Nobody wants to be a Humpty-Dumpty.
For seniors, a fall can be more than an inconvenience. It can mean injury and an end to independence. It can mean never being put back together again.
The statistics are stark.
One in three seniors 65 and older will fall this year. One-fourth of those will suffer an injury, perhaps a fractured hip, that requires surgery and convalescence. Only a quarter of those will make a full recovery. And the risk goes up as we age.
Numbers such as these spurred an orthopedic surgeon, a resident of Tampa, to look for a way to slow the flow of injured seniors coming into his practice. Dr. Christopher Grayson of the Florida Orthopaedic Institute in Palm Harbor determined that physical therapy before a fall might be the answer.
"We have a large number of senior patients in this area who, unfortunately, fall and have hip fractures," Grayson said. "The outcomes are pretty scary. About one-fourth of these patients may die in the first year from surgery."
Grayson, 34, said he started looking for ways to "intervene beforehand."
As a result, about six months ago Grayson designed a therapy program for at-risk seniors called Senior Strong. Eligible seniors in the program meet one-on-one with a physical therapist who works with them to develop stronger back and leg muscles.
Those seniors may already be exercising at a YMCA or in a SilverSneakers-style program, but often the exercises in such classes aren't strenuous enough, Grayson said.
In the Senior Strong program, clients work with a therapist for 30 to 45 minutes two or three times a week. The cost, if it's not covered by insurance, ranges from $50 to $60 per visit, Grayson said. In addition to strengthening muscles, the program strives to help clients develop better balance for such everyday activities as carrying groceries and running errands.
Sometimes, the benefits go further than just preventing a fall. "One of the things I noted," Grayson said, "is that patients with a fear of falling cut out activities in their lives. They become more homebound."
This sort of introversion can lead to depression and loss of connection with family and friends. With the Senior Strong program, "... They feel more confident, more stable. They (learn to) do an exercise program on their own and don't need a therapist."
To date, none of the 10 to 20 patients who have gone through Senior Strong have fallen, Grayson said, and there are plans to expand Senior Strong to all 10 Florida Orthopaedic Institutes in the Tampa Bay area. Anyone 60 or older is eligible to apply for the program, Grayson said. "It is safe, when done correctly, for patients of all ages."
Whether or not you are part of a one-on-one program like Senior Strong, there are a number of preventive steps you can take to reduce your risk of a fall, according to Harleah Buck, a registered nurse and associate professor at the University of South Florida's College of Nursing. "Once you have fallen, you are three times more likely to fall again," Buck said.
The key is to be aware of both personal and environmental risk factors. The primary personal risk factor is the sedentary lifestyle many people tend to live as they age. It's a natural slowing-down process. "Our muscles aren't as strong," Buck said.
Other personal factors that can contribute to falls include chronic disease — or sometimes, the treatment received to fight a disease.
Another personal risk factor, Buck said, is a person's "gait — how you walk." People who have suffered a stroke, for example, have a "significant problem with their gait." So can people who have had knee or hip replacements "and older athletes who have had significant damage early in their lives or surgery," Buck said.
There can also be sensory issues for people with diminished eyesight or reduced depth perception. "Sometimes, there can be numbness in the feet due to aging or disease process," she said.
Unfortunately, there's not much a person can do about most personal risk factors, Buck said, but there are environmental risk factors that can be reduced.
These include not wearing "poor footwear (like) flip-flops" and being alert to slippery floors and loose rugs. "Watch out for tripping hazards like things on the floor and pets," she said.
Buck also echoes Grayson's emphasis on increased exercise, increased muscle strength and increased balance skills.
"Use exercise to improve your gait, your balance, your coordination (and) your muscle strength," she urges.
Contact Fred W. Wright Jr. at [email protected]