Sunday, May 01, 2016

Falling, Fear and Fortitude

Trail companions- Raven and nordic poles

I have been afraid of heights as long as I can remember. Very afraid. I am uncomfortable on a balcony higher than the third floor or climbing more than three rungs up a ladder. Seeing someone stand on the edge of cliff makes me feel physically ill. For many years I could not look at a photograph of a waterfall without my stomach doing a loop. Sky diving, bungee jumping, zip lining, and rock climbing have never been on my bucket list. 

As a physiotherapist working in geriatrics, fall prevention is an important part of my job. I see many people who are admitted to hospital as a result of falling and sustaining a significant injury. In taking a good history, it is very important to determine the reason for a fall. Was it due to a medical condition or the physical environment? Does the patient need a gait aid? Our goal is to prevent further falls in hospital and after discharge. 

Whatever the cause, falling aways does one thing. It creates an increased fear of falling. And that fear keeps people at home, decreasing their participation in activities in the community and can even create walking disorders. Canadians endure long winters with lots of snow. We have a few ice storms each season which are far more treacherous than snow storms. Inclement weather is one reason people here can become increasingly isolated as they get older. This increases their risk of depression, physical and cognitive decline, placing them in a downward spiral functionally. 

I am surprised at the resistance I frequently get when trying to get someone with a history of falling to use a cane or wheeled walker. They don’t buy my argument that a gait aid will help them get more exercise, making them more independent and less likely to fall. I tried to get a family member to use a walker after she fell and broke her shoulder because of poor balance. A year later she fell and broke her hip and had no choice but to use one. (Family members are often most resistant to advice!)

Tackling my fear of ice and waterfalls at Niagara Falls
I had two bad falls on ice resulting in a broken wrist and a broken elbow. They happened over 20 years ago and when I see ice, I still feel some panic. Initially I was inclined to want to call in sick at work rather than walk across an icy parking lot after a storm. Instead, I bought ice grips for my boots and a pair of nordic poles which stay in my car at all times. Every time I succeed in walking across a slippery surface, my confidence increases. Nordic poles are also my constant companion when walking on trails and prevent stumbles on tree roots and uneven ground. 

Over the years I have come to understand the source of my fear of heights and my panic is under more control. Fear protects us but is debilitating in excess. Depending on our experiences, added years bring new anxieties which alter or replace childhood fears. We can fall down physically, professionally, socially, or in close relationships, but in each case it is important to learn from the fall, to put aside fear, get up and try again. Other people may have insight into the reason for our fall and may we never be too proud to ask for guidance and advice on our journey. 

Two people are better off than one, for they can help each other succeed. 
If one person falls, the other can reach out and help. 
But someone who falls alone is in real trouble.

Ecclesiastes 4:9-10 NLT


  1. Ruth--you talked about one of the connections I have to the word: falling.
    I have a number of family members who experienced falls--either triggering their own decline or as the result of decline.
    About 3 years ago, an aunt of mine fell and broke her hip. After her hospital stay and a lengthy time in rehab, she was ready to go home. BUT--home was a 2 story house with a very steep set of stairs and the ONLY bathroom upstairs. The rehab facility would not release her to such an environment. So a cousin of mine and I went into action. Even though my aunt lives in NY--my cousin lives in Minnesota and I in Pennsylvania, we did it. We found a 50+ apartment complex, and moved her into a ground floor apartment.
    Interestingly, she did not sell her house. She stayed in the apartment (hating it every minute). Finally, a week ago she moved (with the help of friends) into a new senior apartment, in the town where her house is. She is now getting ready to sell the house. I am gratified that a) she recovered from her fall, and b) that she is now doing well and is happy back in the town she loves.

    P.S. I share your fear of heights!

  2. The general public has no clue how much falls contribute to the downward spiral of people as they age. And, I find, like you, that people are so resistant to using walking/balance aids. It takes so much to convince our brains that our bodies simply are at greater risk as we age. It's lovely that you get to work with people to strengthen their core and be a part of the solution!

  3. You may be even worse with heights that I am. Balconies and ladders bother me. I rode up the CN Tower in my 30s, but just the thought of it doing it now gives me creeps. Somehow, I was able to manage, barely, some suspension bridges in Vancouver about 10 years ago. I'm not sure what enabled me to do it, but I think I might be able to do it again.

  4. I'm grateful that you make the connection between falls and resulting isolation, etc. As a pastor that's something of which I need to be mindful when ministering to those experiencing some of these issues in aging. ... My mother was one of those people who resisted using a cane to assist her with walking. Falls became more frequent for her over the last several years, and I'm not sure anyone took the time to look at common denominators of those occasions. Thanks for the insights in this post, which I will try to keep in mind.

  5. It took a lot of convincing to get my parents to use walkers, too, and I am so grateful that they finally do. So much more stable and mobile with those along. Fear of falling is not just for those who might fall; it's also for their children whose lives get immeasurably more complicated after a parent fall.

  6. So beautiful, Ruth! And I love that particular scripture - such a great application here!


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