Pride Comes Before A Fall

It was Falls Prevention Week in June. Did it happen to pass you by? You might even be wondering what it is and why there needs to be a whole week devoted to it.

It’s very simple actually. As you get older, i.e. into your sixties, you are likely to fall more often. We all do, whatever age we are but as you get older, people tend to fall more often, sustaining injuries that can sometimes be life threatening. Even if they are not, they can leave the person just a little bit more nervous and lacking in confidence. Falls Prevention Week was started to help raise awareness of what you can do to minimise the risk of falling over.

Some of the high risk factors are: being female, being underweight, having fallen once, gait disorders as well as the practical aspects mentioned above. This list is by no means exhaustive. Dementia is also a risk factor as people’s visuospatial awareness becomes impaired.

Inappropriate footwear and the environment can also cause problems. Checking that your footwear fits properly and is in good condition, as well as having a look round the house for loose rugs/mats and trailing wires are sensible things to do. Also getting your eyesight checked more regularly can help. So, sensible, practical measures can prevent a fall.

Physical exercise can also be extremely helpful in preventing falls, which is where I come in. Yoga, Tai Chi, bowling and dancing are recommended as the best forms of exercise to keep you face up, rather than face down.

I do a class for older people which works on their strength, balance and keeping their joints mobilised. Apart from the exercise aspect, the women enjoy each others company and are often to be found chatting long after the class has finished.

As we get older our muscle strength declines and it only gets worse if we are inactive. We do some of the exercises from standing but we also exercise from a chair and I remind them constantly that they can do these at home. They persuade me that they do so, just for that reason. Many of the exercises are easy to do but if done mindfully, i.e. slowly and with full concentration on what they are doing, they keep the joints flexible and the muscles working. Simple things like standing up without pushing into the arms of the chair. Many of us do this so we work our upper body but not the muscles of the legs. Concentrate on using the legs, while keeping the head and shoulders forward, bringing the head into place last, as you come to stand. Slowly rotating the ankles first clockwise and then anti- works the joints but also the tendons and ligaments and the lower leg muscles.

The hip joints cause so many problems because we do not fully articulate the joints on a regular basis. I have them standing behind a chair and very slowly dropping down into a semi-squatting position, coming back up as slowly.

The amazing thing is that my very small class of people love it, and keep coming back for more every week. They are as frustrated as me that they cannot get more people to come along because they are now as passionate as me about how helpful the right kind of exercise can be. I have had the endorsement of the local NHS physiotherapist who wanted to be able to recommend a class to patients recovering from surgery to their joints.

A huge, huge frustration for me though, is that I cannot get any help from the local GP surgery. There is now a large body of evidence to support the fact that exercise does not just help prevent falls but can help people once they have fallen. Yet the doctors at the local surgery will not come to look at what I do, nor are they interested in me talking to them because they “do not contract with private sector providers of exercise”. I am having to breathe more deeply to keep myself calm as I type this. They can happily contract with the private sector pharmaceutical companies but they have no interest in a local provider of a service to help prevent falls in older people. This, despite the fact that falls are the single, biggest reason for call-outs to the ambulance service. 10% of deaths are associated with falls where people have fallen and may not even been injured but have not been able to get themselves up.

In the area that I live there is just not enough provision for older people and I do not believe that they are encouraged sufficiently of the need for exercise. One of my regulars who has been attending the class for over four years, struggled for a long time to find a class to help her become more mobile. Another, who has arthritis, when asked what she could do to help herself was told to keep taking the pills. She has attended the class regularly and has found improvement because of the work that we did on her posture.

It’s great that there is a week to promote this issue but unless older people, in greater numbers, can be persuaded that this is the right thing to do and that the right kind of provision, in the right quantity can be provided, older people will continue to fall. The impact, as I know personally, is shattering for the older person as well as those around them.

As I said earlier though, it’s not just about exercise. If you have an older relative, the next time you visit, have a look around for potential hazards. You might just save them from a fall.

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