News

For seniors, accidental falls a leading cause of injuries

Local experts weigh in on how to reduce the risk

Yoga teacher Lily Anne Hillis, 85, left, demonstrates an exercise that will help increase muscle memory, which helps keep people from falling down. Photo by Marvin Fong.

Falls are the leading cause of fatal and nonfatal injuries among older adults — even those who are fit and active. Each year, 1 in 4 Americans over 65 years old fall, resulting in more than 32,000 deaths, according to the Centers for Disease Control and Prevention.

"There are a lot of different things that go on as people get older — the muscle mass tends to decrease; processing time is longer; the ability of the nerves and joints to sense where the body is in space becomes less effective and the vestibular system that controls balance in the inner ear gets less sensitive and less able to do its job," said Jessica Davidson, an internist at the Palo Alto Medical Foundation and former medical director at Channing House retirement community in Palo Alto. "You can't fix what's happening in the body, but what you can do is compensate for those things."

Davidson and other local experts shared prevention tips to help older adults reduce their risk of falls.

Davidson recommends getting as much exercise as possible.

"If you have less muscle mass, then you want the muscles you do have to be as strong as possible," Davidson said "If you don't have the greatest native balance because of your vestibular system, you can actually exercise and train your vestibular system so it gets used to more movement and more challenges, so it knows what to do with them."

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She said a number of researchers conducted balance studies, and tai chi was the one exercise that consistently came out with the best result.

Any increased movement is good, she added.

'You can't fix what's happening in the body, but what you can do is compensate for those things.'

-Jessica Davidson, internist, Palo Alto Medical Foundation

"Everybody should get as much exercise as they can as many days of the week as they can, even if it's a 20-minute walk," she said. "When we get older people tend to reduce their sphere of movement, or the range of movements they make, so at a certain age we're really just standing, sitting, walking or lying down. Instead of playing tennis, we sit down and do a puzzle. Once you're not in the habit of reaching out or stretching very far, these activities become difficult — you're stiffer, you have less flexibility and you're less able to be active in the moment."

Besides general exercise, Davidson recommends that older people practice shifting their balance and doing some reaching and larger stepping than they're used to. (Do it under supervision or while holding onto something, she cautioned.)

"In my class at Channing House, I had people playing a kind of baseball using pool noodles, swinging at a beach ball, or they'd walk next to each other tossing a beach ball back and forth."

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Michelle Nguyen, a specialist in orthopedic physical therapy at PT Works in Los Altos, said a majority of falls happen as people age because of an interaction of risk factors, including a decline in mobility, cognitive and visual impairments and medications, as well as environmental hazards, such as rugs, pets and poor lighting. Fear of falling is another risk factor, she said.

In addition to reducing environmental and medical risk factors, Nguyen suggests improving one's strength, balance and mobility deficits.

"Being able to work on general fitness has been found to decrease the risk of falls — things like tai chi, yoga and general fitness," she said.

Nguyen said her go-to exercises are usually some sort of calf stretch that covers the flexibility component. Heel raises — going up and down on the toes — is the strengthening component.

"I'm a big fan of practicing standing up and sitting down from a chair, with or without hands. It's safe and it's practical," she said.

In the physical therapy setting, Nguyen identifies goals that are specific to each patient. She determines whether a person needs to work on core strength and hip strength, or should focus on things like static or dynamic balance.

"So much of what we do in life is somewhat repetitive and fairly sedentary, so I've always viewed exercise as your chance to mix it up," she said. "Our bodies move in so many different ways, and we often don't take advantage of that. And that gets much more exaggerated as we age and blends into this fall risk. All of this requires time and effort and practice."

Yoga teacher Lily Anne Hillis emphasizes that muscle memory is what keeps people from falling down.

"Say you trip and lose your balance; thinking does not work because there's not enough time to think before you hit the pavement," explained Hillis, 85, who has been teaching yoga for 35 years. "You need to rely on your instinctual reaction, which you only get from practice, and you need to practice enough so that what you get is muscle memory."

'So much of what we do in life is somewhat repetitive and fairly sedentary, so I've always viewed exercise as your chance to mix it up.'

-Michelle Nguyen, specialist in orthopedic physical therapy, PT Works

Hillis said the bottom of each foot has 25,000 nerve endings — 50,000 in all — and those nerve endings are talking to your brain constantly.

"From that interaction comes proprioception — your sense of where you are in space. It's all unconscious," she said. "You don't have to do anything. It's happening in the bottom of your feet, and that's why I like to teach people in bare feet."

Hillis said the best way to develop muscle memory is to challenge yourself.

"If you have a pose, and you're perfect in it, you want to challenge yourself to become out of balance and allow your nerve endings to bring you back into balance," she said. "You want to put yourself into positions where — with a teacher — you will challenge your balance enough to get wobbly so that you're retraining your brain."

She suggests a simple way to start is to stand with your feet apart, relax your knees and shift from side to side. Then lift the opposite leg and move from heel to toe, toe to heel, keeping your head over your pelvis while looking at the horizon, not at the ground.

"The more you do weight shifting, the more the bottoms of your feet will talk to your brain and your brain will remember how to bring you back if you start to fall," she said.

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For seniors, accidental falls a leading cause of injuries

Local experts weigh in on how to reduce the risk

by / Contributor

Uploaded: Fri, Aug 5, 2022, 7:03 am

Falls are the leading cause of fatal and nonfatal injuries among older adults — even those who are fit and active. Each year, 1 in 4 Americans over 65 years old fall, resulting in more than 32,000 deaths, according to the Centers for Disease Control and Prevention.

"There are a lot of different things that go on as people get older — the muscle mass tends to decrease; processing time is longer; the ability of the nerves and joints to sense where the body is in space becomes less effective and the vestibular system that controls balance in the inner ear gets less sensitive and less able to do its job," said Jessica Davidson, an internist at the Palo Alto Medical Foundation and former medical director at Channing House retirement community in Palo Alto. "You can't fix what's happening in the body, but what you can do is compensate for those things."

Davidson and other local experts shared prevention tips to help older adults reduce their risk of falls.

Davidson recommends getting as much exercise as possible.

"If you have less muscle mass, then you want the muscles you do have to be as strong as possible," Davidson said "If you don't have the greatest native balance because of your vestibular system, you can actually exercise and train your vestibular system so it gets used to more movement and more challenges, so it knows what to do with them."

She said a number of researchers conducted balance studies, and tai chi was the one exercise that consistently came out with the best result.

Any increased movement is good, she added.

"Everybody should get as much exercise as they can as many days of the week as they can, even if it's a 20-minute walk," she said. "When we get older people tend to reduce their sphere of movement, or the range of movements they make, so at a certain age we're really just standing, sitting, walking or lying down. Instead of playing tennis, we sit down and do a puzzle. Once you're not in the habit of reaching out or stretching very far, these activities become difficult — you're stiffer, you have less flexibility and you're less able to be active in the moment."

Besides general exercise, Davidson recommends that older people practice shifting their balance and doing some reaching and larger stepping than they're used to. (Do it under supervision or while holding onto something, she cautioned.)

"In my class at Channing House, I had people playing a kind of baseball using pool noodles, swinging at a beach ball, or they'd walk next to each other tossing a beach ball back and forth."

Michelle Nguyen, a specialist in orthopedic physical therapy at PT Works in Los Altos, said a majority of falls happen as people age because of an interaction of risk factors, including a decline in mobility, cognitive and visual impairments and medications, as well as environmental hazards, such as rugs, pets and poor lighting. Fear of falling is another risk factor, she said.

In addition to reducing environmental and medical risk factors, Nguyen suggests improving one's strength, balance and mobility deficits.

"Being able to work on general fitness has been found to decrease the risk of falls — things like tai chi, yoga and general fitness," she said.

Nguyen said her go-to exercises are usually some sort of calf stretch that covers the flexibility component. Heel raises — going up and down on the toes — is the strengthening component.

"I'm a big fan of practicing standing up and sitting down from a chair, with or without hands. It's safe and it's practical," she said.

In the physical therapy setting, Nguyen identifies goals that are specific to each patient. She determines whether a person needs to work on core strength and hip strength, or should focus on things like static or dynamic balance.

"So much of what we do in life is somewhat repetitive and fairly sedentary, so I've always viewed exercise as your chance to mix it up," she said. "Our bodies move in so many different ways, and we often don't take advantage of that. And that gets much more exaggerated as we age and blends into this fall risk. All of this requires time and effort and practice."

Yoga teacher Lily Anne Hillis emphasizes that muscle memory is what keeps people from falling down.

"Say you trip and lose your balance; thinking does not work because there's not enough time to think before you hit the pavement," explained Hillis, 85, who has been teaching yoga for 35 years. "You need to rely on your instinctual reaction, which you only get from practice, and you need to practice enough so that what you get is muscle memory."

Hillis said the bottom of each foot has 25,000 nerve endings — 50,000 in all — and those nerve endings are talking to your brain constantly.

"From that interaction comes proprioception — your sense of where you are in space. It's all unconscious," she said. "You don't have to do anything. It's happening in the bottom of your feet, and that's why I like to teach people in bare feet."

Hillis said the best way to develop muscle memory is to challenge yourself.

"If you have a pose, and you're perfect in it, you want to challenge yourself to become out of balance and allow your nerve endings to bring you back into balance," she said. "You want to put yourself into positions where — with a teacher — you will challenge your balance enough to get wobbly so that you're retraining your brain."

She suggests a simple way to start is to stand with your feet apart, relax your knees and shift from side to side. Then lift the opposite leg and move from heel to toe, toe to heel, keeping your head over your pelvis while looking at the horizon, not at the ground.

"The more you do weight shifting, the more the bottoms of your feet will talk to your brain and your brain will remember how to bring you back if you start to fall," she said.

Email Contributing Writer Chris Kenrick at [email protected]

Comments

Monte Jackson
Registered user
Midtown
on Aug 5, 2022 at 8:27 am
Monte Jackson, Midtown
Registered user
on Aug 5, 2022 at 8:27 am

Choice of footwear also makes a difference.

Older women should also refrain from wearing stiletto high-heeled shoes as it is both dangerous and fashionably unbecoming.


Carolyn Johnson
Registered user
Stanford
on Aug 5, 2022 at 9:54 am
Carolyn Johnson, Stanford
Registered user
on Aug 5, 2022 at 9:54 am

I agree with Mr. Jackson...elderly women should not wear high heels for the sake of safety and appearances.

My 60 year-old grandmother still wears strappy stilettos and she is far too old to be emulating younger celebrities like Beyonce and others.

She is no spring chicken and should dress with more dignity.


Reggie Washington
Registered user
another community
on Aug 5, 2022 at 3:49 pm
Reggie Washington, another community
Registered user
on Aug 5, 2022 at 3:49 pm

Whenever I see an older woman wearing a leather mini-skirt and 6 inch stilettos, I cringe.

Some styles of fashion wear are best reserved for younger women.


Neal
Registered user
Community Center
on Aug 6, 2022 at 8:03 am
Neal, Community Center
Registered user
on Aug 6, 2022 at 8:03 am

Flip flops should also be avoided. Use snug wellfitting footwear.


Justin Yount
Registered user
Stanford
on Aug 6, 2022 at 8:22 am
Justin Yount, Stanford
Registered user
on Aug 6, 2022 at 8:22 am

Sadly, this perpetual quest to appear and dress younger is primarily an aging Baby Boomer affliction.

My late grandmother always dressed appropriately and having endured hip replacement following a fall, she wore sensible shoes to prevent an avoidable spill.

On the other hand, my elderly 62 year-old mother in-law still thinks she's young and opts for the aforementioned 'strappy stilettos' along with 30-something fashion attire.

She has taken a few tumbles herself and this could have been easily avoidable had she been wearing sneakers or lower-heeled footwear.

Earth to mother in law...you are not fooling anyone and 60+ is not the new 40.

Act your age!


Carol
Registered user
another community
on Aug 6, 2022 at 1:58 pm
Carol, another community
Registered user
on Aug 6, 2022 at 1:58 pm

My relative recently solved shoe problems by holding their event in a setting that does not allow stilettos on their bocce courts!


Local news junkie
Registered user
Charleston Meadows
on Aug 6, 2022 at 4:32 pm
Local news junkie, Charleston Meadows
Registered user
on Aug 6, 2022 at 4:32 pm

And elder men shouldn’t wear elevator shoes, either.


Brett Lehr
Registered user
Portola Valley
on Aug 7, 2022 at 7:11 am
Brett Lehr, Portola Valley
Registered user
on Aug 7, 2022 at 7:11 am

>...this perpetual quest to appear and dress younger is primarily an aging Baby Boomer affliction.

>>...my elderly 62 year-old mother in-law still thinks she's young and opts for the aforementioned 'strappy stilettos' along with 30-something fashion attire.

^ If she really wants to feel young (again),
perhaps she should consider wearing safe and sensible footwear that is more reflective of her generation...Birkenstocks.

Old people can never be young again.


Jim Ferrin
Registered user
Barron Park
on Aug 7, 2022 at 12:21 pm
Jim Ferrin, Barron Park
Registered user
on Aug 7, 2022 at 12:21 pm

Older women and tacky-looking footwear aside, another potential hazard is falling off ladders.

Changing lightbulbs and clearing out rain gutters have led to countless falls that have required hospitalizations.

Best to hire someone or have the kids perform these basic chores.

Getting back to the shoes...older women (50 and over) should not try to emulate 20-something women in terms of shoes and fashion.

You are not fooling anyone...including yourself and others.


Bystander
Registered user
Another Palo Alto neighborhood
on Aug 7, 2022 at 12:59 pm
Bystander, Another Palo Alto neighborhood
Registered user
on Aug 7, 2022 at 12:59 pm

Those of us over a certain age like to think we are not as old as we are. Wearing the styles of our youth, doing chores the way we have always done them, and acting like the teenagers we once were is part of our way to remain young at heart.


Speak your truth
Registered user
Barron Park
on Aug 7, 2022 at 8:07 pm
Speak your truth, Barron Park
Registered user
on Aug 7, 2022 at 8:07 pm

Great article , so important , a spring board into endless conversation to prevent falls . I enjoy this ladies style of exercising . Web Link
I appreciate the optimal tools like transfer poles , various grab bars and excellent options for safe bathrooms .


Spikes
Registered user
Downtown North
on Aug 8, 2022 at 10:34 am
Spikes, Downtown North
Registered user
on Aug 8, 2022 at 10:34 am

What hypocrites you open-minded Palo Altans are. You're all for "my body, my choice" except for women over 50, who are supposed to dress according to what you consider appropriate.

I'd say that by the time a woman reaches the half-century mark, she has earned the right to wear whatever she wants. Sexist/ageist much?


Helen Jackson
Registered user
Crescent Park
on Aug 8, 2022 at 11:09 am
Helen Jackson, Crescent Park
Registered user
on Aug 8, 2022 at 11:09 am

"...by the time a woman reaches the half-century mark, she has earned the right to wear whatever she wants."

I'm not so sure about that as equality and entitlement have two different meanings

Discretion and good taste (though subjective) are also considerations.

As Reggie Washington mentioned earlier...some styles of fashion are better suited for younger women.


Jennifer
Registered user
another community
on Aug 8, 2022 at 6:05 pm
Jennifer, another community
Registered user
on Aug 8, 2022 at 6:05 pm

Exercise is so important for people of all ages. For your physical and mental well-being. Preventing falls for the elderly is something middle aged adults should be talking to their elderly parents about. Rug removals, bars in the bathrooms, etc. Common sense and good judgment.



Marion Pierce
Registered user
Barron Park
on Aug 9, 2022 at 7:54 am
Marion Pierce, Barron Park
Registered user
on Aug 9, 2022 at 7:54 am

"I'd say that by the time a woman reaches the half-century mark, she has earned the right to wear whatever she wants. Sexist/ageist much?"

^ True as there is no accounting for poor taste in fashion choices.


Myron Jessup
Registered user
Another Palo Alto neighborhood
on Aug 9, 2022 at 1:28 pm
Myron Jessup, Another Palo Alto neighborhood
Registered user
on Aug 9, 2022 at 1:28 pm

Until I finally put my foot down, I was publicly embarrassed by some of my wife's 'youthful' attire.

She is 58 and used to dress like an exhalted member of the Kardashian clan.

Long story short, one day she tripped and fell wearing a pair of those ridiculously high-heeled shoes resulting in a badly sprained ankle.

Upon my sage advisements, she now wears Sketchers.


Stelios Karoualis
Registered user
University South
on Aug 10, 2022 at 8:59 am
Stelios Karoualis, University South
Registered user
on Aug 10, 2022 at 8:59 am

My Greek grandmother who was a great cook used to say, "You cannot pass mutton off for spring lamb" and I imagine her gastronomical insights also apply to older women striving unsuccessfully to appear far younger than they actually are.

My grandmother always wore sensible shoes and never suffered a dehabilitating fall.


Jim McHenry
Registered user
Mountain View
on Aug 10, 2022 at 9:30 am
Jim McHenry, Mountain View
Registered user
on Aug 10, 2022 at 9:30 am

@Stelios
I grew up on a small Indiana farm in an extended family (grandparents, parents, children) and my grandmother did most of the cooking.

She would always tell us that the younger and more tender chickens were better suited for frying while the older hens long past their egg-laying days were best suited for stewing since they were kind of dried out and had tougher meat.

She wore those old orthopedic black lace-ups that elderly women frequently wore in the 1940s and 50s and the only time she actually fell was when she was trying to catch a chicken for Sunday dinner.

Now try and picture an elderly woman trying to catch a chicken wearing high heels and an all too revealing cocktail dress.

From that point on, I was assigned the duty of catching, slaughtering, plucking, and cleaning the chickens.

And to this day, I will not eat chicken regardless of it's age or preparation.


Ashley Johnson
Registered user
JLS Middle School
on Aug 10, 2022 at 9:54 am
Ashley Johnson, JLS Middle School
Registered user
on Aug 10, 2022 at 9:54 am

My elderly grandmother (63) recently took a spill while attending a social gathering wearing extremely high heels and her orthopedic surgeon has suggested a hip replacement.

Later that evening I was watching 'Stella Dallas' on Turner Classic Movies and my grandfather mentioned that Barbara Stanwyck's tacky attire and shoes vaguely reminded him of grandmother's fashion sensibilities except that hers is a bit more modern.

He would never have said that to her face.

On the other hand, my grandfather (73) dresses very plain, bordering on dull...just another old man you commonly see at the grocery store wearing a tropical shirt, khaki slacks, white sneakers, and a faded adjustable ballcap.


Anonymous
Registered user
Duveneck/St. Francis
on Aug 10, 2022 at 11:38 am
Anonymous, Duveneck/St. Francis
Registered user
on Aug 10, 2022 at 11:38 am

I agree with Spikes


Clarissa Ward
Registered user
Embarcadero Oaks/Leland
on Aug 10, 2022 at 11:44 am
Clarissa Ward, Embarcadero Oaks/Leland
Registered user
on Aug 10, 2022 at 11:44 am

Any older woman (50+) who actually think she's still chronologically young should have her head examined as there is a entire new generation of younger women far removed from their older and delusional predecessors.

At 40 years of age, there is absolutely no way that I can logically place myself in the same ballpark as far younger women...ask any man.

@Myron...I wear Sketchers most of the time and avoid high-heeled strappy bimbo shoes like the plague.

Though some onlookers might suspect that I am far younger than I appear, chasing the eternal Fountain of Youth is a costly exercise in futility fueled by unrealistic vanities.


Bystander
Registered user
Another Palo Alto neighborhood
on Aug 10, 2022 at 12:46 pm
Bystander, Another Palo Alto neighborhood
Registered user
on Aug 10, 2022 at 12:46 pm

These comments make this the funniest post for days.

I remember my four grandparents well. The grandmothers always wore dull old woman type clothes and the grandfathers clothes they wore to work/play/go out in (in other words the same things) day after day after day. That is until the grandmother who moved into a retirement home in her 80s. She went out and bought new clothes, lots of bright colors, had her hair "done" for the first time in years. She did wear sensible footwear though, but instead of black/brown she chose beige and other colors to match her outfit. Moving into that retirement home gave her a new lease on life and changed her completely. Not sure that would be for everyone, but it did it for her.


Mike Waters
Registered user
Los Altos
on Aug 10, 2022 at 3:20 pm
Mike Waters, Los Altos
Registered user
on Aug 10, 2022 at 3:20 pm

I think this quest to look and dress younger among older women has more to do with many of them being single (i.e. recently divorced, widowed) and in search of male companionship.

It is very difficult for a 60 year-old woman to compete with a younger woman for a man's attention unless she is moderately wealthy (i.e. comfortably divorced, widowed).

That said, I cannot comprehend the older, oftentimes married women who embrace celebrity fashion trends and are trying to emulate 'stylista' wardrobes designed for women who are light years younger.

So if wearing fashionable high-heeled platforms/stilettos that pose a potential risk if injury...walk don't run and for the older ladies, have your Medicare card handy.


Justine Mathews
Registered user
Mountain View
on Aug 10, 2022 at 3:43 pm
Justine Mathews, Mountain View
Registered user
on Aug 10, 2022 at 3:43 pm

This talk about older women wearing "Those Shoes" (an old Eagles song) is more reflective of those residing within the (408) and urban (415) area codes.

Most (650) women (regardless of age) have better taste when it comes to choosing women's footwear.

That's how to tell the outsiders at local midpeninsula shopping malls and restaurants.


Dean Thomas
Registered user
Downtown North
on Aug 11, 2022 at 6:31 am
Dean Thomas, Downtown North
Registered user
on Aug 11, 2022 at 6:31 am

"It is very difficult for a 60 year-old woman to compete with a younger woman for a man's attention..."

^ With that perspective in mind,
most single 60+ women would probably have a better batting average seeking the company of elder men 15-20 years their senior. To a 75+ year-old man, a woman in her 60s might be considered a 'younger woman' but not to a middle-aged single man. This consideration might negate what others consider poor or inappropriate fashion sensibilities as The Love Boat can sail in all kinds of waters.

As far as the (408) observation, this is probably true but most people do not go around asking what area code a person is from and using one's choice of shoes as an indicator is not very scientific.

Lastly, anyone can fall regardless of age.
If I had a dollar for every band-aid, dab of Neosporin, tetanus shot, and stitches applied, I'd be a wealthy man.


Butch Logan
Registered user
Barron Park
on Aug 11, 2022 at 11:03 am
Butch Logan, Barron Park
Registered user
on Aug 11, 2022 at 11:03 am

As a 82 year-old divorced male, I tend to date women in their late 40s and I could care less what kind of shoes they are wearing.

At my age, there absolutely no way that I would ever consider dating a woman over 60 or older than me.

Why bother?


Sally Wengen
Registered user
Stanford
on Aug 11, 2022 at 1:51 pm
Sally Wengen, Stanford
Registered user
on Aug 11, 2022 at 1:51 pm

What constitutes a senior or elderly person? Is this based on eligibility at age 65 for Medicare and Social Security?

On the other hand, AARP membership and its promotional offers are available to anyone over 50 of age.

I've also noticed that there are age variations regarding senior discounts at restaurants.

At 20, I consider anyone over 40 as significantly older but not necessarily an elder or senior citizen.


Margaret Bourne
Registered user
another community
on Aug 12, 2022 at 8:00 am
Margaret Bourne, another community
Registered user
on Aug 12, 2022 at 8:00 am

My 63 year-old mother-in law dresses as though she was a cast member on Sex and the City.

Very unbecoming and she has fallen twice from wearing platformed high heels that got caught in sidewalk cracks.


Jason Billings
Registered user
Los Altos
on Aug 13, 2022 at 11:30 am
Jason Billings, Los Altos
Registered user
on Aug 13, 2022 at 11:30 am

Women over 55 dressing as though they were 20-somethings is just not sexy...except to maybe an 80 year-old man.

Fortunately my wife of 30 years understands this and besides, neither one of us can afford to get divorced at this point in our lives as there is too much to lose or at stake.


Trevor Thompson
Registered user
Los Altos
on Aug 13, 2022 at 5:36 pm
Trevor Thompson, Los Altos
Registered user
on Aug 13, 2022 at 5:36 pm

"Women over 55 dressing as though they were 20-somethings is just not sexy...except to maybe an 80 year-old man."

^ My wife said the same thing over coffee this morning.

Her analogy was that a simple coat of wax does not make an older car collectible.


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