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According to the Center for Disease Control, each year, one in every three adults age 65 and older falls. Falling can cause moderate to serious injuries, including head injuries and hip fractures, and can increase the risk of dying.
“When an elderly person falls, they are more likely to be injured,” says Dr. Roy Adair, chairman and medical director of the Department of Physical Medicine and Rehabilitation at Advocate Christ Medical Center in Oak Lawn.
Their protective reflexes are slower, as opposed to someone younger, making it harder to prevent injury from afall. A younger person will be able to “go with the flow” with a fall versus taking the full force on the head or the arm for example.
“The musculoskeletal system changes with age resulting in loss of strength, decreased flexibility and slowing of reflexes,” adds Adair. “This occurs gradually at about a 1 percent loss of measured ability per year.”
The good news is falls in many instances are preventable.
“It is important to realize that balance is a skill that can be trained and improved,” says Adair. “Physiatrists are trained to evaluate functional abilities and recommend treatment to address the deficits identified. An assessment may result in recommendations for home exercises to increase balance or referral to a physical therapist for a more aggressive and monitored program to improve strength and balance.”
Get with the program
This health problem is of concern to anyone who works with the senior community, especially continuing care residential communities known as CCRCs. Fortunately, some of them are addressing these issues head on through on-site programs tailored to their residents. Two such communities are GreenFields of Geneva and Senior Star at Weber Place in Romeoville.
“As we age, fitness is especially important to staying healthy and active so that we’re able to complete every day activities and enjoy our hobbies,” says Judi Donovan, GreenFields’ executive director. “There is a strong correlation between strength and balance, both of which in turn help tremendously in terms of fall prevention.”
GreenFields utilizes a tool called Senior LIFEsteps that evaluates where people are at in terms of activities of daily living. AJ Alfrey, exercise physiologist of Alliance Rehab (the on-site rehab/exercise provider at GreenFields), invites every resident to participate in this assessment, which checks balance, gait, physical ability, endurance and agility. Alfrey also invites each resident to tour the fitness center during which time he explains the programs and classes. He then develops an individual fitness program for their specific needs and goals. The residents are re-assessed after 12 weeks of participating in the designated program.
Alfrey says that as we age, we tend to lose lower body mass more quickly than upper body mass, which raises our center of gravity and makes us top heavy. “It’s very important to work on lower body and core strength in order to help reduce the risk of falling,” he adds. “Our legs obviously support the rest of our body, so having strong legs makes our base of support stronger.”
Alfrey says he is able to modify a fitness program for any physical limitation or disability. “We encourage everyone to exercise,” he says.
Senior Star recently established a “Falling Stars” program for the independent and assisted living residents in all 10 of its retirement communities across the U.S. including Weber Place in Romeoville.
“Good balance and strength are important as they promote good circulation, prevent muscle atrophy, and assist with ambulation,” says Nate Wolf, assistant executive director at Senior Star at Weber Place. “The more a person moves around, the more confident they feel and it helps them maintain their independence.”
Acknowledging that balance is a growing, worrisome issue as people age, all residents at the community are offered an in-house complimentary fall/balance screen performed by Legacy Health Services. Anyone who could use strengthening or balance improvement is encouraged to attend a program/fitness class on balance.
“The Falling Stars program is a program we started to increase the strength of our residents,” says Wolf. “The staff encourages each resident to attend an exercise class at 11 a.m. every day, seven days a week. It is staffed by a rotation of our nursing team. They do chair exercises and exercises standing up and holding onto the back of the chair. It is very important to keep the calf and feet muscles strong in order to keep a good balance for walking. By meeting each day, it has become a social activity as well, and the residents look forward to seeing each other.”
Never too late
No matter one’s age, maintaining strength and balance is important to not only overall health but also quality of life.
CeCe Graham, 93, has lived at Senior Star at Weber Place for nearly two years. She was evaluated through its in-house therapy for balance and strength.
“After I moved in the staff saw that a need was apparent so they began their evaluation process by asking me to do different activities such as standing, reaching and holding still for a certain amount of time,” she says.
The assessment showed that Graham needed to work on both balance and strength to increase her quality of life.
“The therapists would walk with me and I would use small weights to get my arms stronger,” she says.
Graham’s regimen includes range of motion exercises — stretches, rotating joints, and extensions of arms and legs. She attends classes seven days a week.
“I continue to improve every time I attend class,” she says. “I get stronger and can do things more easily for myself, such as reposition myself in the wheelchair and I am able to assist the staff in transferring myself out of the wheelchair.”
Although Graham says she is not where she wants to be just yet, she says she has more self-confidence in her ability to help herself.
“I know I still need assistance from staff, but it is nice to know that they do not have to do everything for me,” she says. “And it is fun to see the same people (in class) and it gives me something to do that is good for me.”
In 2010 the 75 and older population was 19 million. By 2020 the number is projected to reach 66 million.
—Administration on aging