Prevention of hip fractures among older adult Canadians could have benefits to the larger health care system; but more importantly – to the quality of an individual’s remaining years.Kayla Bartkowski/Getty Images
Thelma Fayle is a writer based in Victoria.
Come winter, Canadians often find themselves on slippery ground. And as I grow older, I think about falling more frequently than I did even a few years ago.
Two seniors in my family have had life-altering falls. Aside from the substantial Canadian health care costs, there was also an unmeasurable cost to the lost quality-of-life for each of them. For my vigorous stepfather, a man in his 80s, the broken hip caused by his fall was the beginning of the end of his life. He fell off a curb where a yellow hazard marking had almost completely faded. As he began a sad and rapid physical decline, the culprit curb was quickly and dutifully repainted by the city – hopefully safeguarding others. Not long after, when my mother was in her 80s, she went over on a tiny granite pebble – the size of a kernel of corn – and ended up with three breaks in her wrist and arms. Determined not to repeat the painful performance, for the rest of her life, wherever she walked, she scoured the ground before her. She beat the odds and lived well for another 20 years after her fall, but wisely carried a lurking fear of another life-changing nosedive.
Neither relative knew anything of the art of falling. Both crashed to the ground in the usual way – filled with paralyzing tension.
Recently I witnessed a third family member fall; this time in the bathroom while rushing to do something inconsequential. But the outcome was completely different.
As my husband, a senior, slipped on the tile floor and started to go down, I immediately thought the outcome was going to be bad. As he hit the ground, the terrifying thought flashed through my mind that I would not be able to help him get up.
But in spite of having limited mobility due to his ankylosing spondylitis, a severe form of arthritis, he shifted his head to avoid hitting the sink, slightly rolled his body and landed less harshly and avoided breaking his wrists. I was shocked when he jumped up – as if he had springs on his feet – and comforted me with assurances that he was okay. I was startled by his quick movements and worried he was operating on adrenalin and might have broken bones.
My husband, who had played and coached football for several years almost five decades ago, explained that he had “learned how to fall” in his youth. Even all these years later, he instinctively knew how to best go down and roll with it.
He recalled an exercise where his football coach had players run on the spot. At the sound of a whistle, the players had to fall to the ground, and then immediately get back to their feet and start running on the spot again. His remembered drills gave me a sense of why his fall-response was ingrained. My husband has fallen thousands of times.
His key advice in learning how to “fall properly” was to: lean into the fall; swing your arms to get some control over where and how you land; protect your head; relax; try to land on your fleshy butt and thighs; and roll on contact. “If you tense your body, everything locks and bones can snap,” he said. “Do your best to go down like a sack of potatoes.”
Never having had sports or military training, I had not heard of the idea of learning how to fall. I was surprised that the skill is not more widely taught to people of all ages – but particularly to seniors. I checked in with a dozen similarly aged friends, and none of them were familiar with the practice. One friend, a community nurse for 35 years, said she had no knowledge of the concept.
A recent study promoting fall prevention, was led by Dr. Jacques Brown of the CHU de Québec Research Centre. His work revealed that three out of four seniors who suffered fractures between 2011 and 2015 were women. (Although bone loss and osteoporosis are key factors, I wondered if the higher rate of women who suffered fractures was partly due to women of that age being less likely to have been involved in contact sports or military training in their lifetime.)
Although it may be harder to master the art of falling when a person is older, I learned there are safeguards we can put in place.
Along with many YouTube videos on how best to pick up the skill, some community centres offer courses specially designed for seniors. And then there are fall tips, grab bars, railings, non-slip flooring, better lighting and removing tripping hazards – all straightforward ways to help seniors prevent serious falls. Even simple daily chair exercises can lead to a small strengthening of bone density, decreasing the likelihood of hip fractures that routinely happen to elder Canadians. Mopping, walking, swimming, dancing and mowing the lawn are easy exercises that can help to lower the risk of fractures. Weight-bearing exercises – even with a 2 lb weight – can also be helpful. Quitting smoking is another way to keep bones from weakening. The impact of eating calcium and vitamin D is also worth exploring. But probably the most valuable tip of all is to slow down. Falls often happen when people are rushing – and they often happen in bathrooms with unforgiving surfaces!
Prevention of hip fractures among Canadian elders could have benefits to the larger health care system; but more importantly – to the quality of an individual’s remaining years. As André Picard wrote in The Globe and Mail earlier this year, falls almost always lead to more serious health problems for seniors and, frequently, to an earlier death.
The only person I spoke to who had any concept of learning to fall was an old friend of mine, Ann Wasserman, whose father counselled her after she fell while roller-skating decades ago. Father had been determined to teach daughter to learn to fall, not because she was blind, but because he said it was a smart thing to know. A lifetime later, as an 84-year-old, retired special education teacher in New Jersey, my friend believes her reflex fall-response has served her well. Not many dads taught their little girls about the art of falling in the 1940s.
My octogenarian friend is grateful to her father’s early guidance. In addition to learning to fall, she suggests there are three important things seniors need to remember: Concentrate on striving for a good posture, attempt to walk at a normal pace, and wear the right footwear – as different shoes affect the way we walk.
Ever-the-teacher, she also proposed ageist attitudes need to die off. “Too many people view walkers and canes as a source of shame and embarrassment. They need to be seen for what they are: solid, helpful, mobility tools – just like cars, and bikes.”
As I strive to embody falling-strategies into my reflex-response mode, I am reminded of Ring Around the Rosie, the old nursery rhyme with its fatalistic ending. Even if we Canadians do tread on slippery ground for a good chunk of the year, and will eventually “all fall down,” maybe we could inspire our savvy seniors to attempt to tumble a tad smarter.