Aged to Perfection

Do you know a senior who has suffered a serious fall? Likely you do, since approximately 30% of seniors who live in the community suffer a fall each year. The consequences of a fall can be quite serious—injury, hospitalization, even death from complications.

“Falling isn’t as much about slips and trips. It’s about the failure to recover. Slips and trips happen at all ages.” - Dr. George Fernie

Did you know that falls are the cause of 90% of all hip fractures, 50% of all injury-related hospitalizations in seniors, and the 5th leading cause of death in the elderly?! These numbers also double when a senior has dementia. So, it is extremely vital in keeping seniors strong and steady on their feet.

Why do seniors fall in the first place?

There are various external factors at play that contribute to slips and trips; such as:

• Loose carpets/rugs
• Poor lighting
• Unstable chairs
• Steep stairs
• Poor footwear (e.g. slippers)

While some falls can be attributed to tripping—such as tripping over floor mats, pets or curbs—other falls seem mysterious. The person will report that they just went down and we're not sure why. In many of those mysterious cases, the fall is due to internal factors such as:

• Visual and hearing deficits
• Vestibular dysfunction
• Cognitive impairment
• Neuropathy (abnormal sensory feedback)
• Low blood pressure
• Edema/swelling
• Pain and foot drop
• Weakness and tightness
• Decreased flexibility
• Slowed reflexes and balance disorder 

What can we do to prevent falls?

Get rid of all the external factors that cause slips and trips! Ensure that your living space has no loose carpets or rugs, the lighting is bright for increased visibility, all chairs are sturdy with armrests, everything needed is on the main floor (no stairs), and that proper footwear is worn in the house.

Improve balance and stability!

The number one key to fall prevention is staying active! Physical activity has shown to mitigate the deathly consequences of falls – just walking, gardening or housework is enough for an elderly loved one.

However, when your elderly loved one refuses to do regular exercise the best option is to increase their base of support. To remain balanced, there must be a stable base of support—the wider the base of support the more stable it becomes. The base of support is the invisible box that can be drawn around your feet when you are standing. Added to this is our centre of mass—which is approximately where our belly button is located.

When someone’s centre of mass is in the middle of their base of support, they are perfectly balanced. When their centre of mass begins to reach the outer edge of their base of support, they are more prone to falling.

“She says she wants to keep living in her home. We say it starts by keeping her on her feet.” - American Academy of Orthopedic Surgeons

For example, a ballerina narrows her base of support to be only one square inch when she is en pointe. Her balance is quite precarious because her base of support has been reduced. The only way that she remains upright is by perfectly hovering her centre of mass over her base of support.  She is constantly adjusting to ensure that her centre of mass doesn't sway too far aware from her base of support.

In the case of a frail senior, their feet may ache or have bunions, causing that person to only walk on the edges of their feet, which reduces their base of support and their balance. Instead of using the full surface of their foot, they have reduced their base of support more like a ballerina.  As well, the senior’s posture may be more forward-leaning, pushing the centre of mass to the outer edge of the base of support, causing instability. A senior will not likely be crouching down to touch the ground for support, the way a football player does.

The best way to create a strong base of support is to use a walker. The four wheels of the walker expand someone’s base and provide the necessary support. Much like a football player, a well-balanced senior using a walker is less likely to fall than a senior who is precariously balancing on sore feet. If their posture is forward-leaning then the walker extends the base of support ensuring that the centre of mass remains in the middle of the base of support.

Encourage the seniors in your life to carefully assess their centre of mass and base of support to ensure that they are as safely balanced as possible. Every fall that is prevented is a great success and ensures a longer and healthier life for that senior. 

Maintaining good mental health requires just as much attention and care as maintaining good physical health. In reality, mental health is a continuum, a scale that ranges from mental wellness to serious mental health challenges. When someone experiences drastic stress in their life, their mental distress level rises.  It is important to have adequate coping mechanisms in place to help reduce one’s mental distress level and maintain mental wellness.

The Canadian Mental Health Association defines mental wellness as “a state of well-being and the ability to function in the face of changing circumstances.” This includes handling stress and loss, relating to other people, and making decisions.

Dealing with stress though is not an innate trait in humans; it is a learned behaviour.  Whether good or bad, we learn coping skills from our environment.  Adding positive and healthy coping skills to our lifestyle is crucial to maintaining or gaining back mental wellness. 

Depression is not always something that you can control—it may be related to a specific situation or it could seem to appear for no apparent reason.  Depression may be triggered by loss—loss of a loved one, an important role in life, a job, loss of health or independence.  Any of these losses create increased stress.  Without coping mechanisms, someone’s mental distress level will climb and they may experience depression. 

Depression after any type of loss is likely due to situational depression, and having the right coping skills will be highly beneficial.  It is important to note that clinical depression is an illness that many people experience regardless of their coping skills.  In either case, it is important that you speak to a doctor.

The Canadian Mental Health Association recommends a few key coping skills to help maintain mental wellness.  By implementing these coping methods when you are feeling your mental distress level begin to climb, you may be able to maintain a higher state of mental well-being.

1. Read and Research

The more you know about depression and mental illness, the more empowered you are to protect your own health. You don't have to do this alone! Research can be overwhelming, ask someone you trust to help you learn more about mental health. 

2. Change Your Thinking Patterns

Many depressed people have negative and anxious thought patterns.  Learning to redirect your focus can improve your mental health. A great tool is to journal your thoughts and to track how you got to that negative thought. Remember to celebrate your successes; focus on your achievements rather than focusing on what you are unable to do. 

3. Ask for Help

Requesting help is not a sign of weakness; rather, it requires the courage to reach out to others when you are in need.  Create a support system of caring people whom you can call when you are feeling low.  Have a list of 5 close friends you can count on; if one person doesn’t answer, you have 4 more names you can call.

4. Use Problem Solving

Determine which problems are stressing you, explore possible solutions, try a new solution (as the same old solutions will yield the same old results), evaluate the effectiveness of your new solution, and focus on the progress of your problem solving rather than on the problem alone.

5. Exercise

When you are depressed, the last thing you may feel like is exercise, but the results make the effort worthwhile.  Exercise increases the blood flow not only through your body but also to your brain.  Increased oxygen flow to the brain improves mental functioning and mood. Your endorphins are also elevated through exercise.

6. Eat and Sleep

Eat a properly balanced diet, even if you have no appetite.  Aim to maintain a regular schedule where you eat healthy food at regular intervals.  Sleep on a regular schedule as well.  Ensure that you get enough sleep, but do not oversleep.  Most adults need an average of eight hours of sleep nightly.

7. Enjoyment

Schedule yourself time to rejuvenate.  Prioritize activities that bring you peace and pleasure.  This may include: meditation, being outdoors, various hobbies, caring for a pet, having a massage, etc.

8. Socialize

Do not cut yourself off from social connections during these difficult times. Social isolation only perpetuates depression.  Socialize with close, caring friends who are compassionate and supportive. If you can't meet with your close friends, you can try to connect online through video calls. 

9. Relax Your Standards. 

Many people experience anxiety and stress because they are holding themselves to unrealistic standards.  Determine to not expect more of yourself than you would expect of anyone else.  Be kind to yourself—sometimes, we are hardest on ourselves!

10. Laugh!

A sense of humour can go a long way.  Sometimes, laughter truly is the best medicine.  You don't even have to wait for a comedy act to come to town; through the internet, you can search for endless comedies on YouTube and select comedies that suit your particular sense of humour.

If implementing these coping skills does not improve your sense of mental well-being or if you are currently experiencing other symptoms as well, you should see your doctor.  Medication may be appropriate for you, or there may be a physical explanation for the mental distress you are experiencing.  Your doctor can advise you best.

It is important to know that help is available.  You do not need to live in a state of mental distress.  To learn more about healthy coping strategies and ways to reduce stress, please visit the Canadian Mental Health Association.

Locally, in Waterloo Region, we are blessed to have Here 24/7 — a  service that is available 24/7 to assist with addictions, mental health, and crisis situations.  The number is: 1-844-HERE247 (1-844-437-3247)