Preventing Falls
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Seniors' specialist: Dr. Alicia Arbaje works in the Bayview Medical Center- a day clinic devoted to the care of seniors. The Center is part of the Johns Hopkins facility in Baltimore, Maryland.
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"I've fallen and I can't get up" became a hilarious line many of us loved to imitate in 1989. It had its origins in a poorly-acted TV commercial for a medical alarm device for seniors.
Seventy-three-year-old Edith Fore played the role of Mrs. Perkins who we saw fall down and then utter her one liner: "I've fallen and I can't get up".
She was a novice who was paid $500 for the part, but she leapt into the celebrity realm as Americans booked her to appear at functions and say the line.
I was at a New York nightclub where she was escorted onstage and delivered her line to rock star-like applause and cheering.
This was real life in the surreal variety. In reality, a 73-year-old woman weakly crying out that she has fallen and cannot get up is no laughing matter.
And here in Bermuda, physiotherapist Diana Brown takes special pains to help seniors that have fallen regain their confidence.
Ms Brown, clinical manager of the Rehab Day Hospital at King Edward VII Memorial Hospital said many local seniors are embarrassed that have fallen.
She is part of a team of health care workers in the Day Hospital that run 'Staying Steady', a programme designed for those at high risk for falling.
According to geriatrician Alicia Arbaje of Johns Hopkins University, the risk of falling does increase in advancing years.
"One out of three older adults falls every year," she said. "In the US, complications from falls are the number one cause of death by injury in people over 65."
We don't compile these statistics in Bermuda so the picture is not as clear, but the problem of seniors falling is not overlooked locally.
The Staying Steady programme run at the Day Hospital sees an average of 86 seniors each year, who have fallen for the first time.
The programme runs for six weeks with a group of 10 people. Exercise and education are the two main features but the approach is multi-disciplinary.
Ms Brown gives specific exercise training to each group member. The programme also features an occupational therapist who gives advice on home security and care, a psychologist helps each person manage the mental impact of falling and the resulting injury, and a registered nurse explains the medical reason why the fall happened.
Dr. Arbaje said falls typically happen for any number of reasons – as a side effect of medication, environmental hazards like loose rugs and poor lighting, Parkinson's disease, dementia, arthritis, osteoporosis, impaired vision, hearing loss and weak muscles.
"Those who fall are more likely to end up in a nursing home," she said.
And she noted that half of all elderly falls in the US take place in nursing homes.
Dr. Arbaje said seniors who fall have a high risk of falling again.
It's the reason why, according to Ms Brown, it is so important to have a psychologist involved in the Staying Steady group. "We found that a lot of seniors felt humiliated and were embarrassed about their falling. In the group they learn they are not alone and this boosts their confidence.
"We also work on their exercises so that they are physically stronger and less likely to fall," she added.
Those in the group are also taught how to get up should they fall and not be injured.
They are also taught exactly how to attract help if they have been hurt.
The programme appears to have had a high success rate. Ms Brown said while it does happen occasionally, it's rare for a person who has been in the programme to have to return because they've fallen again.
She said therapists do have the flexibility to extend the programme when a person is still not sufficiently strong at the end of six weeks.
Occupational therapists and physiotherapists also routinely follow-up with their fall victims ensuring that they are able to manage on their own.
