Preventing falls
An innovative program helps older adults cope with their worst fear
Editor’s note: Full-length version of story.
The fear is real. Debilitating.
And if the fear becomes reality, it can change lives forever.
For many older adults, a fear of falling steadily decreases their physical activity, well-being and independence. At a minimum, their quality of life is jeopardized. At the extreme, the fear becomes a self-fulfilling prophecy.
“Falling is a fact of life. As we age, it’s just what happens to us,” says Deb Eckart, a University of Maine Cooperative Extension educator in Washington County. “We don’t have the balance we did when we were younger, yet we can do something about it. That’s why we’re teaching practical strategies to prevent falling and reduce the concern. It’s about feeling that you’re in control of your life as opposed to letting nature take its course.”
Eckart is the administrator for the Senior Companion Program, a statewide initiative of Cooperative Extension that enlists older adults as volunteers to provide in-home visits and assistance to homebound elders. Two years ago, when she heard about an award-winning fall prevention program for older adults, Eckart knew it could be an effective tool.
“We know older adults experience the fear of falling and, as a result, many curtail their activities,” says Eckart. “Many who fall end up in long-term care facilities and never get home again. The goal is to make them feel more secure and comfortable being independent. It’s really phenomenal the impact the program can have. I’ve been pleasantly surprised at how much it helps people.”
Nationwide more than a third of all adults 65 and older fall each year, according to the Centers for Disease Control. Among older adults, falls are the leading cause of injury deaths, and the most common cause of nonfatal injuries and hospital admissions for trauma. In the past decade, the rates of fall-related deaths among older adults rose significantly.
In response, the program called “A Matter of Balance: Managing Concerns about Falls” was developed by Boston University and the New England Research Institutes with funding from the National Institute on Aging. Translation of the program using a lay-leader model was led by MaineHealth’s Partnership for Healthy Aging.
In the eight-week, 16-hour class, adults age 60 and older are taught how to make changes in their environments to reduce risk, exercise to increase strength and balance, and set goals for increasing activity. Participants learn how to survey their living accommodations, looking for ways to improve safety and reduce falling fears by installing hand rails, nightlights, supports in the shower and tub, and a phone by the bed. Simple exercises done while sitting or holding the back of a chair increase balance and muscle strength.
“It’s coping strategies we’re teaching,” Eckart says. “The class also lets older adults know that what’s happening to them happens to everyone, and they can still help themselves become stronger so they can live independently in their homes.”
In the first class offered by Extension in 2007, 11 people ages 60 to 92 enrolled. Since then, more than 77 elders have completed the fall-prevention class in Washington County, including those who turned out for two capacity-enrollment courses in January.
In their home visits, Senior Companions promote the exercises for their clients, especially those elders who have ceased going to the grocery store, bank, church or post office for fear of falling.
“One lady who came to the class told us she’s so afraid of falling, she stopped going up for communion,” says Eckart, who is one of two A Matter of Balance master trainers for Extension. “By the end of the class, she was back doing volunteer speaking at her church and taking communion. By continuing to do the exercise routines every day, she said she was so much stronger and felt better on her feet. She said her quality of life was so much better after taking this class. We’ve had a number of people who have told us that.”
Questionnaires completed by participants at the start and end of the program are indicative of the difference A Matter of Balance makes. When they come to the program, often after hearing about it from a friend, the older adults say they are “afraid to do things on their own” and fear that, should they fall, they will never come home again. With the training, elders reported more confidence in being able to be active and independent, and have made safety changes in their environments, such as installing two hand rails on stairs and removing scatter rugs.
“What we demonstrate and model is that, by being more active and increasing muscle strength and balance, older adults don’t have to worry about falling as much. It is not foolproof. We can’t guarantee that because they take the class, they will not fall or break a bone. Six months after taking their classes, two participants did fall, one by tripping over something and another most likely because of osteoporosis. But evidence shows that, overall, those who take the class feel stronger and better about themselves, and feel more secure living in their environments.”
Especially in rural areas where there are no sidewalks or shopping malls for walking, and where winter weather leaves elders homebound for months at a time, A Matter of Balance can make a difference in overall well being.
“When people tell me they’re doing their ankle rolls in church and their knee-raising exercises watching TV, and they say they’re not afraid to go out any more, it’s pretty awesome,” Eckart says.
