When I was a kid or a teenager, my skin would heal from minor scratches almost immediately. A scratch (like from walking through brambles, which I did all the time) would heal up in maybe a day and a half or two days. Then, sort of all at once, when I was about 24 or 25, suddenly it took twice as long. I noticed it when I was living in Utah and hiked a lot in the mountains and deserts, and would get similar scratches, which would now take three or four days to heal.

I figured I was just getting old, and it would just keep getting worse. But it did not. Instead, it stayed like that for thirty-five years. However, just in the past year or two—since I reached my 60s—I’ve observed a fresh doubling in wound-healing times. Now a minor scratch takes a week to heal.

The surprise here is not that the speed of healing declines as one gets older, but the weird stepwise nature of the change—stability for decades, and then an abrupt doubling in time to heal.

I don’t know if that will continue. Maybe I’ll continue to heal at this rate until I’m 105 or so?

I’ve documented this largely for my brother, who once expressed appreciation for the fact that having an older brother gave him a four-year heads-up for this sort of age-related change. (I’m not sure he appreciates it as much now as he did in his 30s and 40s.)

I looked for some research studies as to whether my observation points to a more general phenomenon, but wasn’t able to find much. My brother found a study, which says in part:

The rate of epithelialisation appears to be different in older persons, but the magnitude of the delay may not be clinically important.

THOMAS, D. R. Age-Related Changes in Wound Healing. Drugs & Aging, [s. l.], v. 18, n. 8, p. 607–620, 2001. DOI 10.2165/00002512-200118080-00005.

I guess, as long as you do eventually heal up, the length of time it takes is “not clinically important,” but it’s still kind of a drag to be wounded for week(s).

The sort of scrapes that are now taking longer to heal than they used to.

Great advice on the right way to handle fall risk for seniors. Includes an excellent video.

Elliott Royce takes practice falls at least five times every morning. He doesn’t just practice; he preaches, too. He goes to assisted living centers, senior centers and community centers to talk about how to prevent serious injuries if you take a tumble.

Source: 95-year-old shares tricks of safe falling

Perhaps because I’ve reached an age where I might be considered a senior my own self, I’m becoming increasingly annoyed by the way public health advisors infantilize seniors.

It’s most obvious with fall risk, where “don’t fall” not only is repeated constantly, it almost always comes with a particular sort of blame-the-victim advice—remove tripping hazards, wear supportive shoes, be careful on wet or icy surfaces, always use your assistive devices (canes, walkers, etc.)—the implication being that if you fall it’s your fault for not having made your environment sufficiently fall-proof.

This advice is not merely useless or insulting; it is actively harmful.

It’s harmful first of all because it conflates “senior” with “frail” in a way that will inevitably lead the public to harass seniors just like the public feels free to harass fat people, smokers, pregnant women (especially those with the temerity to drink alcohol), or anyone who isn’t conforming with whatever the current public health fashion is.

Inevitably too, it will have that effect in the minds of seniors who will start to think of themselves as frail simply because everybody says so.

More to the point, it’s is precisely backwards for what you want if your goal is (as I think it should be) to prevent frailty.

  • Wrong: Remove tripping hazards. Right: Use pillows, empty boxes, rocks, sticks, 2x4s, and whatever else you have handy to make a little obstacle course on which you can practice navigating tripping hazards.
  • Wrong: Wear supportive shoes. Right: Wear the least supportive shoes you can handle and do foot exercises to gradually strengthen your feet.
  • Wrong: Be careful on slippery surfaces. Right: Pay attention to the surfaces you’re walking on and exercise due care on all of them.
  • Wrong: Always use your assistive devices. Right: Work with a physical therapist if necessary, and then do exercises to make yourself strong enough to obviate the need for an assistive device.

This is perhaps not as harmful as the infantalization of children and youth, which works extra harm because adults have more power to impose their conditions on children, whereas seniors mostly have enough autonomy to ignore inappropriate advice. But it hurts seniors in exactly the same way it hurts children, reducing their ability to become or remain robust actors in the wide world.

Now, I don’t want to fall into reverse-blaming the victim. If you are frail, then taking steps to reduce the risk of injury just makes good sense. My go-to activities to prevent frailty might well put an already frail person at serious risk.

I use the weir across the little creek behind Winfield Village for balance practice, when it’s dry and clear of debris.

I try to resist the urge to suggest to seniors that they should do hazardous activities in the name of preventing frailty. But the advice I see from professionals (and random strangers) goes too far in the other direction. Following it is going to doom already frail people to becoming steadily more frail.

I used to make fun of our culture’s weird fixation on dangers from ordinary things, but now that I’ve seen it have its effect on Jackie’s mom (labeled a “fall risk” at the hospital and now confined to a wheelchair), it’s not so funny any more.

My theory is that this phenomenon has its roots in how safe daily life has gotten: Eliminate any particular danger and there’s always the next most dangerous thing.

I have been predicting for years—only partially tongue-in-cheek—that we’re dangerously close to feeling like it’s a “reasonable” precaution that everyone wear a helmet while taking a shower, because bathroom slip-and-fall injuries are probably the greatest non-motor-vehicle risk that ordinary people face.

Hospitals’ fear of elderly people falling is so great that they are preventing them from walking, reports The Washington Post. This is ostensibly for the patients’ own good — yet not getting up for even just a few days is crippling them…

Source: How We Are Treating Kids as Mirrored By How We Treat the Very Old: Crippling Them with Caution

Just as an aside: One thing about this that drives me crazy is that safety advocates have pushed for all sorts of changes to cars to make things safer for drivers and passengers, but I’ve seen almost no push to make cars safer for bicyclists and pedestrians. If you want to make things safer, there’s a place to start.

It’s also sad not be of an age to think, “Oh. I could practice and get good at that.”

My brother

I’m meaning to write something about rejecting this thinking. I’m constantly thinking, “Oh, well. Maybe if I’d started that in my teens or early twenties, there’d have been time to get good at that thing.” But this is crazy talk on many levels. You can only get good at so many things (is one level). But based on the age of my (both still living) parents, there’s no reason to think I’m not going to live for another 30 years. When I was in my early twenties, my time horizon was way shorter than 30 years.

There are a lot of skills that it might take three years of steady effort to get good at. (I’d guess that drawing is one of those.) I could do TEN of those in the time I’ve got left.

Starting with sedentary mice aged about 65 in mouse-years, half were put on a program of high-intensity interval training:

the interval-trained mice seemed in many ways younger than they had been at the start. In particular, they were stronger; when pulled backward gently by researchers, they would cling to a bar longer than at the start of the study. They also had greater endurance capacity, as well as more muscle mass in their hind legs than the sedentary animals, and they scampered faster. Few now were frail.

Source: High-Intensity Workouts May Be Good at Any Age – The New York Times