A few weeks ago, a friend sent me an opinion piece from a recent edition of The Globe and Mail. It was about falls. Not the waterfall kind. The kind that involves finding oneself suddenly on the ground or on the floor. It was written by Sandra Martin and entitled “A Senior’s Resolution: No More Falling in 2019.”
It was very well-written and also very scary. The piece described so many serious consequences of falling. As I read it, however, I also felt some anger rising up as I contemplated all the restrictions that might be necessary to prevent falling.
As a retired family physician, I am well aware of the effect that a simple fall can have, especially as one gets older. A broken hip can lead to the end of independent living or even death. (A somewhat extreme outcome, but not uncommon.) I am also aware that the effects of diminished vision, hearing and balance (all common in aging) can make one more prone to falling. Then there’s the plethora of medical problems that can increase the chance of serious consequences from a fall. For me though, there is something life-affirming in having the choice to take a risk. I am talking here about physical risk, often the risk of falling. Perhaps that sounds crazy, but it is true for me.
It is certainly an individual decision and different for everyone. If a person has osteoporosis (a thinning of the bones, especially common in small, slight women as they age), it is a very wise decision to do everything possible to avoid falling. But it is also well-known that weight-bearing exercise reduces the chance of osteoporosis. So there has to be a trade-off. I don’t want to stop doing the exercise that makes me feel alive and keeps me fit, but I also don’t want to fall and break a bone. I pondered this back in February standing at the top of Dog Hill on the Mount Mac ski trails. I was trying to decide if I really needed to snow plow or if I should just go for it. How much risk was I willing to take for the thrill of going fast? How confidant was I in my ability to make it? And then, later, as the snow receded, I found I was asking myself whether or not I should resume riding my bike around town. What if I was struck by a car?
It is also true, though, that one can fall and break a hip in one’s own kitchen, turning suddenly or tripping, etc. It is not just a question of the amount of risk, but of the severity of consequences. Unfortunately, most of us cannot know all this in advance. It was a sunny day on the ski trail, the conditions were good, I felt fit, so I decided to go for it!
I actually fell about six times this winter, on the ski trail, walking my dog and on the sidewalk. I try to use cleats on my boots but find that they hurt the bottom of my left foot. So I take a risk. I bypass ice on the trails by going through the woods. I tiptoe across sections of icy sidewalk that cannot be avoided. I was very lucky to come away with nothing more serious than bruises. I also try to be conscious of what I am doing and not lost in my thoughts. Mindfulness is a great preventer of falls. No checking my phone, planning the future or reviewing the past while walking. Just be there. But I acknowledge that I do often take risks. I think that I understand the possible consequences and have decided that I am OK with that. (Some readers may think I am just in denial.)
Perhaps one can make a case for the difference between care and caution, and fear and risk. Fear often leads to excessive caution. That tension and anxiety can increase the risk of falls.
When I was learning to mountain bike my son told me to look where I wanted to go, not where I don’t want to go. Still, my eyes are drawn to that hole beside the trail or that irregular patch of pavement. Why is that? When it happens, muscles tighten up, I clench my teeth and I am more inclined to hit the hole.
I am a very fortunate senior. I have always been physically active and that has contributed to the maintenance of the ability required to do the activities I enjoy. It is extremely difficult, not impossible, but difficult, to begin exercising as a senior if one has not had the habit earlier in life. So for all you younger folks reading this, get moving while you still can.