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Prime Times Weekly publication of the Mail Tribune , Medford, Oregon Photo illustration by Steve Johnson Handrails are a boon for seniors going up or down stairs, giving them something to help maintain balance What you can do to keep from ... FALLING By following some cautions, Rogue Valley seniors can walk safely without giving up active lifestyles By JOHN DARLING Falling is one of the great fears of old age. In response, most seniors either deny it and try to move as boldly as in youth, or they get so afraid of falling they don't move enough to get the exercise they need to stay strong. The trick is to find a middle ground and learn to walk safely and confidently. "It's very frightening to hear someone fall down the stairs," said Ruch resident Margo Homeier, describing her husband Norman's life-changing tumble. "I yelled and screamed and he didn't answer." Norman, 83, escaped with head contusions and dizziness. "I was cocky and thought I was pretty agile. I thought old age was just something they talk about, but I realized I have to act my age," he said. He took the Fall Risk Reduction Program at Providence Medford Medical Center. "They told me I didn't know how to walk," he joked. Using computer visuals, therapists found Homeier was walking with his weight on his toes, shifting him out of good balance. They taught him to walk differently. "I gained a lot of confidence," said Homeier, a former athlete. "As we age, we tend to drag our feet or carry our weight more on one side and this impairs balance," said Providence's Carolyn Piatt. "Another problem is having a near-fall and reacting to it by limiting your activities. Then you get less exercise and grow weaker. Your safety zone gets smaller and smaller." Seniors often forget that walking is a rolling motion, Piatt said. They interpret the roll as a loss of balance and try to walk erect, which only makes them less stable, she added. "We teach people to bend like a willow, not snap like a pine." Using foam-pad backups, Piatt teaches seniors to fall without hurting themselves, so they learn to walk in a relaxed manner. "If you're tensed up from fear," she said, "you can't catch yourself." Piatt also insists patients exercise 30 minutes, four days a week, by walking at the mall or market. Falls are triggered in several ways, all of them preventable, said eldercare physician John Conwell, himself 75 and a nursing home specialist: 1. Getting up too fast. A person's blood pressure is lower while in bed, so standing up too fast can cause lightheadedness. Sit on the edge of the bed before standing. 2. Reduced blood circulation. Often a byproduct of aging, reduced circulation affects the balance center in the brain. Vasodilator drugs and aspirin can help. 3. Clutter. Keep walkways clear of electric cords, throw rugs, pets and children. 4. Slick, wet floors in tubs. Put hand holds and nonskid strips in showers. 5. Men standing to urinate. Sitting down will reduce risks of falling. 6. Pharmaceutical drugs. Many cause dizziness, especially if mixed. Read the warnings. 7. Darkness. As people get older, they depend more on their eyes and less on their sense of balance. Install night lights to light the way to the bathroom. A big fear is falling when no one's around to help, said Margaret Preston, 89, of Ashland, who once was unable to get up after falling when holding her walker with only one hand. "As I lay there, I slammed the bathroom door over and over, until my son next-door knew something was wrong and came," she said. Her fall deafened one ear. Now, Preston wears a Lifeline pendant. She and thousands of others need only push the button to get an emergency response monitor on the speaker phone, said Joan Becker, of Providence's Lifeline program. If monitors don't hear an all-clear from the user, they have names and numbers of the user's neighbors; if they can't find help from neighbors, they will call 911. The most common results of falling are fractures of hips, wrists and ribs, as well as head impact, Conwell said. Healing takes "considerably longer" when we're older, he added, and surgery can bring the risk of blood clots and pneumonia. Surgery and anesthesia at an advanced age can result in "severe, dementia-like symptoms" for a few weeks in about 40 percent of cases, said Tamara Cottongim, nurse manager at Linda Vista nursing home in Ashland. Fear and depression can occur, she added, as some patients realize how fragile they are and wonder, "Am I ever going to be safe?" A small percentage of hip-fracture patients never recover, Cottongim said, and "it's not an uncommon cause of death." For 20 to 40 percent, a hip fracture spells the end of independence, she said, and they must move on to life in a nursing home, assisted living facility or with relatives. The main thing, said Piatt, is to notice what you're afraid to do and keep practicing it safely. "We gradually reduce the activities of our life without being aware of it. It's so easy to make excuses for not being active, but that leads to being weaker and having less endurance. Doing just daily activities is not enough. "It's vital to keep dancing, golfing, walking backwards, moving over surfaces that aren't level," she added. "All these help us keep that ability to balance ourselves." Prime Times front page Mail Tribune front page Copyright � The Mail Tribune 1999, Medford, Oregon USA