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VNA of Cape Cod

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Published on August 11, 2020

Help for this common cause of injury and death

Fall Prevention

A bad fall by an elderly patient often results in broken bones and can be the beginning of physical decline that never reverses. Alarmingly, in recent years, falls have killed an increasing number of Americans.

A study published in June 2020 in JAMA revealed that for people over the age of 75, the rate of mortality from falls more than doubled from 2000 to 2016. In 2000, the number of deaths from falls in those over 75 was 52 per 100,000. In 2016, the number of deaths in that same population was 111 per 100,000.

Fortunately, there are things elderly people can do to prevent falls from happening, said Gina Battles, program coordinator at Healthy Living Cape Cod. Healthy Living Cape Cod is a partnership of the Visiting Nurse Association of Cape Cod and Elder Services. It offers programs to help folks navigate healthy aging.

Two of the programs that Battles teaches that address fall prevention are the Matter of Balance workshop and Tai Chi Quan: Movement for Better Balance.

Matter of Balance

“The Matter of Balance workshop is about half physical activity and half group discussion,” Battles explained. “Through the physical activity we do a group of exercises that work on strength, balance, flexibility and endurance. We teach them how to get up from a fall and when not to get up from a fall. We also coach them how to get up out of a chair.”

As part of the workshop, participants learn helpful tips to make their homes safer. They are given a checklist so they can go through their house both inside and out to make changes that will help prevent falls. Tips include things like making sure all electrical cords are out of the flow of traffic, removing all throw rugs and making sure each room is adequately lighted.

One of the big issues the workshop addresses is the fear of falling, which actually increases the risk for falls.

“The fear is almost always more debilitating than your physical limitations,” Battles said. “In Matter of Balance we address the fact that sometimes people are letting fear call the shots.”

Battles uses the image of a traffic light to address the fear. A red light tells you not to proceed any further. Yellow means proceed with caution and green means to move forward.

An example of how this works is a person who wants to take a walk but realizes it has rained outside and there are wet leaves. The first reaction might be to see a red light and just stay inside. Battles encourages her clients to think about what things they could do to turn that red light to a yellow one. Ideas like bringing a walking stick, making sure they have a cell phone with them and inviting a friend along are all good suggestions to make that activity safer. When they actually leave the house with their safety precautions in place, they are in green light mode.

“By taking those steps to think it through, rather than stop at the red light, we get people to be more active and overcome that fear,” she said.

Battles also helps people through the grieving process of discontinuing beloved activities like tennis, ballroom dancing or bike riding. She tries to get people to think about other activities they can do for pleasure to replace the ones they no longer manage.

Tai Chi

“Although tai chi is slow and gentle, it addresses the key components of fitness,” Battles said. “It’s low impact, slow motion exercise that can help maintain strength, flexibility and balance and it can be the perfect activity for the rest of your life. It’s for all fitness levels so you can get started even if you aren’t in top shape or the best of health.”

The slow, deliberate, repetitive movements are based on coordination rather than muscular tension like some other exercises. Participants learn to deliberately shift their body weight for better balance. Even if someone isn’t steady on their feet, they can practice tai chi while holding onto the back of a chair.

Tai Chi Quan for Better Balance is a 24-week program that is a combination of a short form of tai chi with mini therapeutic movements. It was developed by Dr. Fuzhong Li at the Oregon Research Institute and it is an evidence-based therapy.

Tai chi forms are sets of movements. The tai chi Quan starts with striking a pose, but then adds a therapeutic movement such as a tip of the pelvis while bringing the arms forward and pulling them back to strengthen hip reflexes.

Another helpful motion is to step forward and put your arms in front of your face. It is used to simulate what to do when falling. The idea is that in the event of an actual fall, your muscle memory would kick in and you would instinctively put your arms in front of your face to minimize injury.

“The results of regularly doing tai chi will be more confidence in your activities of daily living and you’ll be more flexible, more balanced and stronger, especially in your lower body,” Battles said.

“By focusing the mind solely on movement, it helps to bring about mental clarity. Tai chi is often described as meditation in motion, but I recently read a story in Harvard Women’s Health Watch that described it as medication in motion. There is evidence that with regular practice, tai chi can help prevent many chronic health problems associated with aging.”

To register for the Matter of Balance or Tai Chi class, call Battles at 508-957-7620 or email her at healthylivingcapecod@gmail.com.

The classes are free but registration is required.