bringing it home with Sarah and Teneil. Sarah March is just about done. I know, I can't believe it. The first quarter of the year is about to turn behind the page turned on it.
Well, when you look at it that way, it does sound like time is just flying. But one thing that we're wrapping up here in Extension is Tennessee Extension Month. That's right. We've designated March as the month to highlight all the programming that is done through the Boke University of Tennessee Extension and the TSU Extension programs.
Yes. And we have a new program with kind of a new focus. And I'm so excited because we have a guest that we enjoy having with us today. And she's the perfect person to help tie up Extension Month for us.
We have got Lisa Washburn, Dr. Lisa Washburn. Let me give her her due respect. She is an associate professor and community health specialist with the University of Tennessee Extension.
Hi, Lisa. Hey, thanks for having me. Yes, thank you for being with us and closing out Extension Month for us. And Sarah, we have firsthand about this program that we have.
That's new. Right. UT Extension has a new program. ATSU Extension has a new program.
We're offering thanks to training led by Dr. Lisa Washburn our guests today. And it's called Matter of Balance. And its focus is on fall prevention.
Yeah. Yeah. Well, you hear balance. You think about OK, balancing our lives, balancing our check books, you know, and in Extension, we talk about balancing a whole lot of different things.
But we're talking about balancing ourselves, our bodies, right? That's right. That's right. And according to the CDC, more than one out of four older people actually fall each year.
That's a lot. That's a high statisticity. It is. And something that goes along with that.
If you fall once, that doubles your chances of falling again. OK, so this is an important topic. And we're glad that Dr. Washburn is here, so we can get her input.
And so I just want to start with an obvious question, I guess. You know, what are some of the health factors that would make a person more likely to fall? Well, one of the biggest risk factors is age. And unfortunately, that's not a changeable risk factor.
But most of the others are. So there are things like being weak in the lower body, having low muscle strength, having difficulty with walking and balance, foot pain, and wearing poor shoes, and vision problems. Those are all risk factors. A final one is a vitamin D deficiency.
So folks who are low in vitamin D have a higher fall risk. And there are some types of prescription over-the-counter medications that increase risk. Now, Sarah, this vitamin D conversation came up last month in February. We were talking about hard-he'll.
It did, yes. Making us think vitamin D is pretty important. And I feel like it's something that's a relatively new conversation in a lot of the programs that we are teaching. So it may be something new for our clients.
Yeah, but it's good to know that that's a role. That can have a role in us being more likely to fall. And Dr. Washburn, you said getting older.
That's something all of us want to do. I mean, it's not that alternative. We all want to get older. Yes, we all do.
So we've got to work on those other things that you name, that you said were changeable things, manageable things. Yeah, to reduce our risk. Yeah, absolutely. So another question I want to ask revolves around a statistic too that the CDC gives us.
They state that less than half of the older people that fall each year, they don't mention this fall to their doctor. So what are some reasons for this? That's not a good thing. No, it's not.
It's really a big thing. People who have a fall, even if it doesn't cause an injury, really do need to talk to their health provider. I think the reason why 50% may not is because 20% of injuries, 20% of falls cause an injury. So that means 80% don't cause anything serious.
So they may not feel like they have a reason to go to their health care provider. Some people may also feel embarrassed that they fall in or they may be worried that they're going to lose their independence. Like if their doctor knows that somehow that's going to indicate that maybe they can't live on their own anymore, they may think the fall wasn't that serious. But some of these relate to personal beliefs.
Some people hold the idea that falls are just a natural part of aging and we should get used to it, accept it. And that's not true. Or they may also believe that there's nothing that you can do to prevent a fall. And that also isn't true.
So it's important to think about how we can think about falls as we get older and know that there are things that we can do to prevent them. So did I understand correctly, you said a lot of people may not go to the doctor or tell the doctor because they didn't get hurt. So if a person is falling, even though they're not getting injured, is this still something that they need to bring up to their doctor? They absolutely do.
Many of the reasons why someone falls, whether they can enter or not, are really easily fixable. So having the wrong type of glasses on when you're outdoors, so progressive lenses and bi-focals are not that great when you are outside walking or doing outdoor activities. So you might just need a different prescription. It could be that your prescription has changed for eyeglasses.
And it may be that some of your medications are interacting and making you unsteady on your feet. And those are things that your health care provider can help you to adjust. So the bottom line is if you don't talk to someone about it, you can't get to the root cause. And we want to find out what's causing it so that we can prevent it from happening again.
I feel like a lot of what you just said ties over into a lot of the other health classes that we're teaching, not just matter of balance, but we really encourage conversation and regular checkups with your health care providers, getting your vision screened, having your feet checked, all those things, it's all connected y'all. It really is. And I didn't mention hearing, but if you are supposed to be wearing a hearing aid and you don't wear that, or if there's something about your hearing aid that isn't functioning, that also increases your fall risk because sound and how we receive it in our brains helps us to orient ourselves to the spaces that we're in. I didn't think about the connection with sound as far as all risk.
So that's very interesting to think about. So you mentioned Dr. Washburn, if they don't tell their doctors about it, I'm kind of going to the next level, they're probably not telling their adult children that they fall in or other relatives or friends. So if we do learn that somebody has fallen, that we know and that we care about, what is the best support that we can give that person?
Well, if an older adult or any person shares with you that they've fallen, then you are in their support circle, they trust you. And that means you have an awful lot of influence with them. So that is something to be held dear and treasured. So you're in a position like that to be able to encourage someone, encourage them to talk to their health care providers so they can find out what caused it, because there may be some simple things to change, like switching out eyeglasses or getting your hearing checked.
Another thing is those medications that can cause dizziness or sleepiness, they can cause you to be more unsteady on your feet, that's another reason to visit a health care provider. They also may be able to connect you with local resources for some home modifications, or you as an individual might be able to help your older adult friend who's shared that they've fallen with some simple home modifications that can help them to stay more stable. So even falls that don't result in an injury can make people afraid. And that fear of falling is very real.
And so as the friend of someone who has shared with you that they've fallen, I would keep a check on them and see if they do start to limit or restrict their activities. Because that could mean that their fear of falling is interfering in their lives. And there are programs that they can enroll in to help them increase their confidence and increase their physical strength. Right, good to know what to do.
That's what a great idea is. Yeah, absolutely. Okay, so keeping on this, this trend of some statistics, we know that one in five falls do calls some serious injury, okay? They can't keep that a secret most of the time, you know, that they have fallen and it has occurred.
So what kind of injuries do you know that we will see the most if this happens? What are the greatest injuries, I guess, associated with a fall? Well, unfortunately, sometimes we see injuries that result in death. So those are very serious injuries.
Falls are the leading cause of unintentional injury, death among Tennesseans, who are older than age 65. So that's in our state, top cause of unintentional death. As far as other injuries, we can see things like broken bones. You may have someone who has broken or fractured a risk or their arm, ankles and hips are also prone to being broken or fractured.
Head injuries are, they're common and they are very serious. But you can cause a concussion and you really need to visit healthcare provider very quickly then. But the bottom line for someone who's wanting to maintain their independence is that those injuries make it really hard to get around. It may mean that you have to rely on someone else to help you take care of your daily activities.
So that's why it's so important to take some steps to prevent falls because they can be prevented. Hmm, that's good to know. Now I wanna walk back to something that you said just a little bit, you mentioned the fear of falling. So we've got a population of people that have not actually fallen before necessarily, but they have a fear of falling and that is affecting their lives.
So I just wanna know is the fear of falling actually linked to the probability that they might fall one day? Fear of falling is a risk factor for falling, absolutely. So it starts this vicious cycle of being afraid that you're going to fall. So you limit your activities, become more sedentary and that reduces your physical functioning, which further increases your risk for fall.
So all of this starts with being afraid. Oh wow, that was kind of a loop there. That's my goal, yeah. So, but we do have some participants in our programs who report that they have fallen previously, but their fear of falling is non-existent.
So I think there may also be a personality factor there. Some people are not afraid of very much and others may be nervous and Ellie's, but after you experience one fall, that does tend to make you pretty nervous about experiencing another and you want to take some protective steps and you can't, they can be prevented. But unfortunately, sometimes the steps that we take are those that make us more secluded, more isolated at home and less active, which has a negative result. Yeah, it definitely sounds like the person's life can be negative effect, negatively effect it if they have a fear of falling.
Okay, so let's talk about something positive we can do. What are some things that we can do physically to condition our bodies, to make them stronger, to help prevent falls? Well, preventing falls really relates to moving physical activity. So activity is the antidote to many of these age related issues that we talk about for health.
So increasing physical activity, if you've been sedentary, will absolutely help. And it can be something simple, like just going for a walk or doing some strengthening exercises and they don't even have to use any weight and just be some simple movements that help to increase your muscle strength. Exercises that strengthen your legs are great, they will also help your balance. So programs like Tai Chi are really excellent for people who want to condition their bodies to prevent falls in the future.
So you're saying you don't have to go out and purchase dumbbells or any kind of special equipment. There are things that you can do without buying anything to help you strengthen. Yeah, and if you've been sedentary for a long time, it may not be that you need a lot of weight to begin with. It could be that just doing motion activities and using your own body weight can help just strengthen.
So something as simple as standing up and sitting back down in a chair repeatedly, that's an activity that is necessary for us to function in life, usually. So doing that as an exercise can help to strengthen your lower body muscles. That and cause pain, it's right all, Sarah. No, that's a great thing.
Yes. So, okay, so activity, are there certain booms, things that we need to make sure we're getting a mobile in our diet so it can help us along the way with the strengthening fall prevention? Well, good nutrition is always a great idea. So an overall healthy diet will help your body to be stronger overall.
You also wanna look for foods that are rich in calcium to keep our bones strong and then also low in sodium. We have a very high proportion of not just adults, but adults in Tennessee who have high blood pressure and having a diet as high in sodium is one of the risk factors for that. So we wanna watch the salt in the added sodium processed foods. We've already talked about vitamin D deficiencies.
So we can look for foods that are high in vitamin D, but for that one, we may really wanna talk to our healthcare provider. There's a test that can be done to test your vitamin D levels and then they can assess that and see if you need to take a supplement of some sort. And then the last thing that I'll say is staying hydrated is really critical regardless of your age, but especially as we get older, being dehydrated can make us dizzy. It can make us more tired and it can also influence our blood pressure and all of those things, play a role in increasing our fall risk.
So water and staying hydrated really is a good prevention strategy when it comes to falls. Well, you know, spring is in full effect now. And so people are getting busy, they're doing more things around the house and around the yard. So, you know, we just wanna get some quick tips because we're almost out of time, just some quick things to keep in mind if we're doing some of these different activities, you know, this morning.
So I think about gardening and yard work. So if I'm trying to prevent a fall, what types of things need to come to my mind first when I'm outside gardening, yard work? Hey, someone. That is gonna come to my mind first.
That was a joke. That was a joke. No, that is gonna come to my mind first. But a lot of people find that therapeutic and stress relief.
So what can be really great for that? Yeah, what do you do to make it less appropriate? People need to figure out what they're going to do when they're doing this garden. And they need to plan and they need to take all of their tools with them to where they're going to be so that they're not having to get up and down and down if that's part of what they're doing.
If they know they're gonna be in a kneeling position, then you need to plan for how you're going to get up. So that may mean having a sturdy object nearby that you can use to help raise yourself from a kneeling position. Take breaks. You know, fatigue is one of the things that can decrease our ability to balance ourselves.
So taking breaks is really important. Staying hydrated, I would say wearing good footwear is also important because, you know, poor footwear, poorly fitting footwear or where the soles are kind of worn. You don't have much traction. That can also affect our ability to stay upright.
You can contribute to slipping and falling. I would also ask a friend to come help you. Yeah. You have someone there.
Don't go it alone. Sarah, what situations do you think of that might create a situation for falling? Well, we always talk about spring cleaning in the spring and we all have those hard to reach top cabinets or things, you know, things that are high up in our closets or we might want to get in the attic and clean out. So what about that?
You know, just some deep cleaning that it may be high up or low down or baseboards, those types of things. So when it comes to, you know, cabinets and shelves, if we have items that are high, like out of our reach, it's really not recommended that we use a step stool for those who need to have someone to come help us. But if you do have a step stool that you can use for things that aren't real high, just to help you a little bit, you need one that has a handle on it. And you also need to inspect it really carefully to make sure that it is stable and that none of the screws are loose.
Sometimes tightening those up can help with the stability of the stool. You also want to make sure that your floor is clear of dripping hazards. So when we're doing our spring cleaning, sometimes you may pull everything out so that you can look at it and rearrange it. And doing that sometimes results in things being in the floor that weren't there before.
So that can cause a dripping hazard. Another is to put your pets outside or in a different room because pets get underfoot. And if we've already pulled a lot of things out of the cabinet, then things look different. And we may be, you know, visually we may not be as oriented where we're putting our feet.
And I would also say, be really careful when stepping from side to side, many, many falls or calls by side to side movement, not necessarily forward movement. And sometimes in the kitchen, we step sideways and off a lot to reach or to grab. So before we overextend our reach to grab something, let's take a few more steps and get a little bit closer so that we can make sure that we're really stable. The last thing I would say is to don't try to get it all done in one day or one weekend, plan for doing it in stages, because it's going to be tiring.
You'll need some breaks. And it might be that you take a set of cabinets to do one day and then you put the other off until later. I definitely like that idea. We want to ask about one more thing, because after we get done working in the yard, we get done doing all this deep cleaning, we're going to have a bath or a shower.
And that is a fall risk in a lot of ways. Is that right? Yeah, up to 80% of falls in the home happen in the bathroom. Oh my.
Yeah, so really high percentage. So there are things that you can do to make that room safer. And then there are some behaviors that you can adopt. So the first thing is the things that you can do.
You need a grab bar in your shower or tub. You need a grab bar on the wall outside of it. You also need one year of your toilet. Adhesive strips, some kind of texture for non-slip.
That should be on the bottom of your shower or your bath tub to help you avoid slipping once you're in there. You may also need some that are on the floor outside of your, outside of your shower. If you have mats that need to be non-skinned and a shower stool can be really helpful if you get fatigued. Finally, the behaviors, sometimes we sit down a lot in the bathroom to take care of our business.
And we may try to stand up too quickly and get dizzy. So we can have some low blood pressure that happens after we sit for a long time and try to stand up quickly. And that really is a risk factor for falls too. So we need to be careful when we're sitting down and getting back up from the toilet to make sure that that doesn't happen.
Wow. Great too. Yeah, we know we've covered a lot of that in our Matter of Balance class. So I would encourage any of our listeners that are interested in that class to contact your local county extension office to see if it's offered in your area.
Or go online, right, Lisa, to our, the website. If you wanna share that, that would be great. Yeah, let me fill up that web address. And I can say that a majority of the counties in Tennessee have people who are trained to conduct Matter of Balance classes.
So if you wanna look for one online, go to fcs.tinnacy.edu slash health slash matter dash of dash balance. Or you can call your extension agent. That would probably be easier. You can call your extension office and ask them to pull up the page for you.
They can take a deep break. Yes, great. Thank you so much for joining us today. Dr.
Washburn, so many good tips. And I know that our listeners, you know, learn something because I didn't realize that 80% of the balls in the home happen in the bathroom. And we don't spend that much time in the bathroom. So that's kind of a scary thing to think about because, you know, lots of balls there.
So we're all gonna be really careful. We're gonna practice fall prevention. And hey, check out our friends. You know, make sure that everybody is doing okay.
So thank you all for joining us for this episode. In the words of Mr. Bob Marley, live the life you love. And love the life you live.
Take care friends.