Fear and Falling

Did you know that falls are the second leading cause of accidental deaths in the world? 

So you have good reasons to be afraid of falling. 

Maureen's hand showed no fractures.

Personally, I have a hard time standing on a short ladder to change a light bulb because I get vertigo, so I’ve never been the kind of person that likes rock climbing. Even when I studied dance, I was fine on the floor, but the minute my gym teacher wanted me to walk down a balance beam in gymnastics, I was frozen by fear. I am in awe of Olympian athletes who fall over and over again, practicing for perfection. In sports such as soccer, falling is as common as running. For the elderly, falling is a completely serious matter, and prevention is hardly a straightforward issue.

My mother has luckily learned to fall in a relaxed way, often taking advantage of a wall to slide down; so far she has been spared broken bones. Still, due to blood thinning medication she bruises easily, and the aches and pains after a fall take a long time to go away. We use arnica and other creams and gels, massage, hot showers, and gentle stretches to help the healing.

Even dancers need support.
Pablo Picasso
Two Dancers III, c. 1922

I taught her some basic posture secrets I have learned from my own yoga practice, and I remind her to take her time, to watch the path ahead as she takes careful steps, and to use railings or me for extra support. She has a tripod cane when she needs it. She always has on shoes or slippers with a rubber grip sole. We have eliminated rugs she can trip on, put a nightlight in the bathroom, and generally keep clear pathways throughout the apartment. But lately I have been wondering what else can be done besides these common sense preventions.

In a fascinating 2016 article by Robert Epstein, he elucidates the problems with the information processing metaphor of human intelligence. I think this is particularly informative reading for those interested in Alzheimer’s and memory shortcomings, because we tend to use that prevalent metaphor to describe the apparent wiping out of memories. Epstein explains:

Because neither ‘memory banks’ nor ‘representations’ of stimuli exist in the brain, and because all that is required for us to function in the world is for the brain to change in an orderly way as a result of our experiences, there is no reason to believe that any two of us are changed the same way by the same experience. 

What if the Alzheimer’s affected brain loses in part the capacity to “change in an orderly way” as a result of experience? Might certain kinds of experiences solidify knowledge that there are, for example, better and worse ways to respond during a fall? How can fear be kept in check so as not to morph into unreasonable phobia? The New York Times recently reported on a popular course in the Netherlands that teaches elderly about falling and prevention strategies. As in any learning situation, it seems that the social aspects of taking a course with others helps the experiences among instructors and participants bring in humor, lessening the paralyzing effects of irrational fear.

It may seem obvious, but many elderly people take medications that can cause dizziness, which is the third most common cause of falls for that population. Meds can make them feel faint or weak, and even slight dehydration can bring on those symptoms.

Mimi is a senior cat but she still can jump up on a lap.
When cats fall, they usually land on their feet.

This makes them even more vulnerable to falling or losing their balance. In my mother’s case, she is often reluctant to admit she needs assistance, so I have to be proactive and try to diminish the stigma she feels about being dependent on me. It helps to blame medication, so even though it may be hard to know precisely the cause of periodic lightheadedness, that’s my go to reason. Because of her memory issues due to Alzheimer’s she will often ask why this is happening to her, and she sometimes even forgets that she had a fall that presented some serious setbacks physically. Reminders that her medication may mean she needs my help to get up and moving seem to alleviate her despair in being less independent.

My goal is to get her back into the pool, as swimming has always been her favorite kind of exercise. Even walking in the water is good for the body, with water providing resistance and a safety cushion if you lose your balance. 

 

Some pools build a river with a current due to the popularity of water walking for exercise.