Saturday, April 20, 2013

Aging Gracefully: Avoiding Falls


What does Aging Gracefully mean to you?  For some of us aging gracefully is not much different than living life as it has always been--daily work for economic survival. Some of us put greater emphasis on finding spiritual meaning. For some individuals it means natural decline, sitting down, finally having a chance to rest after a lifetime of sacrifice--putting others before self. Others focus on family and caring for grandchildren. Others pursue their hidden dreams to travel and try new activities. However you view aging gracefully, the last third of life brings many physical challenges. Physical activities we took for granted no longer seem to flow smoothly, yet it is possible to regain some of our physical flow with the right physio-therapy plan.

“While aging is inevitable, there is no reason why advancing years must be associated with pain, disability or mental decline. You cannot stop the changes of time, but you can modify lifestyle and activity as you age, and it is good to know that help is available to maintain the efficiency of your healing system." -- Dr. Andrew Weil

The difference between an effective aging lifestyle and feeling limited by aging is knowledge. Knowledge is proactive and empowering. We now know that those individuals who said, “The brain is like a muscle---use it or loose it,” were actually right. Neuroscience research shows early therapy for developmentally delayed children does create changes in the brain. We have also learned that body-mind strategies can help maintain our vitality as we age.

Neuroplasticity is the word used to describe this brain attribute. The brain and nervous system have the capacity for adaptation or regeneration. The brain has a natural ability to form new connections in order to compensate for injury or changes in one's environment.
Current questions being researched concern the manner in which the brain will modify its structure and function throughout one's lifetime. Recently research has identified the extensiveness of experience-dependent alterations that take place in the brain. The definition of life experience has broadened to include drug and hormone experience, brain injury, and aging.

Dr. Helena Popovic in her article To Harness Neuroplasticity, Start with Enthusiasm (12/31/2012) has this to say:
“For millennia, however, we were oblivious to our enormous creative capabilities. We had no idea that our brains were changing in response to our actions and attitudes, every day of our lives. So we unconsciously and randomly shaped our brains and our latter years because we believed we had an immutable brain that was at the mercy of our genes. Nothing could be further from the truth. The human brain is continually altering its structure, cell number, circuitry and chemistry as a direct result of everything we do, experience, think and believe. This is called “neuroplasticity”.  Neuroplasticity comes from two words: neuron or nerve cell and plastic, meaning malleable or able to be molded. The implications of neuroplasticity are enormous: we have the ability to keep our brains sharp, effective and capable of learning new skills well into our 90s, if we protect our brains from damaging habits and give them ongoing stimulation and appropriate fuel.

“As little as three hours a week of brisk walking has been shown to halt, and even reverse, the brain atrophy (shrink­age) that starts in a person’s forties, especially in the regions responsible for memory and higher cognition. Exercise increases the brain’s volume of gray matter (actual neurons) and white matter (connections between neurons)…it is also important to maintain emotional connections. Not only with ourselves, to have self-confidence and self-esteem, but also with our family our friends…. Sleep and over­all health conditions are other factors that also matter.”

To take Dr Popovic’s advice we need to maintain our activity level. This means we need to accept that as we age, falls are a symptom telling us there is something in our life style we need to address. We should always start with the easiest lifestyle changes such as removing tripping hazards in the home (remove loose wires and throw rugs) and having a yearly vision exam. As we live in our bodies we accommodate to them and over time we do not consider that there might actually be something we can do to improve our situation.

My elderly father became embarrassed by the fact that he was tripping over things. He displayed a great deal of difficulty getting up out of his chair. At one point he fell off a thick jute outdoor doormat and as a result of the fall broke a window in the storm door. My father was fully competent but he never considered changing anything in his lifestyle—even easy things. My attitude was why sit here and be embarrassed when all of these things are fixable.

Of course he was angry with me because he did not want his child telling him how to live—but the truth was he was just stuck in old habits. I threw away the inch thick jute doormat (which was probably the worst product ever created by man!) and bought a very effective thin rubber doormat. I threatened to throw away his slip-on shoes, which were a size too large (he bought them because they were a bargain). We compromised by him going out to get athletic-style shoes with Velcro closures. He went to the eye doctor. And I took him to the osteopath to check on pinched nerves in the low back, which might be causing toe dragging and clumsiness. Pinched nerves adversely affect the body’s process of proprioception.

Proprioception is a neurological feedback process between the brain, sensory organs and muscles. As our muscles, tendons, joints, and inner ear detect motion and our body position in space we respond to the physical environment. The body’s awareness of posture, movement, equilibrium, position, weight, and resistance of objects can be adversely impacted by diseases, alcohol, medication, hormones and previous injuries.

Fall-related injuries, such as hip fracture, can have a serious impact on your life. If you fall, it could limit your activities or make it impossible to live independently. The Centers for Disease Control and Prevention report that roughly more than one-third of adults ages 65 years and older fall each year. In this age group falls are the leading cause of injury-related deaths. Falls are not a normal part of aging. Most falls are preventable. As we age we must develop a wellness lifestyle that includes adequate exercise, appropriate medication management, yearly vision checks, and a review of our living environment for fall hazards.
False beliefs about older adult falls: 1. Falling happens to other people, not to me. 2. Falling is something normal that happens, as you get older. 3. If I limit my activity, I won't fall. 4. As long as I stay at home, I can avoid falling. 5. Muscle strength and flexibility can't be regained. 6. Taking medication doesn't increase my risk of falling. 7. I don't need to get my vision checked every year. 8. Using a walker or cane will make me more dependent. 9. We are unwilling to talk to family members or health care providers about the risk of falling--we don’t want to cause alarm and we worry about keeping our independence. 10. We are unwilling talk to parent, spouse, or other older adult about their risk of falling out concern for hurting their feelings; maybe it's none of my business.
Whatever our age the desire to be independent and self-sufficient is human nature. Physical activities help us stay independent. Although we do lose muscle as we age, exercise can partially restore strength and flexibility. Strength and balance exercises can be designed for you by a physical therapist that will address the body’s awareness of posture, movement, equilibrium, position, weight, and resistance of objects.

Causes of fall
·      Muscle weakness, especially in the legs, is one of the most important risk factors
·      Foot problems that cause painful feet
·      Wearing unsafe footwear can increase your chance of falling
·      Your balance and your gait -- how you walk
·      Your reflexes may also be slower than when you were younger
·      Vision problems contributing to falls include poor depth perception, cataracts, and glaucoma
·      Blood pressure that drops too much when you get up from lying down or sitting can increase your chance of falling.
·      Some medications can increase a person's risk of falling because they cause side effects like dizziness or confusion.
·      The more medications you take the more likely you are to fall.
·      Confusion
·      Sensory problems 
·      Balance Problems

There are many types of balance disorders and various treatments depending on the cause. If you experience dizziness, vertigo, or other problems with your balance see a doctor. Benign paroxysmal positional vertigo, or BPPV, is a brief, intense feeling of vertigo when you change the position of your head, such as when rolling over to the left or right, upon getting out of bed, or when looking for an object on a high or low shelf. BPPV can occur at any age and results from small calcium particles in the inner ear. These displaced calcium flakes hit the inner ear balance sensors, causing dizziness. And may be caused by an inner ear infection, head injury, or aging.

Aging Gracefully is about creating a wellness lifestyle. There is no One-size Fits All Wellness Lifestyle because we are all unique. I say again the difference between an effective aging lifestyle and feeling limited by aging is knowledge--knowledge is proactive and empowering.  Being knowledgeable gives you the personal power to know what is right for you. Everyday new knowledge gives us new opportunities for a happier, healthier life than for those who came before us. If you are interested in the advancements in brain research, understanding and technology check out this link     http://sharpbrains.com



http://www.health.ny.gov/prevention/injury_prevention/falls_in_older_adults_nys.htm





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