Beyond Grab Bars: Adapting to Reality

Article excerpt

"Fall prevention is not as simple as home modification or grab bars," stated former U.S. Assistant secretary of Aging Fernando Torres-Gil. He added, "It's really, in many ways, a total mind change."

Torres-Gil, associate dean of the School of Public Affairs at the University of California, Los Angeles, spoke with special expertise: A post-polio survivor, he also recovered-and learned from-a damaging fall in 2004. In his address last fall at the California Fall Prevention Summit in Long Beach, Calif., he said, "One has to first go through the emotional, psychological and attitudinal change to say, I am potentially vulnerable. I could fall. I have to accept the reality that it is not a safe world out there. I need to set aside my own pride and sense of independence, accept that vulnerability, begin to act on it and plan and do the necessary adaptations.'"

TOUGH TO ACCEPT

Torres-Gil said he has noticed in working with his mother, mother-in-law and other elders that older people often struggle to accept their new reality following a fall. This difficulty especially affects those who have been physically independent throughout their lives. "It's tough for them to accept what a fall means, other than the immediate consequences. And it's tough for them to resocialize their thinking toward how to avoid it, how to get beyond the fears of another fall."

Frequently, he said, older people who suffer a fall-especially men-become so unnerved following the incident that they isolate themselves: "They're afraid to get out of bed, afraid to get out of their homes-they're afraid to go out and enjoy life-because they're afraid of falling again." He added that professionals in aging and public-education efforts on fall prevention need to emphasize that "one way or another, you can bounce back and it's OK. In fact, one can learn and grow from that experience."

As someone with a lifelong disability, Torres-Gil said, "I have a great advantage, and I'm really fortunate and grateful, which might sound weird." He explained, "My advantage is that I have a lifetime of getting my head into that type of thinking."

The challenge for each person who is vulnerable to falling, Torres-Gill said, is identifying the pieces of his or her puzzle: "My holistic puzzle was first to accept my limitations as a post-polio survivor, then to accept what my strengths and limitations are physically." Restrictions for older adults might include a range of conditions from mobility limitations to sensory impairment, especially involving vision or hearing. Also, each person must adjust to particular surroundings. For example, Torres-Gil, who walks with the aid of a cane, noted that on arriving at the conference ballroom he first negotiated the steps to the stage so "there would be no surprises for me and that I could limit how much energy I would use to get up here."

More generally, he said, "I ensure that I stick to a good diet and keep my weight down because that's an important part of maintaining balance." Exercising "religiously," he said, is also critical, whether one chooses Pilates or other forms. Torres-Gil offered that he practices tai chi and chigong, which contribute to his being as rested and stress-free as possible, besides improving his balance, strength and range of motion. In addition, his routine helps him regulate his breathing, which in turn aids his ability to manage his energy limits. …