Archives August 2017

By Meredith Kimple

We have all fallen at one time or another.

Whether we trip on the edge of a rug or an uneven walkway, slip on a wet floor or a patch of black ice, a fall always ends in a combination of shock, pain, and humiliation (particularly if other people witness it). Mid-fall, we are suddenly aware that there are limits to our bodily control; but standing up after the incident, bruised and a bit shaken, we dismiss that feeling of temporary vulnerability until we experience our next mishap.

That is, if we’re younger and physically fit. For the elderly, the impact of a fall extends beyond the event itself.

It is estimated that more than one out of four adults over the age of 65 falls each year, and that is based only on falls that have been reported. Falling not only takes a critical toll on an elderly person’s body, it can also increase their hospital visits, medical expenses, and do irreparable damage to their confidence.

Why are the elderly at greater risk of falling?

There are several factors that contribute to an older person’s increased risk of falling, including:

• Balance and Motor Impairments

Age-related physical changes may affect an older person’s gait and ability to balance. A lack of exercise, muscle weakness, arthritis, and other medical conditions can also leave older people highly susceptible to falls.

• Vision

Poor eyesight, an outdated eyeglasses prescription, as well as glaucoma and changes in depth perception, can all increase the likelihood of a fall.

• Wrong Footwear

Wearing shoes that are impractical and / or uncomfortable can sabotage an older person’s sense of balance. Slippers, flip-flops, high heels, and smooth-soled shoes provide little traction and support, making walking twice as difficult and falls twice as likely.

• Medications

Certain medications may cause confusion, unsteadiness and dizziness, all of which can lead to falls. Taking four or more medications also increases an older person’s risk of falling.

These are not the only risk factors, but they are a few of the more prominent ones. Other health conditions, sudden drops in blood pressure, poor diet, and advanced age can influence an older person’s stability while moving.

Because approximately six out of every ten falls occurs in the home, we may be especially concerned for our senior loved ones who live alone. If they fall and are unable to get up or access their phone, they could remain hurt and helpless for a prolonged period of time.

The following are a few of the steps we can take to help our senior loved ones minimize their risk of falling.

1. Adapt the Home

Since the majority of falls happen within the home, making the necessary modifications to your senior loved one’s living space is very important. Installing handrails (particularly in the bathroom and on the stairs), removing clutter and wires that might be tripped over, securing rugs to the floor, and improving lighting are just some of the changes that can be made to lower an older person’s risk of falling. Mobility aids, like a walker or a wheelchair, may be helpful for moving within the home and out in public.

2. Exercise

Though an older person who struggles to maintain their balance may not be able to engage in vigorous physical activity, there are certain gentle exercises that can help improve motor function, like Tai Chi and swimming. Tai Chi in particular provides seniors with a stronger awareness of their bodies, which can reduce their fear of falling, restore their confidence, and improve their balance. If these physical activities are too difficult or strenuous, a physical therapist can help your senior loved one develop an exercise regimen that is tailored to their abilities.

3. Consult A Medical Provider

Encourage your senior loved one to report any falls to their doctor. Falling may be an indication of a new health problem, or it could be caused by one or more medications; keeping their doctor informed will help ensure the best decisions are made for their health. Their physician can also assess their fall risk and provide additional ideas for minimizing it.

Falling at an advanced age is more than a little painful or embarrassing; one out of five falls results in serious injury, and once an older person has one, their chance of having another increases significantly. A fall can lead to broken bones, hip fractures, head injuries, a decline in overall health, and, not surprisingly, a crippling fear of falling. If you notice your older loved one suddenly uses furniture or walls to maintain their balance when walking, or if they mention that they fell recently, encourage them to discuss these developments with their doctor.

Instability significantly undermines an older person’s sense of control over their own body, so as their family and friends, we should be there to provide reassurance, suggestions, and a listening ear.

By Meredith Kimple

In a previous blog post, we discussed the importance of monitoring and supporting our older loved ones’ emotional health. Depression is more prevalent in the elderly population than we might think, and yet, it is frequently overshadowed and unconsciously dismissed in the face of more prominent physical and cognitive illnesses. Without undermining the enormous impact diseases like Alzheimer’s and cancer have on an older body, I would like to once again emphasize the importance of, and acknowledge the challenge in, promoting senior mental health.

We all have our fair share of worries. Giving a presentation in front of an assembly, paying our children’s college tuition bills, watching the Heels play Duke, mulling over the state of the world – any of these things can cause us to break into a sweat. Though very unpleasant, worrying is perfectly normal, and in fact, fear can prove to be a powerful motivator when it comes to thoroughly preparing for the future.

But there’s a big difference between the occasional worry and an anxiety disorder.

An individual who has an anxiety disorder lives in a state of excessive, prolonged anxiety, to such an extent that it impedes their ability to function. Though they tend to appear most strongly in the years between adolescence and middle adulthood, anxiety disorders can develop at any time.

It is estimated that anxiety disorders affect about 15% of older adults every year. In the past, research seemed to indicate a decline in anxiety disorders with age, but in recent years, there has been greater recognition of the condition’s occurrence in the elderly.

So what causes anxiety disorders in older people?

There are several factors that can leave our older loved ones susceptible to an anxiety disorder. Though the majority of older people who have an anxiety disorder have had it since their youth, certain aspects of the aging process can worsen or even cause this condition. Many of the illnesses and diseases that affect the elderly population, like heart disease and diabetes, can aggravate an anxiety disorder; even some medications can cause older adults to experience chronic anxiety.

Anxiety disorders frequently occur alongside other psychiatric illnesses, particularly depression. As they age, seniors undergo countless physical changes, suffer the loss of friends and family, sacrifice their independence, and experience feelings of loneliness and uncertainty. These events and adjustments are emotionally taxing, leaving many older people vulnerable to both depression and anxiety.

While anxiety disorders are not fatal, they can exacerbate other physical and psychiatric illnesses, increasing the likelihood of hospitalization and decline. Compromised mental health can, at its best, lower an older adult’s quality of life and harm their self-confidence.

Anxiety disorders can be difficult to spot in older individuals, in part because seniors are often reluctant to vocalize their symptoms. This may come either from ignorance or from a fear of being labeled “mentally ill”; for centuries, mental illness has been unfairly stigmatized, and your older loved one may be afraid to admit their anxiety, even if they suspect they are suffering from that condition.

To further complicate matters, other medical conditions may mask the usual physical symptoms of anxiety; headaches, muscle tension, and pain can be misidentified as part of a pre-existing problem. Cognitive impairment can make identification all the more difficult; a person with Alzheimer’s disease or dementia may exhibit behaviors that could easily be mistaken for the symptoms of an anxiety disorder, and they may be unable to communicate or understand their feelings.

As their loved ones, how can we determine if they actually have an anxiety disorder?

Different disorders present different symptoms, but Generalized Anxiety Disorder (GAD) is the dominant variation among older adults. If your senior loved one has trouble sleeping, is restless, tired, and tense, and has spent at least six months worrying about everything from their relationships to their finances, they might have GAD. It is important to note that these behaviors must impede their normal day-to-day functioning, and their worrying must be uncontrollable. Things happen that cause all of us to worry, but an individual with an anxiety disorder experiences excessive, often irrational worry for a prolonged period of time.

If you suspect that a senior loved one is suffering from an anxiety disorder, it is very important that you act as soon as possible. First, try talking with them about any recent changes in their lives, and ask them about their feelings; having your support may help them to honestly share their concerns with you. However, they may be more willing to speak to a doctor they know and trust. Calling your older loved one’s primary physician can help to rule out other health issues; as mentioned above, anxiety can be aggravated by certain diseases, conditions, and medications. Anxiety disorders are treatable, both with medication and cognitive behavioral therapy.

Crippling anxiety may not be life-threatening in and of itself, but it can keep our older loved ones from living their lives to the fullest. Fear is powerful, and it is, above all, incredibly isolating. Age brings a plethora of rich experiences, some of which are wonderful and uplifting, and some of which serve to reinforce negative thought patterns. If there is nothing to counter these doubts and fears, our loved ones are in danger of losing their resolve to live and participate actively in the world around them.

You might think that at the end of our lives, many of our daily worries would abate. But the lives of our senior loved ones are often far from carefree, and they may have fewer coping strategies. Anxiety disorders cannot be managed without professional intervention, and we must be there to encourage them to seek help. In supporting and caring for their mental health, we are bolstering both their physical wellness and self-esteem through times of tremendous change.