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 An Overlooked Demographic?

A Good Samaritan Society program  addresses falls, wellness, and well-being in people 80 years old and older.

 

 
 
In Loveland, Colo., an 88-year-old woman is on the floor. But she hasn’t fallen. Quite the opposite, actually. She’s balancing on her hands and toes in a core-strengthening plank during a floor balance class at her Good Samaritan Society–Loveland Village home.
 
She’s one of hundreds of wellness participants at the Loveland Village senior living campus, where staff have spent nearly a decade pioneering a fall-prevention program specifically targeted to people in their 80s and 90s. And it’s working.

The Statistics Aren’t Good

“There’s an epidemic that affects more than 50 percent of people in this demographic—and we’re not doing enough to address it,” says Jeff Finer, wellness director. “Once we look at that oldest-adult demographic, more than half of them will fall every year.”

Of those, more than half will fall again within a year, and an alarming percentage will never recover from their fall-related injuries, he says. “If this were a disease, where more than half of a population would go into a quick decline, people would be freaking out.”

Building up from a handful of classes he volunteered to lead as a part-time employee 13 years ago, Finer has helped establish a thriving wellness community at Loveland Village. Nearly 250 people attend more than 600 classes each month at the campus, where residents’ average age is 85.

It’s through these specially tailored classes that they’re improving their balance, endurance, coordination, and—perhaps most prevalent—their willingness to try new things.

Fears Can Lead To Isolation

According to Finer, a successful fall-prevention program must address much more than a person’s physical well-being. The program must also take an older person’s fears about exercise into consideration, recognize the loss many older people feel when they can’t do everything on their own, and challenge the widely accepted notion that falling is inevitable as people age.

“People in their 80s and 90s still have a lot to give us,” Finer says. “And when they isolate themselves because they’re afraid of falling, it’s not a solo act. They harm the whole culture around them, because we’re then not able to learn from them and their experiences. They are full of life, and we need to help them live it.”

Finer believes the entire senior care community must work together to prevent falls and keep seniors active.

“Physical therapy can’t do it alone. Walking won’t save us,” he says. “There’s no magic piece of equipment. Asking people to follow an at-home regimen isn’t realistic. We have to work together to create a culture where sitting in front of the TV and resigning to a life of stagnation isn’t OK anymore.”
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Generalized Exercise A Nonstarter

A common recommendation to the general population is to exercise 20 to 30 minutes a day to stay fit. But as Finer points out, once people are in their 80s or 90s, their neuromuscular systems aren’t nearly as responsive as 60- and 70-year-olds.

“You can be an active, good walker—maybe even a great walker—and still lose the postural, hip, and ankle responses necessary for safe reactions in this world,” Finer says. By not targeting weaknesses and compensations, “what you become, then, is a ‘strong faller,’ with unspecific, uncoordinated, and undependable strength.”

The FinersAnd this general exercise recommendation only improves the rate of falls by 13 percent for those 80+ seniors.

“That’s just not good enough,” says Finer. Besides, he says, “the word ‘exercise’ is too noncommittal and passive to make any real difference to the people who need our help the most. It doesn’t give them the tools they need to relearn how to live their lives the way they’re meant to.”

Tailoring Program To Each Individual

It’s difficult to pinpoint the root cause of a person’s fall risk; factors like age, medication, eyesight, past physical ailments, environmental obstacles, and mental obstacles all play a role. So Loveland Village staff members take each individual’s whole lifestyle and history into account when recommending classes, and they tailor their programs to the specific needs and hesitations of the oldest-adult population.

Staff members from physical therapy, dietary, nursing, activities, and wellness classes all collaborate to address the physiological—and even emotional—roadblocks each person faces. It’s an approach that’s shown improvements of up to 50 percent in fall rates.

At Loveland Village, there’s beginner, intermediate, and advanced levels for each of the wellness classes. “No one can progress in a one-size-fits-all program,” Finer says. “Individual needs are seen and responded to on a daily basis.”

Beginner classes focus a lot on small, digestible bits like sitting correctly, breathing deeply, or mindfully observing surroundings.

“We tend to take these basic skills for granted,” Finer says. “And we start to lose them and compensate around them. So once those skills are relearned to their fullest potential, you can branch out and become more than you thought possible.”

Imagery Smooths Moves

A particularly effective method Finer and the other wellness instructors have found is using imagery to teach movements and concepts. “When you give the brain an image during a particular exercise, the person’s nervous system and imagination attempt to complete it. It gives the mind a project that manifests in physical responses we might not otherwise be able to tap into,” he says.

Finer says he uses the Franklin Method for these types of visualizations.

“I could say, ‘Move your arms up and down.’ But if I say, ‘Imagine you were a bird, flying against a thick headwind,’ or ‘Imagine I’ve tied a balloon to your wrists, and your arms are now floating up to the sky,’ I’m going to see a much different, more engaged movement from class participants.”

Experience Transforms Residents

Finer has seen many participants in the wellness program go through a transformation.

“You see their eyes light up, their sense of humor come back. Their vocabulary improves. They invite people to join them for meals or entertainment or activities. They share with others about their latest successes and joys. They encourage life.”

Finer says too many people in their 80s and 90s feel the world has left them behind. “They believe all that’s left is a life of either a passive vacation mindset, or a defeated sitting disease. They forget their value.” It’s this perception that Finer hopes to shatter with better wellness program options.

“If we create a culture where they have soulful choices to make every day, where they choose and commit to who they want to be, we can make a real difference,” he says.
 
Megan Baldridge is a communications coordinator, writer, and editor for The Evangelical Lutheran Good Samaritan Society, Sioux Falls, S.D.
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