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“Hospitals have become so overzealous in fall prevention that they are producing an ‘Epidemic of Immobility’” — The Washington Post

In an article by Melissa Baily in today’s Health and Science Section of the Washington Post and produced by Kaiser Health News (not affiliated with Kaiser Permanente), the writer describes how people like you and me, who may have been admitted to a hospital as a result of a fall, may have their condition complicated as a result of both current law and the hospital’s internal “Cover Your A__” policy.

This article is SCARY and should serve as a warning as to what can happen when hospitalized after a fall. It seems that many hospitals, in their attempt to avoid financial penalties, are restraining patients who should be up and moving around, from doing just that. They are not allowed by hospital edict, to leave their beds. The article reports that some patients leave the hospital with major muscle deterioration that could have been prevented and could result in future problems.

According to the article, there are a number of reasons. Financial penalties to hospitals began in 2008 and were increased by Congrress under the Affordable Care Act. The Centers for Medicare and Medicaid Services (CMS) reduced payments to hospitals with the highest rates of falls and other “hospital related injuries”. Thus hospitals kept patients in bed and even have “movement alarms” for those patients who try to move.

In addition, because of pressures from hospital managements, nurses are reluctant to help patients get up and move for fear of repercussions if the patient falls while there. Understaffing of nurses aggravates the problem.

The article cites research by a U of California (San Francisco) geriatrician and researcher who found that “one-third of patients 70 and older leave the hospital more disabled than when they arrived.” The article was unclear about whether this referred to all patients, or just those patients who were admitted as a result of a fall.

The article says that there are efforts to change this. Private initiatives are spreading the message of this problem across the country. Nurses are being encouraged to get patients out of bed and moving. Other initiatives are in play but the article made no mention of any potential changes in the law that penalizes hospitals financially for patients who fall while under hospital care.

So what’s the takeaway here? DON’T FALL! At least don’t fall in a way that requires a visit to the hospital.

How do you prevent a fall? The best way is to have strong legs, a strong core and good balance. Will that prevent you from falling? No, but it will help. Most falls are accidents. They result from slipping or tripping. I have strong legs, a strong core, and decent balance. Yet, I fell on my hip last winter— after dark on ice I didn’t see. I had a bad bruise and hurt for a week, but I didn’t need to go to the hospital.

Winter is approaching. Slipping on ice is one of the main reasons seniors make trips to Emergency Rooms in the Winter. Much more so than a heart attack or a stroke.

So stay strong and pay attention to your surroundings. Be bold but be careful.

Thank you for reading.

If you are a Senior and you exercise, then injury prevention must be one of your top priorities —  more so than other age groups.

Some injuries to Seniors occur as a result of  bones becoming brittle and easy to break or from a decline in muscle mass (Sarcopenia).  But most exercise injuries to Seniors result from structural changes in your joints due to the aging process.

Knee joints, hip joints and shoulder joints seem to be the major joints where problems arise.  Microtears (tiny tears) in the muscles surrounding a joint, and calcification of the joints are the main culprits. Calcification of the joints are not as common as tears. Repetitive stress can also be a culprit for injuries to smaller or weaker joints.

Tears are most common in the shoulder joints. For the most part, the dreaded rotator cuff injury is a microtear in one of the muscles making up the shoulder complex. I know, I had one. It was painful. It healed.

Injuries generally occur as a result of overuse, or some sort of unusual strain or pressure on the joint and associated muscles, tendons and ligaments. This could happen from an unusual turn or twist, or from a quick movement that your joint is not used to.

Exercise can be the cause, the prevention and the solution to these injuries. Seniors who exercise have a much stronger infrastructure than those who don’t. Movements that would cause injury to the non-exerciser normally wouldn’t bother the exerciser.

On the other hand, if you exercise, you are likely to move in ways that the normal person wouldn’t move and thus are more likely to overuse muscles and joints.

Finally, both rest and certain exercises are most often the recommended solutions to muscle and joint injuries, and both are normally recommended by a Physical Therapist. When you see a doctor or Physical therapist for an injury (and I recommend you do) you will get a series of exercises to help heal the injury. Do them!

And keep in mind, too, that Seniors will normally take longer to heal than younger people.

So, what’s the takeaway from this article? Be careful. Don’t make really sudden or unusually movements, particularly if weight or resistance is involved. You are better off exercising than not exercising but you must still be careful not to abuse your muscles or joints. In other words, be bold but be careful!

Thank you for reading.

How many of you reading this article expect to be able to take a fast walk around the block, let alone a 2 to 3 mile trek at a fast clip — at age 97?  This past Sunday, that’s exactly what I found.

My wife and I take an occasional walk on the very nice woodland walking paths available to us where we live in Reston, Virginia, just outside Washington, DC. This past Sunday we did our normal two and  a half mile walk (35-40 minutes). It really feels good to get out on those paths and walk at a pretty brisk pace.

While we were walking, we ran into some old friends. They were walking the same path at a pretty good clip, maybe not quite as fast as us. I always thought the man was maybe a year or two older than I am, probably in his early eighties. He was in high spirits, was lean and trim and had a strong voice with a pronounced French accent with no outward indication of age. It turns out he is 97 and a half years old. He had a huge grin on his face and was filled with personal energy as he told us his age and how good he felt.

He and his wife, who is in her seventies, attribute their good health and fitness to mostly walking. They do a lot of it. They are very active and travel back and forth to France a couple of times a year.

I also ran into another friend yesterday morning who proudly told me that he had just lost 15 pounds in the last 18 days. He attributed it to a changed diet and a lot of walking. He didn’t talk about the diet, but he did talk about how good he felt and how much he believed the walking had to do with the weight loss. He is a year younger than I am and is pre-diabetic. He is doing the diet and walking as part of a supervised, pre-diabetic program. He said he feels terrific as a result of the walking and the weight loss.

What is it about walking that makes some aging “experts” say that walking is the best of all basic exercises for seniors — not the only one you should do, but the best overall?

Let’s take a look. . .

Walking is a whole body exercise. It builds up your legs and your breathing capacity. It strengthens your heart and lungs and is easy on your knees. It’s sort of an ideal exercise. When you combine it with a few simple resistance exercises, you have an ideal exercise program for overall health and fitness. It is minimal, but it is excellent. Add to that, moving around a lot during the day, and you can’t go wrong.

Not every town has walking paths and trails as nice as we have here in Reston,Virginia. Yet more and more cities and towns are creating environments friendly to walkers, runners and cyclists. My wife and I were passing through Tampa, Florida not all that long ago, and there were people walking, running and cycling all over the place in areas that have been set aside just for that purpose. Other towns and cities are doing the same. It is gratifying to see.

Most places have sidewalks where you can get out and walk. High school tracks are a popular place for walkers after school and school activities hours. There are usually public parks with lots of open space to move around in.

It might be “dumbing down” to the reader to suggest that you wear light clothes in the Summer, and dress warmly and layer your clothes in the Winter. Drink plenty of water and stay hydrated Summer and Winter.

So, no matter the time of year, grab the opportunity to take a walk wherever and whenever you can. Your body will love you for it.

Thank you for reading.