Monday, September 15, 2003 - Page updated at 12:00 AM

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Growing Older / Liz Taylor

Take an active approach to preventing falls at home

All of us want to live at home as long as we can as we grow older. Yet home is where most injuries occur due to falls, forcing us to move. Numbers tell part of the story. Falls are the leading cause of fatal and nonfatal injuries for people older than 65 in the United States. Ninety percent of the 300,000 hip fractures treated annually occur because of falls, most at home.

But numbers don't come close to describing the devastating pain, trauma, cost, inconvenience and permanent disabilities that a fall can bring. First you're on your feet, then you're on your face. In less time than it takes to read this sentence, your days of living independently may be over.

Michael Lake of Seattle inspired me to address this critical topic when he wrote, "I've had several falls lately (I'm 77), the last of which sent me to the ER for stitches to my eyebrow and chin. So far, no real damage. How do you go about avoiding falls?"

Most of us assume that age leads to frailty — that it's normal, inevitable, and there's nothing we can do. Not so, say the experts. While our bodies certainly change as we get older, most falls are within our power to prevent. A combination of remedies is required. Ask not what you're doing to escape disability, ask what you can do to avoid it. One is passive, the other active. Here are some active choices.

First, fall-proof your home. Forty percent of falls are the result of environmental factors. Use bright lights on stairs, halls and in the kitchen and bathroom. Remove clutter where you walk. Avoid slipping and tripping by eliminating throw rugs, repairing loose or torn carpet and using nonslip floor wax. Bathrooms are the most dangerous rooms in our homes because they're slippery, so install nonskid surfaces and grab-bars in the tub/shower and by the toilet.

Second, be aware of how your vision, balance and reaction times are changing as you age — vigilance is half the battle. An eye exam can screen for glaucoma and cataracts or the need to change your glasses.

Have a nurse or doctor evaluate your medications, including over-the-counter ones, to make sure they're not making you unsafe on your feet. Sedatives, cold remedies, antidepressants and many prescription drugs can form a potent brew, especially if mixed with alcohol.

An excellent book on the topic is "Home Sweet Home: How to Help Older Adults Live Independently" (AAL QualityLife Resources, $12.95), which I reviewed Aug. 21, 2002. Written by two veteran gerontologists, Dennis La Buda and Vicki Schmall, it lays out in easy-to-read language the ways to "de-barrier" and re-invent most living situations to allow older people to live at home longer, happier and more safely.

But where the pedal hits the metal in fall prevention is — dare I say it? — exercise. "If you could take exercise and put it into a pill, you'd have the first longevity medication," said Dr. Robert Butler, president and chief executive of the International Longevity Center — USA and a Pulitzer Prize-winning author on aging.

Alas, lacking a pill to pop, we must return to what we know works: strengthening our muscles and learning balance techniques. To regain or retain your vitality and safe footing, you must get off your rump and move. Research shows that exercise improves the health of virtually everyone — even those past age 90, frail and suffering from diseases that accompany old age.

What we want to avoid is sarcopenia (pronounced sar-ko-PEEN-ya) — severe muscle loss that comes to people who are inactive for many years. Gradually losing strength, they become unable to perform everyday tasks, much less avoid calamity.

Sarcopenia is preventable and curable with exercise, says Michael Hewitt, Ph.D., a physiologist and research director for exercise science at Canyon Ranch Health Resort in Tucson, Ariz.

What's the best exercise? It's whatever you like to do, he says. The trick is, you need to go from nothing to something, then from something to more. Exercise benefits all ages — only the mode might differ. For example, he might recommend jogging for a 35-year-old and walking for someone in their 70s. But everyone needs exercise, especially as we grow older.

There are four critical factors: endurance, strength, balance and flexibility.

In my next column, I'll tell you more, including a surprise (at least to me) and a great book on the subject.

Liz Taylor, a specialist on aging and long-term care, counsels individuals and teaches workshops on how to plan for one's aging — and aging parents. E-mail her at growingolder@seattle or write to P. O. Box 11601, Bainbridge Island, WA 98110.

Copyright © 2003 The Seattle Times Company


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