Discovering what's behind older adults’ fear of falling may encourage more activity
"Minding Our Elders" columnist Carol Bradley Bursack says it's important to be nonjudgmental while trying to address a parent becoming sedentary.
Dear Carol: My mother lives with pain from rheumatoid arthritis and she’s also experiencing early symptoms of Alzheimer’s. She’s used a cane for years and was confident with these aids, but recently she’s become terrified of falling. I bought her a walker, and she says that makes her feel more stable. Still, she’s fearful when she moves around so she’s become extraordinarily sedentary. I can understand caution, but I’m afraid that if she avoids all activity, her health will decline even faster. She lives with me and there can be friction when I make suggestions. Is there a better way? — LD.
Dear LD: It’s true that once older people become completely sedentary, they can become weak and their overall health may decline, so kudos to you for addressing this.
As you likely know, friction with an older parent who lives with an adult child is common — and this is especially true if dementia is part of the picture. So, my first suggestion is that you double-check your approach to make sure that you’re using soft, nonjudgmental language.
Be curious about why she doesn’t want to do more walking and listen to the emotions behind her words since she may not be able to find the specific words to explain her fear. Perhaps she’s experiencing dizziness, increased pain from her RA or something more elusive.
Assure her that you can see why (fill in her reasoning) makes it scary to walk around, and then tell her that you’ll help her discuss this with her doctor to see if adjustments can be made.
A cautious look at her pain medications might be worthwhile because it’s not uncommon for medications, especially when combined, to cause both brain fog and dizziness. Controlling pain without causing these problems can take fine-tuning. Additionally, low blood pressure, anemia or a urinary tract infection could cause instability.
If these are ruled out, physical therapy exercises can enhance balance. I realize that this could be a hard sell for someone in your mom’s situation but in some locations, the therapist can come into the home. Very often, an older adult will be more cooperative with a professional than with their adult child.
There’s another reason for dizziness that while more prevalent in older adults can also happen to younger people. This is called benign positional vertigo, which simply means that the ear crystals that help us stay balanced have floated out of place. Many physical therapists can diagnose this condition by looking at the eyes and are trained in a maneuver that moves the crystals back to their rightful place in the ear canal.
My last thought is that changes in vision due to dementia can make people hesitant to move about. Since your mom is in an early stage of Alzheimer’s, this may not be the problem, but it’s still something to consider. You might not be able to remove her fear entirely LD, but it’s worth pursuing to see if some of these steps can help.
Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.