Finding out what lies behind older people’s fear of falling may encourage them to be more active – InForum

Dear Carol: My mother lives with pain related to rheumatoid arthritis and she also experiences early symptoms of Alzheimer’s disease. She used a cane for years and was confident with these aids, but recently became terrified of falling. I bought her a walker and she says it makes her more stable. Yet she is afraid when she moves, so she has become extraordinarily sedentary. I can understand the caution, but I’m afraid that if she avoids all activity, her health will decline even more rapidly. She lives with me and there can be friction when I make suggestions. Is there a better way? —LD.

Dear LD: It is true that once elderly people become completely sedentary, they can become weak and their general health can deteriorate, so kudos to you for solving this problem.

As you probably know, friction with an older parent who lives with an adult child is common – and that’s especially true if dementia is part of the picture. So my first suggestion is that you double-check your approach to make sure you’re using gentle, non-judgmental language.

Be curious about why she doesn’t want to walk more and listen to the emotions behind her words, as she may not be able to find the specific words to explain her fear. Maybe she’s experiencing dizziness, increased pain from her rheumatoid arthritis, or something more elusive.

Assure him you can see why (fill in his reasoning) makes walking scary, then tell him you’ll help him discuss it with his doctor to see if any adjustments can be made.

A careful review of his pain medications might be worthwhile, as it’s not uncommon for drugs, especially when combined, to cause both brain fog and dizziness. Controlling pain without causing these problems may require adjustments. Additionally, low blood pressure, anemia, or a urinary tract infection can lead to instability.

If these are excluded, physiotherapy exercises can improve balance. I realize this might be a tough sell for someone in your mother’s situation, but in some places the therapist can come to the house. Very often an older person will be more cooperative with a professional than with their adult child.

There is another reason why dizziness is more common in older people, but can affect young people as well. It’s called benign positional vertigo, which simply means that the ear crystals that help us stay balanced have floated out of place. Many physical therapists can diagnose this condition by looking at the eyes and are trained in a maneuver that returns the crystals to their rightful place in the ear canal.

My final thought is that vision changes due to dementia can make people reluctant to move. Since your mom is in the early stages of Alzheimer’s, that may not be the issue, but it’s still something to consider. You may not be able to eliminate his LD fear entirely, but it’s worth pursuing to see if some of these steps can help.

Carol Bradley Bursack is a seasoned caregiver and established columnist. She is also a blogger and author of “Minding Our Elders: Caregivers Share Their Personal Stories”. Bradley Bursack hosts a website supporting caregivers and elders at She can be reached via the contact form on her website.

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