Our world is filled with rhythm and flow, from circadian, to the pulsing of blood pumping through our veins, the thrumming of cars and planes journeying people to who knows where, or the gentle lapping of the tidal waves. You see there is cadence in all aspects of living, so why do we occasionally feel thrown off our own rhythm of life and what can we do about it?
A feeling of being a little off kilter can often occur following an alarming event such as a fall or indeed from the fear of falling itself. Perhaps this may be contributing to disruption of daily routines, or sleep and physical health problems which are becoming challenging. If these disruptions to daily life are impacting how a person functions or feels, an occupational therapist can look at establishing the nature of the issues, which may include unease and hesitancy getting out of the shower, walking the dog, maintaining a hobby, preparing meals, or walking to the postbox. Confidence and motivation may also be affected, and this can lead to withdrawal, and a person’s world becoming smaller and smaller as they avoid engaging socially or environmentally.
Experiencing falls and a fear of falling is common among people with neurological conditions, or the elderly, with evidence suggesting that 33% of people over 65 will fall at least once per year, with the figure rising to 50% for over 80’s.
Falls can occur for a variety of reasons, a few common reasons being:
- The environment
- Reduced balance
- Visual impairment
- Muscular control
- Reduced muscle strength
The occupational therapist will recommend ways to help overcome these areas of difficulty to improve and maintain everyday independence.
Occupational therapy advice will be targeted at reducing the risk of falls, and the fear of falling, though will need to be tailored to suit each person. It is important to consider the symptoms the person is experiencing, their activities and the environment. The advice given might be focused around making the home safer, for example careful positioning of furniture, looking at flooring, lighting and any equipment needed. There might be advice given surrounding appropriate walking aids and footwear, or focused on improving balance, mobility and movement through exercise and rhythmic walking patterns. Many types of exercise can help improve strength, posture, and balance control, often with an element of rhythm. For example, Tai Chi and Qigong concentrate on flowing movements to improve balance and increase flexibility, both can be done seated and standing.
A collaborative falls reduction and recovery plan may be written, setting goals and intentions to work towards, as well as agreed strategies. Or the use of a fall diary may be recommended to journal any near falling, anxieties, and concerns, as well as any falls which have happened. This could lead to many therapeutic interventions, including the recommendation of a walking aid, such as a rollator, which provides increased stability whilst supporting engagement in activity.
It is so important that people try not to let the fear of falling stop them from doing the things they enjoy or want to do. By introducing new or changed daily routines, considering how activities are done, and by following advice recommended, people can help allay their fear, reduce the risk of having future falls, and begin getting their rhythm of life back on track.