We’ve heard of an emergency evacuation plan: every public agency is supposed to have one or is it every agency with more than five employees is required to post the nearest plan of evacuation in case of an emergency?  In any case, as individuals, we must take responsibility for our personal safety and be aware of how to get out if the need arises.  Always be aware.  As aging adults, it is important that you take the same responsibility and follow a fall prevention plan to reduce the risk of falling.

Engaging in consistent exercise routine, done either seated and/or standing, is the best thing you can do to minimize the risk of falling.  However, preventing a  fall involves more than balance training, it requires awareness of environmental, pharmaceutical, and dietary risk factors.  In other words, there is not a one-size fits all approach to staying upright.  In addition to being aware of and respecting physical limitations associated with aging,  an individual must be aware of his surroundings, his medications and what he eats.  An effective fall prevention plan would increase awareness of factors contributing to a greater risk of a fall then empower a person to make reasonable modifications that reduce the risk of fall.  Remember, falls are accidents!  No one plans on falling but with some education, you can reduce the risk of a tragic event happening to you or a loved one.

The first thing to do is to get started on an exercise routine. It doesn’t matter what level you start, just get going!  Your body will adapt and improve with consistent practice.  Don’t try to do it all at once, afterall, Rome wasn’t built in a day! Take 5 to Exercise each day and you will notice improvements during your activities of daily living. The four components of a thorough fall risk reduction exercise plan are:

1.  Flexibility

2.  Balance

3.  Strength

4.  Endurance

Make sure to address each of these components in your exercise routine.  This can be a lot to remember so follow along with a senior exercise video as you reduce the risk of a fall.

Secondly, check your environment! Believe it or not, 2 out of 3 falls occur in the home and 70% of falls at home occur in the bathroom.  A simple home checklist will provide a guide to go through your home (or apartment) and look for specific risk factors.  Look for local, non-profit agencies that serve older adults at a discounted rate:  affordable, quality service, like Rebuilding Together. Installing grab bars in the shower, removing throw rugs, or using night lights should not be taken as an ageist insult but rather an opportunity to demonstrate your wisdom for remaining safe within your environment.

Learn, Learn, Learn…what your medications are doing to your body.  Find out what organ is primarily affected by each medication you are currently taking.  I can tell you already that medications take a toll on your liver which is why it’s important to drink plenty of water and try to eat a healthy diet.   Some people are surprised when I discuss diet as a fall risk factor but not eating a healthy, fruit and vegetable-based diet will affect your physical strength and mental clarity.  Lean proteins, calcium supplements, plenty of fruits and vegetables and half your body weight in fluid ounces is a good nutritional guideline to try to follow.

Here’s a good start to your own Fall Prevention Plan:

1.  Get started in a consistent exercise program, either with friends or at home.

2.  Check your environment for fall risk factors

3.  Learn about your medications

4.  Eat a healthy diet

5.  Get plenty of sleep

6.  Drink at least 5 bottles of water daily.

The Fall Prevention Lady

I teach a workshop that is worth 3-CEUs (continuing education units) for healthcare workers.  My class is approved by the Department of Social Services (DSS), Board of Registered Nurses (BRN) and RCFE (Residential Care Facilities for Elderly) workers.  There are millions of healthcare workers who deal with older adults.  Many of these workers are not trained in fall prevention exercises not to mention aware of the intrinisic or extrinsic fall risk factors.

My 3-hour workshop is designed to educate workers about factors that increase the risk of falls and to demonstrate effective seated exercise routines that will help older adults remain strong, flexible and independent.  However the exercises I demonstrate are not just for older adults; everyone benefits from consistent activity.  The senior exercise videos that are included in the workshop price provide instructional cues to remember when flexing and stretching your body while seated.

Because I am a certified FallProof balance and mobility instructor, I am able to provide cutting edge, research-based techniques that  challenge the body systems involved in balance, thereby promoting confidence and esteem of those who participate.  I am available to hold this CEU-training workshop in your facility so contact me today so we can arrange a date and location.

And remember, Take 5 to Exercise each day!

The holidays are over.  You survived the stress of gift-giving, travel arrangements, and family disputes. Now that we are well into January,  you are either on the right track to making a lasting lifestyle change or not.  Resolutions are out, commitments are in.  People are quitting bad habits and making healthy lifestyle changes.  As Americans, we are finally getting the importance of prevention-based approach to wellness.  Keeping politics out of this blog, all I want to say is that it is crucial that each person does what he/she can to remain healthy, to prevent chronic disease and lifelong disability.

The choice to take responsibility for your well being is a personal decision.  Sometimes, a person has to “hit bottom” before making a lifestyle change.  Often times, it’s too late when that realization hits home but regardless of when, the intention is good and a person must be commended for initiating change.  Mistakenly, a lot of seniors think “it’s too late for me” or “this won’t work for me, I’ve never worked out a day in my life”.  This negativity keeps a person stuck in the same rut and the result is inevitable; a compromised quality of life. For years, a person doesn’t reach his/her potential because he/she doesn’t believe in the power of change.

For some, 2009 was a nightmare.  Some feel lucky to have survived with a roof over their head or a job to go to each day. For some, the fear of falling may have severely affected their independence or quality of life.  The message here is simple:  start today and your body will respond, no matter where you are in your journey on the wellness continuum.

You’ve got to see it to believe it.  I think you have to believe it to see it. Everything may have been fine in ‘09 but it’s time to win in ‘10.   Realize that you are responsible for your action, or inaction, and it all starts with your attitude.  Believe you can do it and you will remain independent.  Realize that you are strong and capable and you will remain so.  Take 5 to Exercise each day.  Consistent movement will keep you strong.  Set goals and chart your progress because you are going to win in 2010.

Here’s to setting goals and reaching them.  Here’s to getting out of your comfort zone and watching your body improve.  I am looking forward to working with you this year.  Educating you.  Inspiring you.  It’s time to win in 2010.

The Fall Prevention Lady

I’ve been studying to become the best fall prevention exercise instructor/health educator possible.  I realize I am a forerunner with this type of niche so you can imagine my surprise when I read about the Fall Prevention Clinic of America!  Yes, in the Heartland (Illinois), there are clinics that specialize in the early detection of vestibular and balance disorders!

Dr. Debra Rose’s FallProof program, one of the top 7 fall prevention programs in the country, stresses the early detection and thorough assessment of older adults who have fallen or are concerned about falling.  In fact, the Fullerton Advanced Balance (FAB) scale is a 10-item test designed to identify system weakness and impairment.  I have been implementing the FAB within the Sacramento region and although I’m not a doctor, I am trained to recognize a systemic impairment.  While testing, I have identified at least a dozen older adults who may have vestibular disorder and have referred them appropriately.

In this month’s Aging Well newsletter, Flagging Falls By Jennifer Mellace Aging Well Vol. 2 No. 5 P. 10, talks about the body systems involved in balance, including the vestibular system, and the importance of preventative screening and early detection.  There are 4-5 fitness tests that a properly trained professional can conduct in order to identify impairment.  Things deteriorate as we age and the “use it or lose it” theory applies to just about every body system, especially our balance skills.

The good news is that consistent activity can deter further degeneration and even improve symptoms and conditions.  Falls are accidents and although they are associated with growing older, they are not a normal part of the aging process: the risk can be reduced.  The number one way to reduce your risk of a fall is to stay active.   Remember to Take 5 to Exercise each day!

Conducting fall prevention exercise research for Therapeutic recreation classes in graduate school, I have found one recurrent underlying theme article after article:  consistent exercise reduces the risk of falls among the aging population.   Researchers study different aspects of fall prevention exercise such as the type of exercise, the frequency of movement, the age of the participants, and the intensity of the program.

In Effective Exercise for the Prevention of Falls:  A Systematic Review and Meta-Analysis by Catherine Sherrington, Whitney Lord, Herbert Bumming, and Close, the authors compare and contrast the effect of balance training, resistance training and walking on the incidence of falls among community dwelling older adults.  The results of this study indicated that those who DID NOT participate in a walking program but engaged in a resistance training program and balance training improved the most on senior fitness tests indicative of future falls.  In fact, the most important deterrent of a fall was functional balance training.  CONSISTENT balance training.

I cannot emphasize the importance of practicing your balance training.  People engage in resistance training and cardiovascular training so in order to reduce the risk of an accidental fall, a person must include exercises that challenge the balance system:  do your balance training and practice your balance skills.  Balance is an intricate messenger system that involves multiple body systems, the more you use it the more efficient the system becomes.

As a certified Fall Proof balance and mobility instructor, I teach older adults how to progressively challenge the visual, vestibular and somatosensory systems involved in balance.  The FallProof program works… I urge my participants to challenge themselves and I see their bodies responding.  My participants are more confident because they are aware of their limits of stability. They consistently practice their balance skills.

Take 5 to Exercise everyday. Incorporate a routine that allows you to practice flexibility training 3-7 times a week, resistance training 2-3 times a week and balance training 3-5 times a week. This is a complete exercise schedule that will significantly reduce your risk of an accidental fall. Invest in yourself and your future:  Take 5 to exercise daily.

1 in 3 older adults living in the community fall each year (CDC, 2006).
In my opinion, this number is grossly underestimated since a lot of falls are not reported. Once an older adult falls, he/she becomes afraid of falling again. Afraid, the individual begins to limit activities that may increase the chance of another fall; such as grocery shopping, recreational walks, and social events.
The less a person does, the weaker she becomes.  The weaker a person is, the greater risk of a fall. As a result, the individual becomes isolated and this isolation leads to depression. This is a vicious cycle and it must be stopped!
The first thing a loved one or caregiver can do is to listen to the older adult and his/her fears. It is important to validate and respect a person’s feelings but do not get drawn into doing everything for them, this only teaches “learned helplessness which results in them doing less for themselves thereby getting weaker.
The next thing you can do is encourage the older adult to remain active. Buy them a senior exercise video that can be done while seated and tell them some activity is better than none. Remember that if you don’t use it, you lose it!!! Stretching each major joint helps keep the body functioning as a continuous unit and promotes circulation which helps a person feel better. And don’t forget to strengthen what you stretch. Lean muscle mass helps a person remain independent even if they do the exercises in a chair! By consistently following a seated exercise routine, a person will get stronger which helps reduce the risk of a fall. Take 5 to Exercise each day and get stronger, not weaker after a fall.
In Day 3 of my seated exercise routine series, I deal specifically with the Cycle of Fear as I introduce my C.O.P.E. cycle and how important proper posture is in reducing the risk of falling.

C.O.P.E = Cycle Of Postural Energy

So rather than sit in fear of falling, hold your head up high and face your fears by remaining active. Take 5 to Exercise each day and break the vicious cycle of fear before it starts.

I teach senior fitness classes in my community.  I work with one particular group of older adults in an assisted living facility where the youngest member is 82 years old.  This group consistently does fall risk reduction exercises and I have the opportunity to educate them about any and everything related to falls; from nutrition to medication to how to get up if you fall.

One lady recently came to class with a black spot on her forehead.  When I asked her what happened, she told me she fell in her apartment while making the bed.  She was angry with herself for tripping over the bedspread but she was so thankful for the class demonstrations I have been giving about what to do if you fall.   She said that my instructions helped her get up safely plus the fact that she is stronger and more flexible since she has been doing her weekly exercises to reduce the risk of a fall.

Accidents happen.  A fall is an accident.  The best way to prevent a fall is to do exercises that enable you to remain strong and flexible.  And don’t forget to practice your balance skills!  Here’s what I tell my older adults to do, should they fall:

1.  Relax. Whatever you were doing before you fell can wait.  Focus on your body and be aware of pain.

2.  Once you realize where you are, extend one arm overhead.  Bend the opposite knee.

3.  Roll over to the side that you have your arm extended overhead.  If you have your right arm extended overhead and your left knee bent, roll to the right.

4.  Allow your left knee to touch the floor.

5.  Take a deep breath and push yourself up to your hands and knees.

6.  From there, crawl to the closest chair, sofa, or bed to pull yourself up.

I will explain how to get up if there aren’t any surfaces nearby but that is a little more complex and definitely requires strength and flexibility.  If you think about it, our everyday movements require strength and flexibility, not to mention balance.  Please remember to Take 5 to Exercise each day so you can get yourself up if you fall.

In order to reduce the risk of a fall, a person must first be assessed in order to know what exercises will help her prevent a fall from happening. Sure, walking is a wonderful way to keep fit. There’s no doubt that following along with your favorite senior exercise video several times a week will help keep your body limber and doing seated strengthening exercises will keep your muscles strong.  It’s been proven; consistent exercise is the number one way to reduce the risk of an accidental fall….way to Take 5 to Exercise!!!

But each of us ages differently.  Due to our unique life experiences, we are all facing different physical challenges and as a result, the exercise program that will help one person remain independent can be entirely different from his/her neighbor’s routine.   The Fullerton Advanced Balance (FAB) scale is a unique 10-item test that helps identify possible impairments and weakness unique to each person.

I have been out testing older adults in my community the past two weeks and the results are amazing.  Each person scored differently and everyone was amazed at the difficulty of what appeared to be a simple test. The FAB test items challenge each of the body systems involved in balance, making the participant instantly aware of a weakness.

Every group I worked with was hungry for the multi-sensory training that I am qualified to teach.  As I briefly educated them about some of the FallProof training techniques, their eyes lit up.  These people want to learn how to improve their balance and mobility skills.  Unfortunately, I am busy with my graduate studies so I am currently unable to offer the intensive 12-week FallProof (TM) program to community residents.  However, I gathered some vital baseline data, referred them to the appropriate medical and/or fitness resources and will be returning to retest in 3-4 months.

My Therapeutic Recreation Specialist internship with the Cordova Senior center will be when and where I begin to offer FallProof training to Sacramento residents.  Summer 2010.  We will be ready for Fall Prevention week next year!

It’s official:  September 21-September 25 is Fall Prevention week!  As the Fall Prevention lady, I am out and about in the community each day this week to increase awareness about the risk of accidental falls and what people can do to minimize that risk.  For instance, following a consistent physical activity program is one of the best things a person can to do remain strong and upright.

In addition to regularly engaging in fall prevention exercises, a person should practice her balance skills.  As balance and mobility specialist, I am out in the community conducting the Fullerton Advanced Balance scale in hopes of identifying adults who are moderate to high risk of falling BEFORE they fall.  I have been testing the ladies at the Belle Cooledge and South Natomas community centers and they are loving it!  These ladies already walk and regularly engage in both standing and seated exercise routines but now they are learning the importance of training the balance systems.

Thursday I will be testing older adults in Grass Valley at the Nevada county Falls Coalition Fall Prevention week celebration.  I am super excited about that because the falls coalition also receives grant money from the Archstone foundation, who supports Dr. Debra Rose’s Center for Successful Aging FallProof program.  I know they will love the FAB testing as it’s a real eye opener about the integrity of your balance systems.

Finally this week, I will be at the West Sacramento senior center to do some FAB testing.  They are an active center and very receptive to new, scientifically proven methods of reducing the risk of falls.  The Fullerton Advanced Balance scale was designed for community dwelling adults who are not even aware of the risk of a fall.   Some people think falls happen to “old people” and they don’t have to worry about ‘falling’ since they walk and do seated exercises each week.

WRONG!  Accidents can happen to anyone, including a fall.  Take 5 to Exercise each day and get your balance systems checked!  Look for a local certified balance and mobility instructor in your community and request a FAB screening.  I’m out and about!  Happy Fall Prevention Week.

As a certified personal fitness trainer who works with clients of all ages and of all physical abilities, I am frustrated by the lack of a governing body that oversees the fundamentals of practicing trainers. The reason I am so perturbed by this is what I saw when I observed a fitness class at an active senior center in my area. As a fall risk reduction exercise instructor, I want to be able to refer older adults to decent classes that are offered locally.

This particular instructor spent a disgusting amount of time working the shoulders. The shoulder is not only the most flexible joint in the body but also the most likely to be injured. This woman had the participants doing side and front raises using resistance bands that were not appropriate for shoulder work. Purple and grey bands are good for lower body work but are too difficult (for me) for shoulder and upper body work in the full range of motion. She even commented how her shoulders were hurting as she did the front raises.  The reason her shoulders hurt was because she was doing them incorrectly. OUCH.

I cringed when I watched the instructor begin to do squats.  Knees were shooting out over toes everywhere. DOUBLE OUCH. No wonder older adults think they can’t do squats, they haven’t been properly instructed how. Improper function results in injury. This woman didn’t have a clue how to squat and she was perpetuating the cycle of pain and lack of movement.

This killed me. No, it outraged me. There is no governing body that checks up on these “certified” trainers and how they practice. The result is thousands of bad experiences, unnecessary injuries, and wasted efforts. The older I get, the more I value my time and my effort. I consider the older adults whom I strive to help and if they have one bad experience, they might give up on the message: it’s never too late to benefit from consistent activity; when the consistent activity is done correctly. In my seated exercise routines, I constantly cue the viewer how to breathe correctly, what muscle to be concentrating on during each movement, and to stop if they feel pain.

I do not claim to know it all or to have all the right answers. Quite the contrary, I am a person who is forever seeking more wisdom, more knowledge, more insight into the movement of the human body, especially corrective exercise techniques. I want to know how can I help a person the most? If I observe an inefficient movement pattern, I feel it is my obligation as a certified health and fitness professional to be able to prepare an effective program that will help them move easier, with less pain.

Passionate about working with older adults, I see myself as a protector of the vulnerable. I am a consumer advocate. I want people to get the best training possible but mostly, I do not want people to get hurt. I realize budget cuts or the lack of a budget result in a lack of qualified trainers and instructors working with the older population. I am not discounting the good intention of the thousands of instructors who have stepped up to the plate to fill a need but who is regulating these classes?

Times have changed and there is more knowledge about correct form, sequence and type of exercise that is appropriate for older adults. Effective classes are more than shoulder rolls, arm raises and rubber bands. There is a sequence that classes should follow:

· Warm up

· Balance work

· Leg strength

· Chest/Back

· Shoulders

· Arms

· Core

· Cool down

In the meantime, please be careful. It may be my calling to help establish a regulating body that implements ‘surprise visits’ to senior fitness classes everywhere. Each instructor should be “graded” on principles, techniques and overall safety. I am deeply disturbed that unqualified instructors are not only causing injury but also shaping people’s attitudes about exercise which ultimately increases the risk of an accidental fall.