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Why do Seniors Fall?

 

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.

 

 

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?

 

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). 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 disorders
  • What can we do to prevent falls?

 

1.  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.

 

2. Improve balance and stability!

 

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). 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.

 

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 contrast, a football player crouches low and spreads his feet wide so that he has a wider base of support than he normally would. He may even put one hand to the ground adding a third point of contact and expanding his base of support further. He has a stable base of support, and his centre of mass is positioned in the middle of his base.

 

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!

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Speeding Up Spring

 

Are you experiencing a case of cabin fever?

Don’t be discouraged and let the cabin fever get to you—instead, speed up spring!

 

 

One of the best ways to bring spring to you is to start your gardening early—indoors! Rather than waiting on mother nature to cooperate for a display of spring colours, get things started yourself by forcing bulbs.

 

Indoor gardening is a very accessible way to garden. There is no need to bend over or kneel on the hard ground. Bulbs require very little maintenance or effort. Indoor gardening is a great way to connect with an elderly loved one’s passion and hobby without being overwhelming or too physically demanding. It can also be a great intergenerational activity, drawing children and grandparents—or even great grandparents—together over a common task.

 

Forcing bulbs indoors mimic the outdoor environment that causes a bulb to grow and bloom. Unlike large, potted house plants, bulbs do not need big pots. A small, shallow dish is sufficient. Many bulbs are easily forced using only water and pebbles, rather than soil, resulting in much easier clean up when gardening indoors. It is also more fun to watch the roots develop and see the bulb change as it grows. New growth development is exciting to see—at any age!

 

 

Using your shallow container, fill it half full of pebbles or marbles, then place the bulbs on top of the pebble layer. Gently fill the rest of the container with pebbles or marbles to secure the bulbs in place, but do not completely bury the bulbs. Put enough water in the dish so that the water touches the bottom of the bulb, but do not submerge the bulb in water or it will begin to rot.

 

The step that is most often overlooked when forcing bulbs is the chilling step. Your freshly “planted” bulbs need to be chilled in a cellar or in the fridge to mimic the winter season. Some bulbs only need a few days of chilling, and others need a much more extended chilling period of several weeks. Be sure to check the specifications on the bulbs that you purchase.

 

 

NOTE: Please do NOT store bulbs in an elderly person’s fridge. If that person has dementia or mild cognitive impairment, the bulbs (or pebbles) could be mistaken for other produce. Likewise, if your loved one has impaired vision, the bulbs could appear similar to onions. Senses such as taste and smell become dulled for many people as they age; the smell or bitter taste that might alert you to food being harmful may not alert an elderly loved one.

 

When roots begin to show you will know that your bulbs are ready to begin their growth cycle and it is time to remove them from the chilling stage. With roots now showing, your bulbs are ready to be moved into warmth and sunlight. You need to introduce them to sunlight slowly, just the way that the spring sunlight is soft at first and then gradually gets warmer. Place your bulbs in a cooler area of your home, away from direct sunlight. When your plants begin to grow and the stems take on a healthy green colour, then it is time to move them to a sunny windowsill to watch the beauty unfold!

 

In theory, any bulb can be forced to grow indoors, but some varieties are easier to force than others. Paperwhite narcissus grows well indoors and does not require a very long chilling period. They grow well in water and pebbles and are quite fragrant. Amaryllis are very easy to force and the blooms are giant and colourful. They grow so quickly that you can see growth daily.

 

The warmer the environment, the faster the amaryllis will grow. Once it blooms, it is best to move the plant to a cooler, shaded area for the blooms to last longer, as they can remain for up to a month.

 

Hyacinth and crocus can also be forced and take eight to ten weeks to grow. Although tulips are a favourite spring bloom, they are probably best enjoyed out in the garden as they can be trickier to force and require a long chilling period of sixteen weeks.

 

Enjoy your head start on spring by forcing your favourite bulbs indoors, and use this easy, timeless, and ageless activity to connect various members of your family. You will have spring beauty unfolding in your own living room—no matter how much snow remains on the ground outside!

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Dignified Care means Allowing Sufficient Time

 

Homecare can be defined pretty broadly and mean different things to different people.  To some, it might mean dropping in to check on someone for 5 or 10 mins, for someone else it could be 24/7 care in someone’s home.  It could be just about anything in between!

 

To ensure that our clients receive the best possible service, we have placed parameters around the type of service we can offer to ensure top quality.  Here at Warm Embrace, the minimum visit length we offer is three hours. We have set this minimum to ensure that we are fulfilling our mission and our philosophy of care

 

Within the context of homecare, where an elderly client is living in their own home, apartment or condo, there are some additional reasons why the three-hour minimum is necessary.

 

 

Have you ever dropped by your elderly parents’ home with the intent of staying for a half hour visit?  How did that turn out?  I’m willing to bet that you stayed much longer than just 30 minutes!  Why is that?

 

I’m guessing that by the time you got in the door and settled, got caught up with some friendly chit-chat and had a coffee, you were already at the 30-minute mark.  Just as you were thinking you would head out the door, your mother mentioned a new symptom that’s bothering her.  You discussed that and tried to track down whether a doctor’s appointment had been made since your mother couldn’t remember. Then your father mentioned that the microwave wasn’t working properly so they weren’t sure what they were going to have for dinner.  The next thing you know, you’re busy making dinner for them and your quick 30-minute drop-in lasted a few hours.

 

Of course, your parents tend to stock-pile all the issues until you arrive. Then it takes longer to address everything.  The same is true for our visits.  Clients may save up the dishes and the housekeeping and laundry pile up.  The items you plan in advance that you figure might take an hour or so end up taking much longer when the list keeps growing!

 

It’s not just about tasks; it’s also about pacing.

 

If you personally have a doctor’s appointment at 11 am, how much time do you allow yourself to get showered, dressed, ready and out the door?  Now, what if your parents have a doctor’s appointment at 11 am?  It takes a lot more time since every step in the process needs to be adjusted to allow the extra time they may require or prefer.

 

It likely takes much longer for them to manage to get in and out of the shower.  Selecting an outfit and dressing likely takes longer, as does personal grooming and other morning routines.  Physically getting into and out of the car may take longer, and your parents may prefer to be at the appointment 20 minutes early instead of arriving just on time. . .despite the fact that the doctor is always behind schedule and you know you’ll end up waiting anyway!

 

 

Out of respect for your parents, we allow significant time for outings to ensure that we can match their preferred pace, not our preferred pace.  We know that each stage will take much longer and that we need to allow lots of extra time should something unexpected arise.  If we’re just getting your parents settled in the car and your mother suddenly needs the washroom once more before leaving, we need to have allowed lots of extra time to deal with the (somewhat) unexpected.  For your parents’ sake, we would never attempt to accomplish an outing in only an hour long shift.  Part of providing dignified care is allowing sufficient time for outings and errands and matching your parents’ pace, not necessarily just focusing on fastest efficiency.  It takes time to do things well and the minimum time we need to ensure top quality is three hours.

 

Granting your parents the dignity of matching their preferred pace, ensuring that we have extra time built in for the unexpected, and knowing that they may have a stockpiled list ready for our arrival are all part of how we plan in advance to meet your parents’ needs. 

 

Relationships are about so much more than speed and efficiency; your parents will thrive from the attention they receive from a wonderful caregiver who takes the time to appreciate them for who they are and who gets to know them on a personal level without rushing.

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Independence means that you’re the boss!

 

You know your mother needs assistance, but she refuses to even consider it.  She insists that she doesn’t want to lose her independence. You’re frustrated because you’re trying to be proactive and prevent a crisis, but your mother won’t hear of it.

 

Be reassured!  You are not alone!  Your mother is not the first senior to bristle at the notion of receiving help.  In fact, most of our homecare clients here at Warm Embrace started out exactly like your mother—Estelle sure did.  Estelle started out adamantly insisting that she didn’t need or want any help at all.

 

 

I can hardly blame Estelle for resisting help.  Very few people are quick to put up their hand and say “yes, I need help”—and that is true at any age.  Our North American culture places a high value on independence, and many people tend to define that as “doing everything myself.”

 

Estelle rejected homecare because she was afraid that if she can’t do it all herself, then she won’t be considered independent.  In her mind, that would mean being one step away from a dreaded nursing home.

 

We define independence differently.  We believe that independence doesn’t mean that you do it all yourself; instead, independence means that you get to choose how everything is done.  Independence means that you’re the boss.  You make your own decisions.  It doesn’t mean you physically do everything; it means you have control in how it is done.

 

Homecare doesn’t take away a senior’s independence. In fact, it often does the opposite.  It often grants senior more independence. 

 

Estelle did not lose her independence, and that’s probably why she now adores her two favourite caregivers. Estelle did not lose anything; she gained.

 

 
Estelle benefited from:
  • Gaining two new best friends
  • Enjoying stimulating conversation
  • Eating healthy meals and having more energy
  • Re-establishing her social connections because her caregivers can drive her to events
  • More physical activity by keeping up with her caregivers—instead of just sitting watching TV
  • Improved sleeping patterns since she’s no longer napping all day out of boredom

Your mother could benefit from homecare just as much as Estelle.  Your mother can go from just barely surviving to actually thrive.

 

What NOT To Do:

When you mention the idea of homecare or introducing a caregiver, don’t highlight what your mother can’t do.  Don’t point out all the activities she’s no longer managing, even though it may seem obvious and glaring to you.

 

Do NOT point out that:

  • She has lost her licence and no longer drives
  • The only healthy meals she eats are the leftovers you bring
  • She hasn’t been to a social event in six months
  • Her housekeeping standards are slipping

 

What To DO:

Highlight all of the gains your mother will benefit from when she has a wonderful new caregiver in her life. Point out how her life will be even better.

 

DO point out that:

  • She can now go anywhere she likes without worrying about calling a cab
  • She can go to social events and visit friends she hasn’t seen lately
  • Her caregiver will be a new friend with whom to play scrabble
  • She will enjoy having a visitor in the lonely winter months when she doesn’t usually get out
  • Even when you’re out of town, she’ll still have a consistent visitor
  • She will be the boss and SHE gets to decide what she does, together with her caregiver

When seniors see that they are not giving anything up, they are not losing anything, they are more receptive.  Seniors are often keen to accept new friends and live life more fully.

Help your mother to see all that she stands to gain, and the conversation may be easier.  We’ve helped countless families through the exact same struggle you’re experiencing, and we can make suggestions specific to your situation.  Call us for more ideas!

 

A senior benefits from homecare by suddenly eating better meals and that senior now has more energy to independently manage more tasks. Another senior might benefit from our accompanied transportation and now that senior can attend all the activities and functions she once enjoyed.  She is regaining her life back; she is not losing independence!

 

 

When seniors recognize what they can gain from homecare, they are more receptive.  They are gaining a new friend who will ensure that they enjoy each day and live it to the fullest. 

 

The good news is, we managed to win them over and now they are clients who absolutely adore their caregivers and can hardly imagine life without Warm Embrace.

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