This article has information on arthritis, osteoporosis, and falls. Arthritis and osteoporosis can be treated to reduce pain and improve quality of life. There are classes in Fresno to teach management of arthritis and prevent injury in persons who are at risk for falling and fractures.
ARTHRITIS
Arthritis is the most common health condition reported by older adults. There are over 100 different types of arthritis like diseases affecting the joints. Characteristics of arthritis are joint stiffness, swelling, and pain. An estimated 50 million adults in the United States have arthritis, with projections indicating 67 million adults will have arthritis by 2030. Arthritis is more common for females, persons who are older, overweight, or smoke.
Arthritis is the leading cause of mobility challenges for middle-aged and older persons. People with arthritis can have varying degrees of difficulty in walking, lifting and carrying items, climbing stairs, and difficulty with household chores. Because of arthritis pain, many older adults avoid going out with friends and exercising. Not surprisingly, depression is quite common among older adults with arthritis. Older adults with arthritis also experience dependence on family members, overall poor health, loss of joint motion, and diminished quality of life. Unfortunately, half of arthritis sufferers believe arthritis and the symptoms are normal aging.
Classes to help with Arthritis
Self-management programs and exercise are two proven ways of coping with arthritis. Self-management programs provide education, information on pain management techniques and appropriate use of medications, exercise, emotional support, and teach participants how to improve communication with health providers. Individuals who participate in self-management programs experience less depression, anxiety, pain, and disability. Saint Agnes Medical Center offers a group program, “A Healthier You” free of charge. This six-week program teaches self-management and life skills to help individuals who have health conditions, such as arthritis, live a healthier lifestyle. Call (559) 450-3770 for more information and to register. For people who may not be able to participate, the northern California chapter of the Arthritis Foundation offers an online “Better Living Toolkit” with resources to help manage arthritis.
Exercise is important for maintaining physical ability among elders with arthritis. Tai Chi, aerobic and resistance training, and fitness walking all help decrease the pain and stiffness that comes with arthritis. In Fresno there are several exercise groups you can join to help manage arthritis. Class information is listed at the bottom of this article.
OSTEOPOROSIS
Osteoporosis is a systemic skeletal disease characterized by low bone mass and deteriorating bone tissue. Bones become more fragile and susceptible to fracture. The consequences of osteoporosis are severe. More than 1.5 million osteoporotic fractures occur each year. Loss of height and curvature of the spine limit mobility and cause pain. Age, low calcium intake, family history, vitamin D deficiency, steroid use for inflammatory conditions, alcoholism, tobacco use, and diabetes all increase the risk of developing osteoporosis.
Many older adults are unaware of their osteoporosis risk. Osteoporosis has historically been thought of as an “older women’s” disease. There is now emerging awareness of male osteoporosis; approximately 2 million men aged 50 and older have osteoporosis. For perspective, a man’s lifetime risk of developing prostate cancer is lower than his risk of having a fracture because of osteoporosis. Although men are less likely to break a bone, they are more likely to die from their injuries. According to the American College of Physicians male osteoporosis is underdiagnosed, undertreated, and not properly researched. Older adults and their family members need to be aware of the need for osteoporosis testing.
Fortunately, osteoporosis is one of the more preventable diseases. Calcium, vitamin D supplements, and exercise are effective in maintaining bone health. Exercise usually includes mild weight training to increase muscular strength and bone density, and balance training to prevent falls.
HIP FRACTURES
Currently, 70% of all hip fractures are sustained by women. Additional risk factors include white ethnicity, dementia, difficulty getting in and out of bed, and bathing independently.
The average length of hospitalization for a hip fracture is a week. Forty percent of hip fracture patients are discharged to a skilled nursing home; a year later, 25% to 33% remain in long-term care. Older adults should continue to visit their doctor, participate in physical or occupational therapy, and practice strength training in order to restore walking ability. Depression, anxiety, and pain are barriers to recovery. Older adults with dementia or other health conditions also experience limited recovery.
Fall prevention is crucial to reducing hip fractures. Increasing bone mineral density through calcium supplementation, and Vitamin D also reduces hip fractures. Hormone replacement therapy (HRT) prevents bone loss and fracture. However, the risks of HRT depend on many factors including age, type, and duration of administration. Consult with a doctor to discuss individual risks and benefits of treatment.
FALLS
Falls happen more frequently to older adults than most people think. According to the American Geriatrics Society, each year approximately one-third of older adults fall at home. Falls have serious health consequences. There is an average of 2 million yearly emergency room visits by older adults due to falls; 41% have some type of fracture. Falls account for the largest percentage of injury deaths in older adults.
Even if an older adult has never fallen, many fear they will fall. They may be embarrassed about falling and having to depend on others to get up. The fear of falling keeps many older adults from participating in social activities. Fear of falling leads to being alone, depressed, developing muscle weakness, and being more dependent on family members for help. Fear of falling even predicts moving into assisted living homes among older adults who have never fallen.
Over 130 risk factors for falls are identified. Reducing fall risk requires attention to health, home safety, and making sure older adults have enough help at home. Weakness in the legs, problems walking and with balance, poor vision, and taking multiple medications all increase fall risk. A physician should review medications to determine if there are any risks associated with taking multiple medications, the use of medications for mood and memory, and look for potential side effects, such as dizziness.
About 30% of all falls happen due to home safety issues. Common household hazards are throw rugs, dim lighting, clutter, slippery floors, floppy slippers, and not having handrails and grab bars. Simple changes at home can be helpful in reducing falls. Home safety is especially important for those who have poor vision, or difficulty walking. The CDC has a home safety checklist that can help.
How Family Can Help
Family members play an important role reducing an older adult’s chances of falling and providing emotional support. Family members can offer help as simple as an arm to lean on when going down stairs, or getting in and out of a car. They may also help with household chores, grocery shopping, and lawn care. Older adults who need help bathing and toileting also experience fall risk if they do not have help with personal care. Family responsibilities and anxiety increase after an older family member falls. This is because most older adults who experience fall-related fractures and other injuries will take over a year to fully recover. It is important to encourage older adults to see a health care provider for disease management, particularly health conditions related to falls.
Help from Community Care Partners
Older adults who are at risk for falling may also want to consider getting help at home. Adult day care may be an option for older adults who live with family members, and the family members work during the day.
Fall Prevention Classes
An award winning fall prevention program offered by Community Medical Center is available in Fresno. A Matter of Balance has received recognition from the American Society on Aging and the National Association of Area Agencies on Aging for innovation and quality. These classes help seniors learn to control fall risk, set goals for increasing social activity, provide information to increase home safety, and exercise to increase both strength and balance. Contact Eliana Troncale at 559-459-4450 for more class information.
References
This article has been extensively modified and previously appeared in:
Lenard W.Kaye, PhD, DSW and Miltiades (2015). Musculoskeletal health
and functional capabilities in older adults. Handbook of Social
Work in Health and Aging New York: Oxford University Press.