Exercising such as walking and muscle strengthening, and perhaps balance and stretching exercises too can actually help mitigate or even prevent the effects of osteoarthritis.
And there is a strong link between osteoarthritis and falls, though this is one of many reasons. But to point out a few interesting facts:
One 2009 study reported in the AMA involving 750 adults 70 years and older who reported two or more areas of pain, or even one area of severe pain, or pain that interfered with their activities of daily living were significantly more likely to fall. Another study in Arthritis & Rheumatism involving 6500 men 75 and older found that those who had knee pain had a 25 percent increased chance of falls, and twice the risk of hip fractures. The more severe the pain, the greater the risk of falls and hip fractures.
One or both of your parents may be at risk for falls, something that could put them in a nursing home sooner than later. There are different risk assessment tools, but borrowing some from each makes sense, such as:
- A history of previous falls
- Poor mental cognition, confusion, disorientation, impulsivity
- Having dizziness, vertigo
- Having a poor gait to begin with
- Being on benzodiazepines, opioids or other medication
- Poor limb strength and lower body strength (one can test this by seeing how well one rises from a seated position)
- Advanced age in general
- Poor vision, and even poor hearing!
The CDC also suggests one can ask three simple questions:
- Have you fallen in the past year?
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
Some of these risk factors can be preventable or even correctable to a degree with exercise designed for fall prevention, often found in the community. One popular community-based program is Tai Chi, which also has been proven to help prevent falls by as much as 70%, probably by increasing balance and strength. https://taichiforhealthinstitute.org/the-worlds-largest-fall-prevention-study-2007/
When I researched the reasons one can end up in a nursing home, there didn’t seem to be much data out there. One common reason is having three or more deficiencies in one’s activities of daily living such as dressing or bathing. Incontinence and poor vision were others.
Of course, many of these overlap, but the number one reason seems to be dementia, with 50-70% of nursing home admissions attributed to this, with most being due to stroke. I was surprised to see that only about 5% of admissions were due to hip fractures, though this number may increase during one’s stay in the nursing home. However, another study ranked hip fracture as #2 after stroke.
The lesson learned here is that avoiding falls should be a priority for your parents overall wellbeing. What can we do then to help them?
Steps to Reducing Falls
- Get your parents onboard with the idea that avoiding falls is extremely important, and yet avoidable. Many people think that falls risk is something irrelevant in their lives. The National Council on Aging debunks several myths in this regard.
- Get your parents to get their eyes checked. I constantly hear patients telling me that their eyes are blurry after more than 15 years of using the same glasses!
- Home safety: Are all the lightbulbs at least 60 Watts, and changed for that matter? Are their dark areas in the home needing a lamp or night lights? Is the shower or tub easily accessible for your loved ones? Do they have grab handles? Are their loose rugs easy to trip over? Is the house cluttered?
- What does the doctor say about their risk of falling? Are they on medication that make them more prone to fall?
- Exercise to improve mobility, balance and strength. Walking is probably the best exercise overall, but swimming is also great to get a safe and effective workout. Tai Chi is a great way to improve balance too—check your parents’ community center to see if they know of any available sessions. This is really becoming popular in many towns and cities across the country.
- Avoid loose clothing, especially if they interfere with one’s feet. Non-slip socks that grip the floor are important. Making the bathtub non-slippery with non-slip mats can be a big step too.
- Just take it easy! Tell your parents to take slower moves when the stand up or sit down, change position, or use the stairs, for example.