Thursday, April 30, 2009

Preventing Falls: Resources

If you haven't read it, please take a look at today's tips to prevent falls in the post "Preventing Falls".

There are many good articles about preventing falls on the Web. I've listed the ones in which I found the information I've shared. They have good details to get you started.

Department of Health and Human Service. Centers for Disease Control and Prevention. Injury Center. Preventing Falls Among Older Adults. Accessed 4/30/2009.

Wright State University--Miami Valley College of Nursing and Health. Tips to Prevent Falls in the Elderly. Updated 9/16/1998. Accessed 4/30/2009.

Tremblay, KR and CE Barber. Preventing Falls in the Elderly, Consumer and Family Online Fact Sheet No.10.242. Colorado State Cooperative University Extension. Updated 6/9/04, Accessed 4/30/2009.

Health A to Z. Preventing Falls in the Elderly. Merck Source: Health Information, Pure and Simple. Published 10/18/99. Reviewed 2/3/2003. Accessed 4/30/2009.

To find more detail , in your Browser Advanced search box, use three search concepts combined with an AND:
Concept #1: Falls or Falling
Concept #2: Preventing or Prevent or Avoid or Prevention
Concept #3: Elderly or Seniors or Older Adults or Elders or Aged
Search examples: "falls and preventing and elderly"; "falling and elders and avoid"

Happy Reading!

Preventing Falls

Earlier this week, we talked about the importance of preventing falls in keeping your parents healthy and independent. It is equally important for you to check your own situation for hazards so that you can continue caring effectively. Here are some tips in each of the five prevention areas:

Prevent Osteoporosis
  • Eat or drink sufficient calcium. Post-menopausal women need 1,500 mg of calcium daily. Men over 50 need 1,200 mg per day. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds.
  • Get sufficient vitamin D to enhance the absorption of calcium into the bloodstream. Men and women over 50 need between 400 IU and 600 IU daily. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement. Check with a doctor for more details.
  • Do regular weight-bearing exercises. There are many ways to add weight. Lifting books and walking use weight and gravity to give your bones a workout. Use light exercise bands, hand-held weights, or weights that slip around wrist or ankle when exercising or when doing housework, gardening, or mowing the lawn with a push mower.

Get Moving!
  • You've heard this before, many times...because it's TRUE. Maintain a regular exercise routine (e.g., every day for about 15 minutes, every other day for 30 minutes a day) designed to increase muscle and bone strength, and to improve balance and flexibility. Choose something enjoyable that you will stick to, and be consistent. Mix it up. Walk one day, use light bands for strength exercise another day, do water aerobics another. Check with a doctor to design a program right for you.
  • Undertake daily activities in a safe manner, such as reaching and bending properly, taking time to recover balance when rising from a chair or bed, learning the proper way to fall, and learning how to recover after a fall.
  • For improved balance, try Tai Chi. Researchers at Emory University in Atlanta found that this Chinese martial art of slow steady body movement improved balance in older people after just a few weeks and cut the risk of falling nearly in half.

Check Your Vision
  • Clean eye glasses often to improve visibility. It's a simple thing, but critical!
  • Wear the glasses prescribed by the physician. Don't be vain, we're talking about avoiding broken bones and torn muscles.
  • Have annual checkups by an optometrist to discern the extent of age-related eye diseases such as cataracts and glaucoma.
  • Use color and contrast to define balance-aiding objects in the home (e.g., grab bars and handrails).
  • Add contrasting color strips to first and last steps to identify change of level.

Review Your Medications

  • Know the common side effects of all medications being taken.
  • Talk with a physician or pharmacist about ways to reduce the chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance.
  • Remove all out-of-date medications and those no longer in use.
  • Suggest that a physician or pharmacist conduct a "brown bag lunch" medicine review of all current medications at a local senior center and attend.
  • Limit intake of alcohol as it may interact with medications.

Make Your Home Safe

Did you know that one-third of all falls occur inside the house? You do a safety check if you have an infant or toddler in the house. Why not give your parent (and yourself) the same consideration?

  • Do a safety check around the house. Check for clutter, extension cords, scatter rugs that may slide and flooring that may be uneven.
  • Improve lighting
  • The bathroom can be a dangerous place. Add sturdy handrails in the tub, shower and by the toilet.
  • For a checklist of ways to make the home fall-resistant, check out the web site at the National Center for Injury Prevention and Control (See the "Preventing Falls: Resources" post).


  • Be very conscious of where you’re walking when moving out and about. Slow down.
  • Uneven walking surfaces, like uneven pavement, cracks and sidewalk potholes can be treacherous. Make sure that all the walks and driveway at the house are in good repair.
  • Mother Nature does her share to trip up a walker. Snow and ice are the biggest culprits here. Prevention means proper shoes for inclement weather and a bag of kitty litter in the car to take care of slippery spots.

Dress Properly for Walking

  • Wear low-heeled shoes with rubber soles. You’ll see many seniors in good athletic walking or running shoes. These give support and do not easily slip. Avoid leather soles and scuffy slippers.
  • Ask your doctor where you might obtain protective gear available to protect hips and limbs when you do fall. Elbow and knee pads that are used for roller blading or skateboarding are good.
  • Make sure that clothes fit properly. No long pant cuffs over which you might trip. Keep sleeves the proper length so that you can get a good grip on a handrail, walker or cane. Trousers that are too baggy can impede your progress.
  • For women, consider using shoulder bags that you can carry across your chest or small backpacks instead of purses which you clutch under your arm or hold in your fist. Shoulder bags and small backpacks keep both hands free to assist in balance and for gripping.

Many of these tips come from organizations and professionals who have many more suggestions. I've listed these in another post entitled "Preventing Falls: Resources". Check it out!

Have a safe and happy day!

Tuesday, April 28, 2009

"I've Fallen..."

We smirk at the commercial of the older woman calling out for help, but the statistics are sobering. According to the Red Cross, one out of every three persons over the age of 65 sustains an injury through a fall each year. Other sources report that, overall, falls are the second leading cause of unintentional injury and death in the United States and the leading cause of injuries. Falls are the leading cause of death for Americans over 65. About 90% of those who fall are aged 65 or older. Two-thirds of those who fall will fall again in six months.

Although we do hear of broken hips or thighs that require hospitalization for the elderly, most falls do not result in serious injury. However, there is often a psychological impact. You know from your own experience that if you fall, you become vigilant, at least for a while, in any similar situation which might cause you to fall again. For the elderly, the psychological impact can be even more dramatic. My mother, in her 60's, slipped and fell on an icy patch while running errands. Bruised shoulder muscles brought her pain for weeks. More restrictive was the way that she began staying home, stating in even the mildest winter weather that she might fall. Staying home made her depressed and fearful, since she was not engaging in activities that she enjoyed and that may have lifted her spirits. Studies show that approximately 25 percent of community-dwelling people aged 75 or over unnecessarily restrict their activities because of a fear of falling.

From these statistics it is easy to see why preventing falls for your parent is the #1 measure you can take to increase your parent's chances of living longer as an independent, active individual. Preventing falls will also relieve you, the caregiver, of unnecessary worry and more care duties. Preventing falls is a good practice not only for your parent but also for you, so that you can care without the burden of injury. Since the majority of falls happen at home, many can be prevented.

There are five major factors that contribute to falls:

· Osteoporosis
Osteoporosis is a condition wherein bones become more porous, less resistant to stress, and more prone to fractures. It is a decrease in bone density which contributes to falls and resultant injuries. In some cases, a bone breaks spontaneously, causing the fall; in others, the fall comes first with breakage as a result.

· Lack of Physical Activity
Physical activity helps muscle tone, bone strength, and balance. All of these physical capabilities are needed to stay upright on unsteady ground, walking up or down stairs, and dressing.

· Impaired Vision
Medications, aging, and illness can all contribute to changing vision. Less visual acuity means that we miss obstacles and may feel less balanced.

· Medications
Dizziness, drowsiness, and decreased alertness are side effects of some medication and all can contribute to falls. Be particularly aware when a new medication is added to what is already prescribed. Often a combination of medications will cause a problem when taking only one drug will not.

· Environmental Hazards
These hazards include icy sidewalks, wires lying across a floor, slippery tubs, throw rugs, and pets. Inside or outside the house, anything that hinders walking or contributes to uneven or unsteady floors can be a cause of a fall.

Begin this week to become more observant of your parent's environment, perhaps to ask more questions. Has your parent been tested for osteoporosis? What are the side effects of her medication? When you visit, look out for potential hazards in the home that could easily be fixed. Can your parent see clearly?

Make your preliminary list and on Thursday, I'll share things you and your parent can do in each hazard area to prevent falls, and provide a few resources to read more.

Until then, be safe!

Thursday, April 23, 2009

Myths of Eldercare

I'm wrapping up this week of blog introduction with a reality hidden beneath the fuss and flurry that is often a caregiver's life. A reality that affects how you and your parent react to the dynamic caregiving situation you both have entered. A reality of which you may be totally unaware.

After the first months of caregiving, as I recognized that my relationship with my ailing mother was more complicated than I ever imagined, I spent a lot of time reading and talking to others about the emotional and relationship side of parentcare.

What I learned along the way was that I had bought into the Myths of Eldercare:

MYTH 1: In all families, parents and children love each other unconditionally.

MYTH 2: No matter the quality of the parenting, parents deserve a child’s unquestioning devotion, duty, love and service.

MYTH 3: Every child is obligated to care for his parents as they age.

MYTH 4: A person honors her parents only if she sacrifices her own life and mental health for the sake of the parent. Without total sacrifice, the child can not be judged as “good”.

Note the "all-or-nothing" quality of each of these myths. They are rarely stated outright and never written down. We breathe them in from our families' actions, conversations with friends, from newspapers and television. The myths invade us as easily as secondhand smoke and become a part of us. And in living, we act as if these myths were immutable laws. They become the bars of a cage, restricting the options we have in life. Often we don’t even think about what we are doing. We just act.

What are the Facts of Eldercare?

FACT 1: Parents and children should love each other unconditionally. But let's be honest, dysfunctional families exist. Even in "normal" families, love's depth and expression are different and different even between each parent and child.

FACT 2: Parents are human, and their love is not always given in a fair or evenhanded manner. Some parents are abusive; some have abandoned their families. Being a parent is no guarantee that a child will offer unquestioning devotion, duty, love and service. (Talk to a teenager sometime for clarification on this point.)

FACT 3: There is no contract or rule that obligates a child to care for an aging parent. The Bible says, “Honor Thy Father and Thy Mother,” but it’s vague on how to do that. In any case, you can not mandate love or respect.

FACT 4: Sacrificing your own well-being in caregiving does your parent no good. It drains precious energy away from caregiving and weakens you. To care for someone else, you must first care for yourself.

What I'm asking you to do now is to be honest with yourself. Have you accepted any or all of the myths as Truth? If you have, how might your belief in the myth affect how you talk with your parent, decide priorities in your life?

And just as important...does your parent believe in any of the myths? Does that belief bring with it expectations that you might not be able to meet?

A counselor once told me that 80-90% of our behavior comes from the subconscious, from our instincts, from beliefs deep within us. Until we pull the myths up into our thinking, conscious decision-making brain, we will act on them instinctively, perhaps to our detriment.

What myth do you believe? Is your belief filling you with guilt or with joy in your caring? Do you need to discard that myth for something more realistic, more positive? Is your myth helpful?

Tuesday, April 21, 2009

Welcome to Parentcare 101!

My mother lived in the small town in which she had been born. When I began caring for her, I lived over 250 miles away. My sister, my partner in caregiving, lived another 500 miles away from me. The geographic distance promised to add logistic difficulties to an already difficult situation. Within weeks, I recognized another sort of distance that would play a tremendous role in my caregiving--I didn't particularly like my mother.

These were the facts of my situation. They were unique to me.

What are the facts of your caregiving circumstance? I'm guessing they are different. What can you recognize as challenges? What about your situation makes you breathe a sigh of relief that, at least that one thing is working among everything that you deal with on a daily basis? Do you view your caregiving as a duty, a sacred trust, payback or a little of all three?

In Parentcare 101, you and I will take a look at your unique situation and offer tips and suggestions. These ideas will be perfectly valid if you care for an elder who lives with you or with whom you have a loving, supportive relationship. But in Parentcare 101, I acknowledge that for many of you there is distance in parentcare...either because your parent does not live with you or because your relationship with your parent is not perfect. Together, we'll explore what needs to be done, how best to get it done and whom you should ask for help. Although all of your situations are different, caregivers deal with three areas of care:
  • Providing Basics for Your Parent: food, shelter, clothing, health care, transportation and a social environment;
  • Caring for Yourself: placing yourself at the top of your priority list so that you will have the energy and stamina for caregiving; and
  • Preparing for the Future: gathering information about your parents, their home, available resources, always looking forward just a little.

Each week in Parentcare 101, I'll focus on one of these areas. I plan to post twice a week on Tuesdays and Thursdays. With this schedule, you'll know when to check in for something new, and we'll have time for comments and processing one topic before moving on to the next.

An integral part of the service of this blog is the Parentcare 101 website. The website and this blog will work hand-in-hand to share tips, resources, and advice. I know that those of you caregiving now have a lot of great ideas. Bring them on.

To get us started on our journey together, on Thursday, I'll talk about the "Myths of Eldercare" and how those myths can block good care for your parent and for you.

See you on Thursday!

Tuesday, April 14, 2009

Coming Soon!

On Tuesday, April 21, 2009, Parentcare 101 will launch. Looking forward to sharing CareTips and resources for caring for your aging parents. See you on Tuesday!