Falling Down – Don’t Do It

I’ve been rushing around impetuously all my life. Last year I was hurrying up my path to the gate when one of my hens flapped her way between my feet.  I felt myself going over, instinctively threw out my right hand to break the fall and landed on it hard.  It only took a second to break a bone in my wrist and tear three tendons off the bones on the back of my hand.   But it was six painful months before I could really use my hand again, and 16 months later the wrist is still stiff.  I was lucky to regain so much mobility. 

The wrist is a complicated piece of architecture with 8 small bones delicately connected with nerves, tendons, ligaments, muscles and nerves to the hand and forearm. A bad fracture can require surgery, implants and months of physiotherapy.  I got off fairly lightly.  But it really made me focus on the issue of falling.

We Boomers living abroad are used to thinking of ourselves as strong, adventurous, resilient and active.  We’re in denial that if we fall down, we could hurt ourselves. We’re resistant and indignant but the reality is that a fall these days can be serious.

We can take denial too far.  Two of my friends in Ubud had falls and then walked around for days in great pain before going for X-rays. Both had broken hips which required emergency replacement.

Hip fractures are the most common and serious of all the injuries sustained by older people during falls.  According to the American Academy of Orthopaedic Surgeons, 20 per cent of elderly hip fracture patients die within one year after their fall.  (I don’t know how they are defining elderly, they can’t mean US!)  Half will become dependent on a cane or walker. Forty percent will need support to perform daily activities. 

Here are some sobering factoids.  Falling is the leading cause of accidental death among people older than 65.  About one in four falls requires medical attention, and falls are responsible for about 95 per cent of all hip fractures. Only a quarter of older adults who suffer a hip fracture from a fall actually make a complete recovery.

And there are so many opportunities to fall here in Bali!  It’s as if the environment had been specially designed to knock us off our pins.  Uneven pavements, gaping holes, steep steps without railings, slippery tiles, mossy paths, piles of sand or gravel blocking the way… all open invitations to take a tumble.   And once down, we are not in a country where 911 will quickly bring skilled assistance. If an ambulance can penetrate the traffic to reach us, we need to know which hospital has the best diagnostic equipment and orthopaedic support.  (A general rule for any medical emergency in Bali is to always take a friend to advocate for you; never go alone.)

Falling can cause minor injuries from scratches and bruises to more serious harm such as head trauma.  Fractures occur most commonly in the hip, but can also affect the spine, arms, wrists, ankles or legs. The risk of fracture is increased in those who suffer from osteoporosis; those fragile bones can snap like matchsticks.   Susan Tereba will talk about osteoporosis in her next Boomer column.

Even those of us in robust health are at risk because Bali is such a dangerous environment for older people.  But most falls are preventable.  

– Medication is a leading cause of falling.  Some medicines or combinations of medicines cause side effects such as dizziness or drowsiness. Taking more than four medicines poses a risk of falls.  If you’re taking four or more medications, get a doctor or qualified pharmacist to review them.

– Staying active maintains strong bones, muscle and cartilage and therefore increased balance, coordination, strength and flexibility.  Walk, swim, do yoga, go to the gym, whatever, but be sure to include activities that improve balance.

– Get your eyes checked.  Identifying medical conditions like glaucoma or cataracts plays an important part in fall prevention.  If the vision of one eye is compromised, it will affect your depth perception.

– Wear sensible shoes.  Flip flops or shoes with slippery soles are treacherous, especially in wet weather. We need shoe designers to start creating stylish, comfortable shoes with non-slip, textured soles and good ankle support.

– Lighting around the house becomes an issue as we grow older.  Shady corners and unlit steps or paths can be risky, not just in regards to falling but in seeing snakes as the rainy season approaches.Nightlights en route to the bathroom at night are very helpful.  As we get older, it’s important that that toilet is near the bedroom, definitely on the same floor. Bathrooms are the room in which most falls at home take place.

– Floors and stairs need special attention.  These days non-slip tile is widely available.  It was not when I first built here, and wet, shiny ceramic floors can be deadly.  Wait for freshly washed floors and steps to dry before walking on them. Attach non-slip backings to carpets and throw rugs.

– Pathways need special attention. In shady areas they become mossy and slick in the wet season. Uneven surfaces and loose stones can catch one unawares.

– Stairs in Bali can be daunting even to the young and fit. Navigating steep, wet stairs without a railing is an open invitation for a fall.  I’ve taken to crab-walking up and down steep steps sideways.

– I constantly seem to have pets underfoot.  No matter what I’m cooking, at least one dog will be hovering in front of the stove.  If they can smell chicken or eggs in the pot, there are three of them weaving between my legs.

– De-clutter your floor space. Keep frequently used items in easily accessible places.

Get over assuming we’re as invincible as we were 20 years ago.  But we’re Boomers.  We’re the generation that discovered sex, drugs, rock and roll, yoga, vegetarianism, civil disobedience and so much more. Now we’re embracing elderhood with style.

I’m seriously considering carrying a walking stick as a sort of third foot to give me extra balance out there on Ubud’s shattered sidewalks.  Perhaps we should make walking sticks a new fashion accessory and compete to design the most attractive and unique examples. 

Anyway, don’t fall down.  Get used to watching your feet.  And twirl that walking stick with aplomb.

By Ibu Cat

The Boomer Corner is a column dedicated to people over 60 living in Bali.  Its mandate is to cover topics, practicalities, activities, issues, concerns and events related to senior life in Bali. We welcome suggestions from readers.

E-mail us at : Baliboomers@gmail.com

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