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Four Small Changes

Older adult women sitting down with zoom in on her hands holding on to top of wooden cane.

So here I am celebrating 10 years of falls prevention and what have I learned? I have my area rug stuck to the floor, I’ve done away with a throw rug by the kitchen sink, and I have grab bars in my shower. I’ve lost weight, I use a cane on the street and I exercise three to four days a week. I’ve done it all and yet I’ve had four falls in those 10 years, with costly scans and lab work during each of the four visits to the emergency department.

With the help of a physical therapist (PT) I have learned that the key to reducing my risk of falling is making some small changes in behavior and attitude such as:

1. Use the appropriate assistive device. The PT did an assessment to determine if I needed to use a cane (or a walker) and then advised which kind of cane was better for me. It wasn’t the bamboo walking stick I had been using in order to look cool! It turned out to be that aluminum one from the drug store. I’m working on not forgetting my cane when I go out of my apartment or when I become distracted and leave it at the bank. Now that I use a proper cane, I can walk much faster and I feel more secure standing to wait for the light to change.

2. Pace my energy. Learning to pace myself is a tough one as I tend to “give it all I’ve got” until I become cranky and tired. Now when I do get tired, I rest—even going so far as to take a nap! In doing PT exercises, I realized the difference in my balance and strength when I exercise in the morning versus when I exercise after a busy day. As I think about it, I realize that all four falls have happened in the afternoon. I’m trying hard to prioritize my activity so that I do the things that matter to me and don’t worry so much about other people’s expectations.

3. Ask for help. This sometimes means making me visible as an older person in need! Using a cane helps make that apparent (in case they don’t notice my gray hair and wrinkles); however, not all bus drivers are tuned in to how hard it can be to step up to board the bus—sometimes I need to ask to have the step lowered. The airlines have made it easy to request wheelchair assistance in boarding—one of the best perks of aging in this era of the TSA! I’ve found asking for help from my family is especially hard to do. I think they are just as much in denial as I have been about my loss of function.

4. Accept the cost. The cost is in both time and money. It takes longer and takes more energy to get dressed than it used to. Allowing enough time to do the task at hand makes it less likely that I will be rushed and forget my cane or trip on a curb.

I am learning to keep dollar bills at the ready so that I am ready to tip the person who pushes my wheelchair through the airport, or the cab driver who brings the groceries into my home. I need to do better at giving positive feedback to those persons who help me but do not take tips—like the physical therapist.

Slowing down means that a trip that I used to take in one day may now take two days to complete—meaning extra costs for hotel and food. This might mean that some activities that I have always done will be beyond my budget.

These changes in attitude are harder to make than installing grab bars but perhaps just as critical in preventing future injury. Another fall could have a dramatic impact on my quality of life. Ultimately, it is my responsibility to consistently use my cane, pace myself, ask for help, and prioritize my time and money. It is up to me to do the work that will allow me to live independently for as long as possible.


Contributor Sue Shaw is a member of the Seattle-King County Advisory Council on Aging & Disability Services. She currently chairs the Planning & Allocations Committee.

Originally appeared on AgeWise King County (September 2017)