A Saint Louis University School of Nursing faculty member is going to mark the first day of fall with a simple warning to senior adults: Don't let fear of falling stand in the way of being active and engaged with the world around you.
Helen Lach, Ph.D., associate professor of nursing at SLU, serves on the executive lead team of the Missouri Show Me Falls Free Coalition, a group that works to prevent falls. She specializes in gerontological nursing, and has studied ways to prevent falls for more than 20 years.
"While falls can cause problems, we want people to be both cautious and still maintain an active quality of life," Lach said. "You can't get rid of all of the risk in your life. But older adults need to maintain their strength, function and activity to the level they are able."
Lach most recently wrote a review article that appeared in JAMDA (Journal of the American Medical Directors Association) that showed fear of falling is a significant problem in nursing homes.
"People in nursing homes tend to be frailer and have more health problems and physical limitations than older adults who are in the community," Lach said.
"The fear of falling can stop some nursing home residents from doing anything, even participating in their own daily care. They become frozen in inactivity, which makes them depressed and bored. They get more out of shape, which creates more health problems that actually increase their risk of falling."
Lach noted that the fear of falling is part of a cycle that can lead to a frailty and a downward spiral in health.
"As people do less, they become less able to engage in activities. They have difficulty moving around, and their gait and balance deteriorates. This puts them at an increased risk of falling, which unfortunately means the fear of falling actually becomes a self-fulfilling prophesy."
It's important that nursing home staff members recognize that about half of residents have such a deep fear of falling that they limit their activities, and develop a way to assuage those fears. Exercise programs offered in a safe and supportive environment can be valuable in helping residents feel better – both physically and psychologically, Lach said.
Senior adults who aren't in long term care facilities also may need to confront their fear of falling, she added. Tai Chi, walking, weight training and simple exercises to increase muscle strength – such as practicing sitting and standing to strengthen leg muscles or standing on one foot with a chair at arm's reach – make a world of difference.
"Falls can cause problems," Lach said, "but so can the fear of falling."