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. 

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 absoultely adore their caregivers and can hardly imagine life without Warm Embrace.