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.
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 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…
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.