The Importance of Preventing Falls

by Baxter

The Acrobat by Marc Chagall

As I discussed in my post News on Balance, Falling, and Yoga, preventing falls as we age by working on maintaining strength, flexibility, agility and balance is one of the ways—if not the primary way—we can maintain our independence as we get older. My thoughts about this were recently reinforced even more strongly when I dove into a new book one of my students gave to me, Being Mortal by Atul Gawande, MD.

This book may be familiar to many of you, as it is a New York Times best seller, and is sweeping the country with its urgent look at how poorly our society and health care system deals with the realities of aging, and what we may be able to do to turn things around. Although I have not finished the book yet, it seems destined to be on the “must read” list for those who have embraced Yoga for Healthy Aging as part of their strategy for aging well. 

Anyway, as part of his investigations, Dr. Gawande spent some time following a geriatrician colleague around on his patient visits, and was surprised at how important this doctor felt about always checking the health status of his older adult patients’ feet. That’s right, their feet. Even if a 85-year old woman in his office was mentally sharp, generally strong in appearance, and doing well living on her own, as part of the check-up exam, the doctor always insisted on looking at both feet very closely. This intrigued Dr. Gawande, and so he asked why. “You must always check the feet” was the reply, because, as it turns out, this enables the doctor to tell a lot about the person’s overall functional ability. Often times, when a patient is asked to remove shoes and socks, it becomes immediately obvious that patient cannot do this easily on their own. And once the shoes and socks are off, the state of the nails (trimmed or untrimmed) can clue the doctor into the person’s ability to bend down or lift the leg up to care appropriately for their feet. And the presence of cracks in the skin or fungal infections can also let the doctor know about immune status and self-care abilities. OK, so check the feet, but what is the big deal? Well, keeping the feet healthy is one of several factors that can prevent falls and fractures in older adults. And preventing fractures and falls is the main way to keep older adults independent and living on their own, and not being relegated to a nursing home facility!

The following statistics from Being Mortal help frame the issue of the importance of preventing falls:

“Each year 350,000 Americans fall and break a hip. Of those, 40% end up in nursing homes, and 20% are never able to walk again. The primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness. Elderly people without these risk factors have a 12% chance of falling in one year. Those with all 3 risk factors have an almost 100% chance.” (Emphasis is mine.) 

Here at YFHA, we have discussed how regular yoga practice may indeed improve or help maintain balance over time (see Aging and Balance). We’ve also discussed the problem of sarcopenia, the loss of muscle mass, and yoga’s role in helping to maintain and improve muscle strength (see Yoga for Strength: An Overview). Finally, we’ve discussed yoga’s role as part of a holistic treatment plan for a variety of chronic diseases, such as high blood pressure, heart disease, diabetes, and arthritis, all of which are typically addressed by modern medicine with medications. A regular yoga practice that helps to keep the blood pressure down, for example, could conceivably lead to the elimination of a medication or two, thus addressing one of the big three risk factors for falling. And it is worth noting, again, that having osteoporosis is not one of these main risk factors for falling, however important modern medicine places on the treatment of osteoporosis with medications. 

Armed with this new information, I hope we will all be more motivated to continue to use our yoga practices to bring these big three risk factors as low as possible and keep the falls at bay! I feel, too, that working to keep our feet vibrant and healthy has the potential to contribute to decreasing the chances of falling (see Want to Improve Your Balance? Take Off Your Shoes and Your Feet on My Mind).

Gawande said the following about the geriatrician whose work he was observing:

“The job of any doctor, Blandau told me later, is to support quality of life, by which he meant two things: as much freedom from the ravages of disease as possible and the retention of enough function for active engagement in the world.”

Gosh, I love that statement! And I believe that the “job of the doctor” can also become the job of each one of us, acting as our own advocates for healthy aging. 

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