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Getting a leg up on long-term care

The single best predictor of the need to go into a nursing home is how strong your legs are. —Dr. Walter M. Bortz, geriatrician; professor of medicine,StanfordUniversity

Take another look at the beginning quote. What? Didn’t we think that diabetes was the best predictor of ultimate nursing home residence? What about high blood pressure? It’s an indicator of future strokes, they say. A combination of those two can be pretty depressing and unhealthful. But the strength of your legs? Do you think the long-term care insurance industry knows that? I don’t know of a single instance when the LTC underwriting interview included a test of the strength of the applicant’s legs.

Dr. Bortz is talking, of course, about falling. According to the National Osteoporosis Foundation, about a third of adults age 65 and       over fall each year, and half of that number will experience recurring falls. About one in ten falls will result in serious injury and require a trip to the emergency room. The National Institute on Aging says that the estimated costs for falls is now more than $12 billion a year, .U.S.hospitals admit 300,000 patients with broken hips annually. This huge cost is not just for hospital care, it’s also for the many seniors who break their hips, become disabled, lose their independence and require full-time care.

We need good balance in order not to fall. Contrary to what many people think, loss of balance is not a natural part of aging, according to Steady on Your Feet, an article by Anne P. Wright in AARP magazine. Loss of balance can be caused by numerous conditions—problems with vision or the inner ear, certain medications, poor posture resulting from arthritis, weakness, osteoporosis or poor diet and weak back muscle. But, according to Dr. Bortz, the biggest cause of poor balance is “leg muscles weakened by a lack of use.”

One of the very best exercises to improve balance is generally called the “Flamingo” exercise.  Stand on one leg with the other leg flexed behind you for 10 seconds. Alternate legs, repeating the exercise five times. If you need support, hold onto a chair with both hands. As your balance improves, use one hand, then only one finger and then no support at all. Try to progress to the point that you can do this exercise with your eyes shut. Do it at least three times a week.

Janie Clark, an exercise physiologist and author of the book Full Life Fitness: A Complete Exercise Program for Mature Adults, writes that old-fashioned posture exercises can help to improve balance. She suggests that you try walking with a book on your head or pressing your shoulders and the back of your head against a wall while standing.

Many seniors have learned that tai chi can significantly improve balance. Once in an office building, I smiled at an elderly gentleman doing exercises during our elevator ride to the first floor. “I’m taking tai chi at the senior center,” he explained. He said the class had helped him tremendously. Tai chi, perhaps overly simplified, is a martial arts form that improves balance and body awareness through slow, graceful and precise body movements. Anne Wright, the author of the AARP article mentioned above, maintained that tai chi practice can significantly cut the risk of falls among older adults. Tai chi classes are available at our localBowiesenior center.

A wonderful book, Go For Life can be ordered from the web site of the National Institute on Aging:  This guide contains valuable information about how exercise and proper nutrition are crucial for staying healthy as we age and it provides useful tips on establishing and maintaining a regular exercise program.

The AARP Web site, at, lists several publications relating to health, fitness and strength. Multiple resources including a newsletter, books and videos are available from the Fifty-Plus Fitness Association,PO Box 20230,Stanford,CA94309. For articles on improving balance, go to their Web site at

To help decrease falling, review your environment and make important changes. Use nightlights for trips to the bathroom at night. When you need to get up during the night, sit on the side of the bed till you’re fully awake. Make sure stairways and hallways have bright light. Always use the highest wattage allowed by the light fixture. Watch for clutter in the house. Things out of place can cause you to stumble. Keep extension cords out of the way. Be sure all throw rugs have a non-skid backing. If you have a pet, be especially carefully when he is under your feet. Use all available outdoor lighting. Avoid broken sidewalks, construction areas and uneven walkways. Ask your doctor to review your medications to determine whether any of them might contribute to falls.

Remember, growing older is a privilege not granted to everyone. Work on your leg strength and don’t fall.

Thank you for reading. See you next week. Stay well.

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