conversation, it would seem prudent to avoid certain high-risk activities such as skydiving, stock car racing, touch football, and crowd surfing (yes, crowd surfing! Can you believe this dude?)  

One more bit of good news: artists are turning out attractive designs for metal walkers that signal the user’s individuality and fashion sense. Product endorsements can only be next. So by all means, if and when we must lean on canes or walkers, let’s do it in style!

Looking for Retirees and Nearly-Retirees

I’m starting a research project on aspects of retirement, and I am in search of people to interview about their experiences. I’m seeking two kinds of interviewees:

·         Men or women who officially retired in the past three years.

·         Men or women who expect to retire in less than three years.

Do you qualify, or can you suggest people who do? Please let me know at don@donakchin.com. Thanks for your help and for your continuing support.