Sue Lani Madsen: Living well or living in fear

Two years after the start of a pandemic was declared, it’s past time to talk about balancing quality of life and fear of death. For the sake of our health, it’s time to move on.

Some are moving faster than others. Mom saw an invitation on social media and thought it was an exercise class. Since she was already back in person at her old fitness class MWF, the Tu-Th schedule for a virtual class would nicely round out the week without having to drive every day. So she signed up.

It wasn’t a good fit for an active senior citizen and former nursing professor. Her class evaluation form will be full of pedagogical suggestions to Aging & Long Term Care of Eastern Washington for improvement. Her reaction to the class might diplomatically be described as disappointed.

In fairness to the folks at Aging & Long Term Care, she wasn’t the target demographic. The evidence-based curriculum is titled “A Matter of Balance: Managing Concerns About Falls.” Mom isn’t overly concerned about falling, even though she just turned 90 years old. She’s been attending her senior aerobics class for 28 years and still lives in a house where she uses multiple trips up and down stairs as good exercise, made safer with added handrails on both sides.

Safer, but not absolutely safe. Nothing in life is risk free, including sitting in fear at home, giving up on hobbies and losing contact with people. That’s the target audience, according to Kathy Hill, a trainer for the Matter of Balance program. Average age of students is 79, serving those who have limited their lives because of fear of falling.

It’s not an unfounded fear. According to a 2018 plan issued by the state Department of Health, Washington has the 14th highest fall-related death rate for adults 65 and older. The number, which has increased 28% since 2000, stood at 82.6 deaths per 100,000 population in 2016 and has continued climbing. The national average is 64 per 100,000. Spokane County had the highest rate of hospitalizations and deaths among all the larger counties. Falls are a primary cause of fatal injury in older adults.

According to Hill, the decision was made in 2015 to present an evidence-based fall prevention program, which brings us back to a dozen seniors and an instructor Zooming to better health in 2022. Mom was not impressed with an hour and a half of how to get up off the floor, safety topics like why house slippers are dangerous, and a short seated “exercise” routine of light stretches.

“I’ve been exercising my entire life,” said Mom. “Our Dad had my brother and I practice falling when we were under 10 years old. He told us there was a way to fall and not get hurt. He also started us boxing with big padded gloves at the same age.” A lifelong Spokanite, Mom grew up outdoors in pick-up neighborhood ball games, sledding, skating, camping, hiking, hunting, swimming, fishing and playing every high school sport open to girls in the late 1940s. She didn’t stop riding a bike until her 70s, and ice skated until she took a spill on the ice trying to keep up with her hockey playing grandson in her 80s.

Mom had just filled out the class survey proudly noting she hadn’t fallen in three years when she slipped on sheer ice in a parking lot last month. The landing gave her a shiner where her glasses hit her forehead, but she got up and carried on with the day. Those early lessons in falling gracefully must have helped.

Clearly Mom is already managing her concerns well. She trains, she’s careful and she carries on. She’s fully back to her normal routine after the shutdowns of 2020 interrupted both exercise classes and casual neighborhood gatherings with friends. But the shrinking of her world had a significant impact on her quality of life. Vaccination and reopening gyms in 2021 came just in time to prevent deeper impact on her physical health.

That’s the demographic fall prevention programs like A Matter of Balance are seeking to reach. Adults who lose connections and limit activities out of fear are likely to be on a fast track to an early death. Kathy Hill reported they do have satisfied clients. “A gentleman in a previous class said he had stopped fishing and as a result of the class he figured out a way to go fishing again and recover a hobby he really enjoyed, something he’d stopped doing because he was afraid he would fall.”

Insufficient physical activity and isolation are not healthy at any age. Living in a state of hypervigilance, whether in fear of falling with every step or in fear of disease in every breath of air, is not healthy. For the sake of our health, it’s time to move on.

Contact Sue Lani Madsen at rulingpen@gmail.com.