The meaning of falling

Claudia Kalb. Newsweek. New York:Dec 11, 2000. Vol. 136, Iss. 24, p. 63-64 (2 pp.)
Subjects:

Aging, Injuries, Public health, Older people, Aging, Physiological aspects, Publi
citizens, Health aspects

Locations:

United States

Author(s):

Claudia Kalb

Document types:

News

Document features:

Illustrations

Publication title:

Newsweek. New York: Dec 11, 2000. Vol. 136, Iss. 24; pg. 63, 2 pgs

Source type:

Periodical

ISSN:

00289604

ProQuest document ID: 65170914

Text Word Count

999

Document URL:

http://proquest.umi.com/pqdweb?did=65170914&Fmt=3&clientId=17986&RQT=3

Abstract (Document Summary)

Falling, the experts insist, does not have to be a natural part of aging. It "used to be
considered inevitable" says Dr. Mary Tinetti, of Yale University School of Medicine. But
that is beginning to change as doctors and publichealth officials pay more attention to the
impact of falls-and their prevention and treatment. Exercises like tai chi improve balance
and ward off falls significantly. Poor vision can be treated, rugs removed and handrails
installed.
Full Text (999 words)
Copyright Newsweek, Incorporated Dec 11, 2000
[Headnote]
For older people, a major tumble can end life as they know it. For doctors, it's a new
public-health issue.
ANN SCHNEIDER HAS the spirit of a child-but a body succumbing to age. Her physical
decline started 13 years ago, when she tripped and dislocated her hip. A hip replacement
got Schneider, now "80-plus; back on her feet and, until last March, she was still out line
dancing with her friends. But Schneider's joint has weakened over the years, and after
several recent falls in her bathroom, she is barely able to walk. She's still lively, gets out
as much as she can-even doing volunteer work-and is optimistic that her condition will
improve. But another fall is her greatest! nightmare. "That is the biggest fear of many
older people," she says, "that fall, that big fall, that changes your life."
For millions of Americans, many of them our parents and grandparents, that big fall

threatens like a fault line. Other symptoms of aging sneak up slowly: hearing dims, vision
blurs, muscles weaken. But a serious tumble strikes without warning, and can shatter
bones. in an instant. One in three people older than 65 falls each year, and in 1998, about
9,600 seniors died from fall-related injuries. Spurred the realization that the problem will
only worse as our aging population surges, researchers are now focusing on the reasons
for falls and on better methods for preventing them. Falls are "a huge public-health issue;
says Dr. Ron Adelman, co-chief of geriatrics at Cornell University's Weill Medical
College. And they're far more than just a physical event. "Many older people see a fall as
a very symbolic marker," says Neville Strumpf, ofthe University of Pennsylvania's
School of Nursing, "a growing awareness of the consequences of aging."
[Photograph]
Falls can be triggered by a host of problems: muscle weakness, poor vision, a skewed
sense of balance. Diseases, including osteoporosis, arthritis diabetes and alcoholism, can
make people unstable. And then there are prescription medications, specifically
antidepressants, sedatives and blood-pressure drugs, which can cause dizziness,
confusion or sedation. These factors, combined with poor lighting, loose rugs, slippery
tubs and icy sidewalks, can make a single step disastrous. Little research has been done
on psychological causes, but they, too, may play a role. One recent study found that
patients who fell and fractured their hips had experienced more major life events-an
illness, the death of a family member-in the year preceding the accident than people who
had not broken bones. It's possible, says the study's lead author Margaret Peterson of New
York's Hospital for Special Surgery, that people get "so distracted and so upset" by
traumatic events, they payless attention to what's in front of them.
Whatever the cause of a fall, the outcome can be devastating. Ruth Stark works at
Boston's Hebrew Rehabilitation Center for Aged, but she was unprepared for the day
three years ago when her mother, then 82 and living alone, slipped in the shower. "That
was really the beginning of the end," says Stark. Before the fall, her mom, Marianne
Breuer, loved to listen to opera, play bridge and make her native Viennese pastries. But
the accident shattered Breuer's self-reliance and her "interest in just about everything,"
says Stark. Today,
Breuer is confined to a wheelchair in a nursing home. "She bruised herself pretty badly,"
says Stark, "but I think she bruised her psyche the most." And the psyche is often the
most difficult to heal. Carlos Guaderrama has been worrying about his mother, Josefina
Guzman, 75, ever since she fell and had hip surgery last August. He especially frets about
her state of mind. "She's sadder now," he says. Unable to participate in their favorite
activities or visit with friends, seniors like Gunman are susceptible to loneliness,
depression-and fear. That fear is not unwarranted: those who have fallen are two to three
times more likely to fall again. More than the physical trauma, seniors dread the
possibility that a fall could rob them of their independence. Worried that a relative will
yank their car keys or, worse, herd them offto a nursing home, many elderly people keep

falls a secret, even from their doctors. "We'll see a black-and-- blue mark and ask, `How
did that happen?'" says Steven Wolf, at Emory University. Only then, he says, will they
answer: "Well, I kind of fell." A study of Australian women over 75 makes clear how
strongly the elderly value their independence: 80 percent said they'd rather be dead than
suffer a hip fracture bad enough to land them in a nursinghome.
Falling, the experts insist, does not have to be a natural part of aging. It "used to be
considered inevitable" says Dr. Mary Tinetti, of Yale University School of Medicine. But
that is beginning to change as doctors and publichealth officials pay more attention to the
impact of falls-and their prevention and treatment. Exercises like tai chi improve balance
and ward off falls significantly. Poor vision can be treated, rugs removed and handrails
installed. And a study published last week found that hip protectors, customized pads
worn under clothing, can dramatically reduce the number of fractures after falls. Since
fear can lead to hesitation and immobility-- which, in turn, can cycle back to more
tumbles-boosting confidence and encouraging small steps back toward activity may be
the most critical part of rehabilitation. Marge and Sam Lamport are proof that the
downward spiral can be halted. Marge, 81, tripped and broke her hip in 1998; Sam, 77,
bruised himself badly on the ice last March. Walking is difficult, but they're building
strength through fitness classes at their Cleveland retirement community. And they are
determined to visit Marge's son in Taiwan next year. Yes, Marge admits, she's afraid of
falling again. "But you can't stop living because of the fear." A powerful drumbeat for the
older generation-and for the rest of us, whose own sure steps will one day falter, too.
With JOAN RAYMOND in Cleveland and ANA FIGUEROA in Los Angels
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