Life In The Balance

By Jo Singer, PT, CMC

What’s up with this holding on to stuff all the time?

You may have noticed that your elder relative can’t go anywhere without holding on to something. The wall, the back of the couch, and the door jamb may be getting fingerprints all over them. Walking through an open parking lot is a nerve wracking experience. They deny anything is wrong, but something clearly is not usual.

As a certified geriatric care manager who is also a physical therapist, I have a unique opportunity to observe these signs of loss of balance. There are a number of reasons for this, and some are relatively easy to address.

Why we fall

If your elder has had a fall or near fall, they may be fearful of a repeat performance. They may not even realize that their body has gone into “save” mode. Imagine how you look walking on ice—your objective is to stay upright! I see that posture in a lot of my clients. As their dual elder care manager and innate therapist, I can show them some simple exercises to do that will build strength and confidence. People frequently get out of shape without realizing it, and that can be dangerous. I had a client who was 93, living with her daughter. They were concerned about the mother’s balance problems and I gave them five exercises to do. They were amazed how she improved substantially within three weeks of starting the exercises!

Another cause of poor balance can be inner ear problems. The inner ear has a lot to do with our balance and can get bent out of shape, so to speak, by a fall or blow to the head. A visit to an ear doctor and a trained physical therapist can often clear up the vertigo in a few visits. The key word there is vestibular rehabilitation.

There are other reasons for balance issues which are not as easily fixed, such as peripheral neuropathy. (It can occur in hands as well, but we’re talking about balance here…) This is when the soles of the feet lose feeling or the feeling is replaced by tingling or odd sensation. Sometimes low back pathology can damage the nerves that feed our feet, sometimes diabetes can cause this, or it could be something else.  When you can’t feel from your feet what is going on, it’s hard to make the little adjustments to stay upright. Let’s experiment. Stand up and focus on your feet. Where do you feel pressure? Are you forward on the balls of your feet, or back on your heels? If you were to go too far back on your heels, your righting reactions would come in to play and you would automatically bring yourself forward. If the nerves aren’t sending the signals, you won’t be able to correct the imbalance. Being aware of the problem is key to helping this situation. You should tell your doctor if your elder has noticed anything like this.

Advance planning

I consult frequently with our professional geriatric care managers on our LifeLinks team about clients they think may be having issues with balance. Early intervention in the form of directing you to appropriate services for the elderly is key. Having someone who knows exactly where to go the first time can save you time and money. This is only one of many benefits of having a geriatric care manager on board. Stepping in before things get out of hand can avoid a fall with serious consequences. If you are not in Middle Tennessee or the Raleigh, NC areas, consult to find a geriatric care manager near you!


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