Striving to ensure safety and fear of falls consistently top the list of concerns for kūpuna. Unfortunately, fear itself can become a risk factor, leading to anxiety, hesitancy and overcautiousness. Being cautious is natural during activities that involve risk. However, being overly careful out of fear can result in moving less, avoiding activities that require balance skills and reliance on external objects for stability.
Everyone has witnessed the signs:
• Shortened steps and/or increased shuffling
• Stiffening of the trunk with no rotation or turning of the body
• Becoming more robot-like when moving
• Reaching for a chair or wall for stability
• Choosing to sit instead of standing
• Increased difficulty standing up after sitting
As the pattern progresses, kūpuna become even more wary and immobile, resulting in a downward spiral, so using good judgment is critical. Balancing the pros and cons of being too cautious in each situation is imperative.
Being sedentary leads to weakness and loss of range of motion and coordination. We all need to “use it or lose it,” and keep moving to maintain our muscle strength and balance. By being “safe,” good intentions may actually contribute to an increased risk for falls. Therefore risk assessments become critical in determining whether an activity is actually beneficial or dangerous.
A home assessment and modifications are a good place to start in order to fall-proof your home. An activity assessment and modifications are also needed. When a loss of balance is observed during an activity, note whether the body is able to compensate adequately and get re-centered and stable again without falling.
Although we tend to overreact when observing unsteadiness, having the ability to recover from a loss of balance is an important activity that requires coordination, core stability and strength. These skills must be retained.
So the next time you feel anxious about the safety of someone doing an activity, carefully observe the person and conduct a risk assessment and assess if there is a modification that could be made to make it safer before eliminating the activity altogether. Every activity has inherent risks at every age. Just be aware that inactivity poses even greater health risks.