It can happen in a dimly lit hall, or on an icy driveway – places where anyone, any age, might miss a step or lose traction. Suddenly, the ground under your feet disappears, and for a few heart-stopping moments the world is spinning as you fall. Seconds later you land, and realize the pain you feel means something is really wrong - and you don't have a way to get help.
April Miller knows how lucky she was that her older son heard her call for help when she tumbled down a flight of stairs in his newly-built home. "I came into the house for a cup of coffee, and I didn't know the layout yet. I was walking down the hall and I didn't see the stairs at the end - I have low vision, and there wasn't a light over the stairwell. I fell down an entire flight of stairs."
"I was yelling 'I've fallen!'…you know, just like the commercial," April says with wry humor. But her injuries were no joke. The Chetek, Wisconsin woman broke her hand in 3 places that day. Although her kids knew their mom's vision was deteriorating, her son admitted, "It's getting really real now."
Falls are the leading cause of accidental injury or death for adults over 65, according the National Council on Aging. Wisconsin has more than twice the national rate of deaths due to falls, with a financial cost of over $1.2 billion annually. Injuries like April's broken hand and worse happen in about 20% of falls. More than 95% of hip fractures are caused by a fall, and falls are the most common cause of traumatic brain injury. Falling once doubles your risk of falling again.
Despite the high personal and financial cost of falls, discussing them can be taboo. The CDC estimates that most Medicare beneficiaries who had a fall in the previous year didn't tell their health provider. The powerful link between falls and losing independence frightens people into denial. Unfortunately, this means people overlook another important fact: falls are not an inevitable part of aging. Research shows they can be prevented. Wisconsin seniors who completed the 7-week Stepping On falls prevention workshop have shown a 35% reduction in falls within 12 months of taking the class.
At 78, Merrill, Wisconsin resident Deloris Bauman lives alone and maintains her own home. "I am very independent," she stated. After she fell twice while clearing snow from her driveway, her daughter-in-law was concerned and wanted her to get a medical alert device. These devices can be life-saving, but they don't prevent falls. They help you summon help after a fall. "I heard the ad for the Stepping On class," Deloris recalls. "I said, 'That's perfect for me.'"
April found her Stepping On class through the low-vision group at the ADRC. Chris Hagen, Outreach Coordinator at the Aging & Disability Resource Center of Barron, Rusk & Washburn Counties, invited her to attend the first program tailored for those with low vision. "I learned new things on the first day," she said. "It was fun!"
Strengthening muscles and improving balance top the list of Stepping On's approach to fall prevention. "It's about keeping your body going - and strong!" says April. "The exercises keep my legs strong - because my low vision can keep me from walking as much as I know I should. I still do them every day." Deloris recalls how everyone in the group needed steadying when her group practiced heel-toe walking for the first time. "Now I can do it and not hang on to anything!" She noticed other physical changes, too. "I myself can see the muscle I gained, so I don't give up on the exercises. I am busy, busy, busy, but I do them every day I possibly can."
Participation and group support are another key to Stepping On's effectiveness. The group setting helps people overcome isolation and anxiety. Using the “prevention framework” in class, the group learns from each other how to modify ideas that didn’t work, and finds support to keep trying. Worries about limitations soon turn to encouragement as attendees share their progress, and gain a realistic understanding of their fall risk.
“I've learned how to be honest with people,” Deloris said. “Being with this group has opened me up a little more.” April seconds that observation. After her fall, she was naturally “leery” of stairs. The Stepping On course helped her overcome any shyness about asking whether there are any stairs to be aware of when she visits new places.
For someone who has had a fall, fear of future falls is one of the most debilitating outcomes - even if the person wasn't injured. Stepping On sessions address this worry with practical solutions. Community professionals – from firefighters to pharmacists – share ways to avoid hazards that can lead to falls. April found out that colorful duct tape could help her be safer on the stairs. "I put pink duct tape along the edge of the stairs in my home. With my low vision, the steps were all one color before. Now, I can see each one." When April's son saw her new pink stair edges, he was impressed. "This is nice, Mom," he told her. "I can see where it will really make a difference for you going up and down the stairs." Stepping On led April to make other changes in her home. "I rearranged my house after the program," she says. "It has meant picking up shoes from the bedroom floor at night - and throw rugs I really didn't need in my kitchen!"
Each Stepping On guest expert demonstrates simple fall prevention strategies to use at home and in the community. "The physical therapist got right down on the floor with us," Deloris said with admiration. "She showed us what to do if we fell.”
What Deloris learned that day became life-changing when she lost her footing again on her icy driveway. Even though she was wearing her medical alert device, getting back on her feet under her own power meant a lot to her. “I lay there and I thought, ‘How am I ever going to get up?’ Then I said to myself, what did they teach us? Roll over...get on your knees…crawl. So that's what I did. I crawled into the snowbank - and once I was there, that was it. I could get up!"