Among the things it malnutritionally lights is the pull-down stairway leading to our attic — a stairway that’s actually more of a folding ladder, the second to the bottom step of which I missed a couple of weeks ago in the dim light.
That I was alone in the house at the time didn’t occur to me until after I caught myself. After I did, I noticed that if I’d failed, my next chance would have come on the first floor landing, a full flight of stairs down.
I then realized if that had happened, my future would have included months of traction and physical rehab, leading to the speech therapy I would have needed so that I could apologize to my wife for getting blood on her favorite childhood doll, which resides behind a pane of glass I’d have crashed through as I hit the display case snugged up to the wall on our first floor landing.
As Patrick Dolan, supervisor for physical medicine at Springfield’s Excel Sports Medicine put it to me: “Your home is the No. 1 place where you can injure yourself.”
When it comes to preventing falls, Dolan is a big believer in light: lights in rooms, lights in hallways, solar lights along pathways and steps, and lights near keyholes, where we fumble with our keys. He makes a good point. Because although we sometimes fear that criminals might attack in the dark, we seldom give a second thought to the unseen enemy that’s always waiting for us to stumble: gravity.
Lynn Willford, assistant director of rehabilitation at Springfield Regional Medical Center’s outpatient clinic, said, as we age, gravity develops partners in crime.
Age slows the reflex that links our vision with the brain’s vestibular nerve, the place that puts out 9-1-1 calls for us to balance ourselves when we falter.
With age, the crystals located in our ears and that serve as our personal gyroscopes can shift, sending us the wrong information about which end is up.
Then there’s the wear-and-tear age brings to the muscular-skeletal system.
“Our reaction, our quickness, our ability to respond — those things start to fade or lessen,” Willford said.
If we don’t adjust, that can make everyday life hazardous.
Rachel Bican, at Excel for her first clinical experience toward a doctorate of physical therapy from Ohio State University, worries that older people carrying bulky laundry baskets on stairs will put themselves into the tumble cycle before they get near a dryer.
In the face of such growing obstacles, she, Dolan, Willford and about everyone else on the planet trying to keep older folks from falling and breaking hips, legs, shoulders and anything else have a piece of advice: Clean house.
“The cluttered house is the most dangerous,” Willford said.
Throw rugs are bad, not only because they can slip out from under us but because their edges can trip us up, particularly if we’re wearing the wrong shoes.
“Tie shoes are the best,” Willford said, with a low heel so a person, even one losing feeling in his or her feet, can better feel the ground.
When she sees older people wearing flip-flops or slip-on shoes in their homes, “I want to throw them all away in a pile and burn them.” Just to be clear: She wants to burn the footwear, not people or their homes.
Things can take a turn for the worse when ill-fitting shoes are paired with ill-suited canes and walkers — assistive devices chosen not because they’re the most helpful for the injury impairment at hand, but because they happened to be in the basements, closets and attics of friends or relatives who may have had far different problems years ago.
Using the wrong device is only a step away in poor choices from those who “furniture walk,” reaching for chairs or couches that may slide, something that’s more difficult if it involves dodging books, knitting, newspapers and pets (sorry, Fido) that may be on the floor.
If all this is enough to make you want to sit down, don’t.
“I tell people life is exercise,” said Sue Creager, a physical therapist at Springfield Regional Rehab. (Creager fitted me for orthotics more than two decades ago and remembered the details of my foot problems so clearly and immediately that I found it nearly disturbing.)
She works with clients to regain their balance and get back moving, whether they’ve been slowed down by stroke, aging, weakness or injury. Simple manipulations often can realign those pesky crystals in the ears. Training can help people get back to a wider walking pattern if they’ve spent too much time doing a Victoria’s Secret walk behind a walker.
“Generally, when you train, you gain,” Creager said.
One of her favorite stories involves a 92-year-old woman who wanted to regain her sense of balance so she could go back to tap dancing. With a few weeks’ training at parallel bars, she did.
On the flip side of that, she told the story of a retired woman who had lost her sense of balance to vertigo and, over the course of two years without treatment, lost much more: She’d stopped driving, stopped going to church and stopped going to see grandchildren.
Creager said the good news is that, depending on the source of the problem, regaining a sense of balance usually involves less time spent than regaining physical strength. It’s training not done to fatigue or exhaustion.
When it comes to physical strength and balance, Dolan told me the problems seldom involve ifs-and-buts but often involves butts. That’s my translation of what he actually said: That the gluteal muscles connecting our upper and lower bodies do most of the work in helping us to maintain our balance.
Perhaps because I was the dim bulb sitting in front of him, Dolan also talked about the importance of using the brain — of giving thought to “slowly remodeling” our homes as we age: Adding grab bars in showers; putting non-slip strips on slick outdoor steps or adding sand to paint that coats them; widening doorways to make room for walkers or wheelchairs; and reorganizing pantries and shelves so the most often used items are easiest to reach.
Bican ticked off reasons for not putting it off: It’s cheaper when we’re still able to do the work ourselves; it prevents injury because what’s necessary will be in place by the time it’s needed; and it can lessen family conflict because, if the work is done, there will be less likelihood that children like mine already worried about an injured parent will have to fight with a stubborn old goat like me to make changes that are so obviously necessary.
After I change that dim bulb on the second floor landing, I plan to install another in the stairwell to the basement, put in handrails on both sets of stairs and do some more thinking.
It’s what a dim bulb has to do.
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