Seniors at Fall Break
Robert A. Hayden, DC, PhD
My title above is designed to catch your attention. You may be thinking about upper level college students on a fall break. If you are a guy, you may even have visions of "Girls Gone Wild" in your head.
Now the disappointment: I am really referring to senior citizens who, when they fall, break. I would like to take this opportunity to talk about a topic that is personally important to me because I take care of an aging parent. No only am I not alone, but there are going to be many more caretakers like me who are providing for parents as the Baby Boomer generation comes of age.
Mr. and Mrs. Brunson are in their late eighties. They lived alone with precarious independence that was as fragile as their health. Nevertheless, they cared for each other in their golden years as well as they could. Life was "normal."
Then Mrs. Brunson recently suffered a catastrophic fall at home. She fell onto her left side, fracturing her upper left arm and her left hip. She went to surgery quickly for insertion of metal rods, screws, and other hardware designed to stabilize her broken skeleton.
Mr. Brunson, who suffers from his own list of ailments, is trying his best to help serve her needs. They exemplify what is meant by "till death do us part." They are an inspiration to watch, even in a time of personal tragedy and stress.
The Baby Boomer generation is moving through the pipeline of life, swelling the conduit by their sheer numbers. Their parents, members of "America's Greatest Generation," are well into the golden years. Many "boomers" are caring for their parents at home, in nursing homes, or personal care homes.
One of the greatest threats to seniors like the Brunsons is sometimes very difficult to prevent. A fall is simply their worst and most likely nightmare.
Among those of the Brunsons' generation, falls are the leading cause of injury deaths and the most frequent cause of non-fatal injuries and trauma-related hospitalizations. The Center for Disease Control (CDC) tells us that in 2005, 15,800 people 65 and older died from injuries related to unintentional falls. About 1.8 million people 65 and older were treated in emergency centers for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized.
More than 95% of hips fractures occur among seniors over the age of 65. These fractures lead to a period of immobility, and that immobility itself carries a high mortality. Most of these patients are hospitalized for at least a week after the accident. About a quarter of the seniors who lived independently before their falls are in nursing homes as much as a year later. As many as 20% of these unfortunate folks will die within a year of such a fall. Men are almost half again likely to die from hip fractures compared to women.
These are sobering numbers for those of us, myself included, who are primary caretakers for senior parents or other relatives. The worry is compounded when the caretakers must leave home to make a living.
Women such as Mrs. Brunson account for about 80% of the hip fractures of the elderly. Seniors of both genders are ten to fifteen times more likely to sustain hip fractures in their mid-eighties than they are in their mid-sixties, so risk increases exponentially with age. This is even worse for those with osteoporosis.
So, what are you as a caretaker to do to prevent such an ignominious end to one so dear to you? How can you ensure safety to your loved one when you are at work? Here are some practical ideas that might help you.
Help your senior stay in shape. Walking regularly will help to keep muscle tone, maintain bone density, and take in some fresh air. Additionally, sun light exposure, despite all the warnings of risk, has positive effects on many aspects of body chemistry, including mood elevation through stimulation of the pineal gland and production of vitamin D for bone health. Aside from these proven benefits of outdoor exercise, it is just fun to hear the birds sing, watch the squirrels play, and observe dogs walking their people.
Review your senior's medications periodically. Be aware of those drugs that may change blood pressure, affect mood, or alter equilibrium. If you need help, ask your pharmacist for advice. Many seniors are over-medicated and may be at risk for injury due to their own prescriptions, interactions among drugs, or interactions between drugs and foods. Your pharmacist can help you understand the risks in the bottles and even weed out those prescriptions your senior may not need.
Get your loved one's eyes checked on a regular basis. There are many conditions that affect eyesight among the elderly, but the most frequent one is macular degeneration. If your dependent has this condition, be sure the living space is as well lit as possible. Ask your pharmacist or doctor about anti-oxidants that may prevent or mitigate some macular degeneration. Ask your optometrist about magnifiers that use digital camera technology to help people with low-light vision to read again. This is a tremendous comfort to someone whose sight is diminishing.
Patrol the living space yourself. Pretend you cannot see or walk well. See what hazards might exist that you may not ordinarily recognize because you are physically whole. Specifically, is there a table that projects too far into a hall or walkway? Are there objects that could impede you? Are there pets who, while expressing love, might cause someone to trip? Are there light fixtures that hang too low? Can your senior walk from a bed to a bathroom in the dark with an unobstructed course? You can also get fluorescent tape to mark a safe pathway at night. Nightlights will also help.
How safe is the shower or bath? Are there hand holds? You can get plastic chairs to place in the bath tub for safety during bathing. Place towels such that your senior does not have to reach awkwardly while standing on a slick, wet tub. Consider placing some friction stripes on the floor of the tub.
Are there stairs in your home? They are not a barrier to you, but they are a safety hazard for a senior who is weak, wobbly, or sight-challenged. Ramps can be built easily. Handholds will help.
Provide a simple method for emergency communication if your senior has a problem. You can find security companies that provide panic-button devices that are worn around the neck. However, a cell phone in the pocket is more versatile if it is easy to use. It allows your loved one to call you with a single touch in the event of an exigent situation. It also provides a way for your senior to connect to others and prevent loneliness in the long hours that you are away on your job.
Well, Mrs. Brunson went to a nursing home for recovery and rehabilitation. Mr. Brunson is trying valiantly to help with her care as much as he can, but it was a great help for her to have the professional nursing care during her post-operative period. He could not possibly have care for her properly, but no power on Earth would have stopped him from giving his all.
I think the Brunsons will make it, but their story is far from unique, and with the boomers getting older, it will be even more even more familiar. For those of us who have seniors at home, there is much to consider. We want to keep them as safe as we can.
In a conversation with a World War II and Korean War veteran recently, I urged this treasure to be careful. After all, a fall in the shower is not the way for one of America's Greatest Generation to go.