by Karen Mahoney, Special to Your Catholic Herald
When slippery winter weather makes us more vigilant as we traverse sidewalks and parking lots, for older adults, falling can be debilitating, leading to isolation and illness. With a grant from the Centers for Disease Control and Prevention, researchers from the University of Wisconsin School of Medicine and Public Health, Geriatrics and Gerontology Section launched “Stepping On,” a study aimed at helping older adults conquer those fears.
Based on a study originally performed in Australia by Dr. Lindy Clemson, the Stepping On program was brought to Wisconsin for further research and modifications to Americanize the program.
The fear associated with falling can be a big problem for older adults who have fallen or who worry they might fall, according to Maureen Redmer, a registered nurse for 27 years. For the past eight years, she has served as parish nurse for St. Francis de Sales Parish in Lake Geneva, and is hosting her second Stepping On series aimed at adults over 65. Ten participants signed up for the first session and ranged in age from 69-91.
Wisconsin 5th in nation for elderly falls
“The research in Australia showed that the course decreased the rate of falls in the participants by 31 percent,” said Redmer, adding, “And Wisconsin is fifth in the nation for falls in the elderly and the second cause of death in those over age 65. Falls-related deaths can be from the fall itself or from complications from the fall such as pneumonia.”
The seven-week series begins July 27 and concludes Sept. 14. The course, free to pre-registered participants, emphasizes balance, exercise, moving about safely, home hazards, vision, proper footwear, bone health, medication, and the use of safe mobility techniques.
Redmer expects that seniors, by attending the class, will remain more independent as they age, thereby reducing the chances of residing in a skilled nursing care facility.
“I believe that the longer we can keep people in their own homes and living at least semi-independently, the healthier and more mentally alert they will remain,” she said, adding, “To say nothing of the cost of long-term care, which can eat up a life savings in a very short time.”
UW-Madison Stepping On research program manager Vicki Gobel is working with grants and state funding to test key elements that cannot be changed from Clemson’s original program, as well as revising the course to better fit American society.
“We are updating the program and working on a training program for leaders and running the series in three sites in the state,” she said. “We are directing our emphasis on three areas: independent living residences, senior centers and parish nurse programs.”
Early feedback is positive
The grants include funds for eight pilot classes in the three locations. Gobel anticipates that once data is collected from the test sites, the program will be developed further and marketed nationwide. As data collection is still coming in to the university, official results will not be available until the entire series is completed, but early feedback is positive.
“Word of mouth is that people really like the program,” she said. “We have heard that the Waukesha Senior Center has a waiting list for another program because it is so popular. This mirrors the history from around the state.”
While she has never fallen, Rita Bouras, 76, a member of St. Francis de Sales Parish, felt as if she were living on a slippery slope and was concerned that she might join the ranks of peers who have suffered hip or pelvis fractures after falling. After participating in the first session, she said she has boosted her self-confidence and learned methods to reduce her chances of falling.
“I have been really lucky and healthy all of my life, and I want to stay that way,” she said. “The program was great and it taught us about keeping an uncluttered house. I am not a messy person, but I had this big throw carpet in my front room that my grandkids would always stumble over, but not me. I learned during the class, that I should get rid of it because I might be the next one to stumble and fall.”
Fear of falling also limits activities
According to the CDC, about one in three older adults who live independently at home will fall each year. As people age and develop health issues, those odds get worse. In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized. Over the past decade, the rates of fall-related deaths among older adults rose significantly.
It appears that the fear of falling – not just the falls themselves – can cause some of the problems that lead to declining health. When seniors develop a fear of falling, they tend to limit their activities, which can lead to decreased strength, confidence and overall quality of life and which will cause the weakness and dizziness that might inevitably cause a fall.
“It can happen so fast; it might be just a simple accident, and from there it is a downward spiral resulting in an additional loss of confidence and the person becomes afraid to go anywhere,” said Gobel. “This class helps the senior adults feel empowered and can make a huge difference. They aren’t having to sit home and accept the thinking that just because they are older that they will fall and there is nothing they can do about it. Those who have taken the class feel more confident about what they can do – that’s what we have been hearing all over, through word of mouth.”
Some falls are avoidable
Some falls are avoidable. As part of the course, participants learned about engaging in meaningful activities, education about fall avoidance, and exercises. Simple techniques to conquer dizziness associated with rising from bed, from the church pew or a sitting position were especially helpful to Bouras who remembers jumping out of bed the first thing in the morning.
“We can’t do it like we did when we were younger,” she explained. “Maureen taught us to get up slower so we wouldn’t get dizzy, and to keep a flashlight by our bed so that when we got up at night we could see exactly where we are going.”
Included in the program were guest speakers that included nutritionists, exercise therapists, pharmacists, police officers, as well as a representative from Prevention for the Blind speaking on eye diseases.
For Redmer, the response has been overwhelmingly positive, and she expects that results in the study will mirror those in Australia.
“All of the participants report that they can do all of the exercises, some have been able to increase the number of repetitions and a couple have added weights, which we offer on loan during the entire session,” she said. “Several are reporting feeling more confident in their balance, less dependence on walkers and having an easier time getting up from a chair.”
Bouras urges seniors to learn more about fall prevention and to take a class if one is available because it just might make a difference in their quality of life.
“Just when I thought I knew everything, I found out I don’t,” she said, laughing. “I hope that the program expands and everyone can learn the techniques we did.”
Who is at risk? (statistics from the CDC)
•Men are more likely to die from a fall.
•Women are 67 percent more likely than men to have a nonfatal fall injury.
•Rates of fall-related fractures among older adults are more than twice as high for women as for men.
•In 2003, about 72 percent of older adults admitted to the hospital for hip fractures were women.
•The risk of being seriously injured in a fall increases with age. In 2001, the rates of fall injuries for adults 85 and older were four to five times that of adults 65 to 74.
•Nearly 85 percent of deaths from falls in 2004 were among people age 75 and older.
•People 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.
•There is little difference in fatal fall rates between whites and blacks, ages 65 to 74.
•After age 75, white men have the highest fatality rates, followed by white women, black men and black women.
•White women have significantly higher rates of fall-related hip fractures than black women do.
•Among older adults, non- Hispanics have a higher fatal fall rate than Hispanics.
What can you do to prevent falls?
Older adults can take several steps to protect their independence and reduce their risk of falling. They can:
•Exercise regularly; exercise programs like Tai Chi that increase strength and improve balance are especially good.
•Ask your doctor or pharmacist to review your medicines, both prescription and over-the-counter, to reduce side effects and interactions.
•Have your eyes checked by an eye doctor at least once a year.
•Improve the lighting in your home.
•Reduce hazards in your home that can lead to falls.
The seven-week “Stepping On” Program runs July 27 through Sept. 14 at St. Francis Parish, 148 W. Main St., Lake Geneva. Classes meet each Tuesday at the parish center from 1-3 p.m. To register for the free course, call (262) 248-8524.