Most people think nothing of getting up in the middle of the night to go to the bathroom. Getting up from a chair or turning around to grab something from a shelf seems like second nature. Yet for many seniors, movement poses a substantial issue within its once safest context, within one’s own home.
But this doesn’t happen overnight. It happens gradually. And by the time families realize something is wrong, chances are, loved ones have been privately wrestling with their condition for months, if not longer. What’s concerning is that many seniors conceal how difficult movement has become, downplaying it and attributing it to aging or merely allowing others to think they’re fine when they’re not; they do this because they don’t want others to worry about them or realize they’re losing independence.
When Movement Stops Becoming “Normal”
It often starts slowly. It takes Mom two extra seconds to get off the couch. Dad has a slight wobble when he’s making his famous mac and cheese. These moments are brushed off as aging milestones until they accumulate at red flags indicating that strength and balance – once taken for granted – are on a steady decline.
This is usually how it goes: with age comes weaker muscles, stiff joints, and delayed reaction times. Throw in the side effects of medication and conditions like arthritis, and suddenly the body can’t keep up with the mind’s suggestions when it comes to movement. Although someone might recognize that they’re going to start tipping over, they can’t muster the power fast enough to do anything about it.
The most dangerous part occurs during transfers – movement – from one position to another. Getting out of bed, standing from the toilet, stepping over a tub (to get into the shower, leg up and not over) represent some of the most common ways where falls occur in older populations. While younger folks may be able to catch themselves or at least break their fall, an elderly person’s fall could result in shattered hips, fractured wrists, or worse – a concussion or death.
Where Fall Risks Are Most Common
Statistically, the most dangerous place in one’s home for an individual experiencing movement challenges is probably the bathroom. While hard surfaces are present in all rooms, the bathroom also boasts wet surfaces and expected movement patterns that can make falling less than avoidable. Toilet use requires significant coordination and weight bearing on legs to sit without falling; foot positioning generally requires one to have decent movement to go from a squat to standing or from sitting sideways in the tub on a bath mat to fully standing again.
But bedrooms are no better; nighttime falls occur when an individual stumbles to the bathroom – half-asleep – in pitch darkness with zero spatial awareness. An elderly person gets out of bed and tries looking for their walker without activating their cortisol levels or opening their eyes wide enough, and these missteps lead to falls into walls or over other furniture.
Stairs are common pitfalls for elderly persons; however, even that one step down into the garage or a small ledge at a doorway becomes an unforeseen problem as individuals struggle to gauge their depth perception but also lack necessary height in their feet and knees to step over even tiny inclines.
The Fall Nobody Talks About
Most families don’t know their loved one is at risk until after the first fall – and by then, something arguably more dangerous than the physical injury occurs – fear. Once someone falls once, it becomes ingrained in their psyche that they’re more prone to falling again. This fear induces anxiety that makes even the most confident person freeze in place or struggle to realign themselves cautiously – and hard.
Some seniors respond by … not moving. They sit in chairs all day. They wait until they desperately need the bathroom before getting up. They refrain from going out as they usually would because leaving requires external transfers (steps into their vehicle, steps into another location) that suddenly become too much to contemplate.
This is dangerous because less movement means more weakness which translates into fall risk. Professional services boast ‘in-home mobility & transfer assistance in Philadelphia,‘ which solely focus on these vulnerable moments – for experienced, trained professionals – to help seniors move throughout their days with as much independence as possible since transfers are not the only movements that present challenges.
Who is Considered High-Risk
Certain factors exist that combine to create a perfect storm of risk. Individuals who have limited vision struggle with gauging distance and spotting obstacles. Medications for blood pressure or sleep disperse false perception and wooziness while other medications designed to ease pain can cause disorientation as well.
Anyone who has fallen previously (whether or not injury occurred) indicates that they may already be more likely to fall again; chronic conditions play a role as well – Parkinson’s affects movement control while strokes may influence one side significantly better than another; arthritis works when it wants and not when people need it to; heart complications can render someone faint or worse at a moment’s notice.
Independence compounds risk exponentially. When a person falls and no one else is around – especially for hours on end – they may not sustain an injury while lying there on a hard floor – but avoidance is more painful than its onset – and waiting for help to arrive only invites complications.
The Implications of Inaction
A fall is not just an awkward experience where someone brushes themself off and continues life as normal. For someone over 75 years old, a serious fall typically indicates that this person will start sliding down a slippery slope no one wants them on – hip fractures lead many into nursing homes because those people never gain enough confidence and momentum back again to keep them physically independent at home while head injuries could lead to subdural hematoma that permeates over days before anyone knows what’s wrong.
Even falls without notable cause of injury lead people to feel “fine,” which is something avoided down the road – bruising creates soreness which decreases confidence and motivation, leading someone to spend more time sitting/lying down than progressing up/exercising/making necessary trips around their home leading them back to muscle loss and decreased efficacy on their bones; their worlds become smaller.
Psychological injuries occur as well – the independence many worked so hard for takes a lifetime to cultivate but a matter of seconds during one slip. Some people become depressed and anxious about feeling like a burden on their family; others start mentioning “just going to a home” because it’s safer/easier for everyone else.
Getting Safe at Home Again
The good news is that most people don’t have to choose between safety and comfort and getting relocated elsewhere for safer measures, due to minor renovations (grab bars in bathrooms, better lighting throughout the home), safety can be increased within homes, but physical safety only goes so far when age complicates what was easily maneuverable once before.
Sometimes having someone else available during high-risk times makes all the difference. A trained professional can assist during transfers, and if it’s known that this safe person reduces hazards during negatives, then seniors can enjoy living in their homes with beds they helped pay for as long as this boost of confidence occurs during risk-prone areas throughout the day.
This type of specific help offers respite because that’s when falls happen most, not 24/7 supervision or taking over someone’s day/life, but during transfers and movement – which people need help with otherwise but can do most things by themselves; this distinction works wonders for seniors who fear losing all control over their independence.
What Families Should Keep an Eye Out For
Family members should recognize when their parent/friend starts adapting their schedule/routine subconsciously trying to avoid certain movements. Are they napping in a chair instead of going up to bed? Are they showering less often and less in general? If so, they’ve likely got issues with bathroom transfers due to nighttime complications with bathrooms more often than not during this age group.
Have family members realized that their loved ones hasn’t used their walker but has been grasping furniture/walls more than usual? Has their shuffling adapted from almost normal gait down to small steps instead? Are bruises starting to appear out of nowhere?
These are all signs of near-falls or falls that others want kept secret because of embarrassment.
The hardest part about all this for families is realizing that their once capable, once-independent parent genuinely can’t do some things safely anymore; it feels demeaning – almost admitting defeat – but giving them appropriate help respects that instead of letting them break a hip and try again another time because they’ll lose independence much faster than they ever wanted.
