Falls

I write about falls and seniors, and I give workshops on how to prevent falls for my age group. So, I should have known better and paid more attention before I fell. We were at my grandaughters second birthday party and we were inside the house, talking and watching the children play when Annie said she was going to the store to get some needed stuff. She asked me to move my car, I said, "Why don't I just go to the store?" She said no it would be more fun if I stayed and watched the children. As we do not get to see them that often, I agreed and then went out to move my car.

The entrance to her house is up a flight of about 8 stairs. It was not raining, I had not had a drink and it was midday, so what could go wrong?  As I started down the stairs, Scott (Annies brother) was about 12 feet away from the bottom of the stairs, waiting at the car, for his sister to come out. Andy (Annie's husband) was to the left of the stairs, walking to the backyard. I took one step, failing to use the handrail and Scott said something and I partially turned and looked over at him and started to respond. As I took the second step, I missed the stair.

I realized that I was going to fall, so I reached out with my left arm to grab the railing, this was a mistake as I now swung back up the stairs. When I was younger I was a runner and a football player and from time to time I would "get in the zone". Athletes know this zone; it is a time when everything is in slow motion and they can see, and predict what will happen next. Some of my friends who have experienced falls also told me that yes, everything seemed to slow down for them as well.  I was in the zone as I started to fall. and everything happened in slow-motion and I was watching it seemed from a distance. This is what I saw.

As I swung back up the stairs, my elbow hit the railing and I bounced across the stairs against the house and after hitting the house, I bounced back and slammed my back into the railing. I was now two steps down with 6 more to go. As my back hit the railing I looked over and saw Scott, who looked absolutely panicked--the kind of look where you see a disaster happening and you are powerless to stop it from happening. 

I then looked down and realized that I was starting to fly forward. I realized that I would miss the rest of the stairs. I also realized that I would ram my head into a concrete wall with full force before landing face first in a bed of rocks and gravel. 

Some people claim that your life flashes before your eyes at moments like this; not true for me. My first thought was I am going to ruin the party because I will probably break my neck or at least sustain some sort of major head injury and they will have to phone 911. My second thought was to get your arms out in front of you, they were currently flapping like wings, which was not helpful.

As I moved forward I raised my arms to protect my head and I decided to turn my head to one side so that the upcoming injuries would only impact my right side. The next thing that happened was Andy, who had moved from going to the backyard, was between me and the cement barrier and I was in his arms. He looked very surprised as I did. Andy is a sheet metal fabricator. He was able to catch me and stop my fall without falling down himself.

I looked at Andy and said, "thank you", he said, "no problem". Scott came over and asked how I was and how my back was as he had seen me slamming into the railing as I fell. By then the adrenaline was pumping and I said I was fine. Andy put me down, and I went and moved my car. 

Scott went in and told everyone what had happened and how Andy had saved the day. When I came back in, Annie was asking Scott why he had done nothing. I said Scott was too far away, but he had his phone out and was ready to call 911. 

I did say that I thought Andy was a hero as he had only seen me start to fall out of the corner of his eye and he had moved quickly to a spot he could catch me. The next day, my back and arms were sore, but I was thankful that I had not been hurt.

My lesson, always use a hand railing and pay close attention when walking up or downstairs. The other good news is that I now have a new story for my workshop on falls.

Planting Season

April showers bring May flowers. Last year we planted our veggie garden a bit late and as result, because of the weather and perhaps poor garden management we did not get as big a crop as we thought. so this year, we are planting early to see if it makes a difference. This got me thinking about when do you plant each type of veggie.  The answer, of course, depends on which Hardiness Zone you are living in. 

Hardiness zones are based on the average annual extreme minimum temperature during a 30-year period in the past, not the lowest temperature that has ever occurred in the past or might occur in the future. Gardeners should keep that in mind when selecting plants, especially if they choose to "push" their hardiness zone by growing plants not rated for their zone. 

For my American friends,  If you aren’t sure what planting zone you are in the USDA has a great interactive map for you. And you can just put in your zip code and it will tell you exactly what planting zone you are in. In Canada and other countries, your Ministry of Agriculture should be able to provide you with the information you need. I live in a Zone called 8b so I need to look for plants that thrive between 15 and 20 degrees Celsius.

So a brief search of the Net I came up with the following visual Garden Org. 

Here is another chart that I found that was also useful

The loss of a spouse

I have known Gary for over 40 years and his wife, with the support of her family, committed assisted suicide (which is legal in Canada). Gary is in mourning, he is feeling grief and sorrow at the loss. He is going through many different feelings at this point. All of his feelings are normal and there are no rules about how he should feel. When I and his friends last saw Gary, he said that there were so many people asking him how he was doing, and when he told them the truth, they backed away, so he is now saying "I'm doing as well as can be expected. or I'm OK". One of the guys told him that he could tell us how he was feeling or he could lie to us, either way, we were not going to go away and we were there for him. We all, including Gary, laughed, and he did tell us how he was really feeling. We just listened.

Although we all feel is a loss, many of us have not lost a spouse and here are some ideas to remember when you are around a person who is grieving. The first is to just accept that the person is grieving and in pain, and let them know you are there for them. Simple advice, but hard to follow, but just saying "I am here for you." may be enough. 

When a person grieves, they can feel both physical and emotional pain. People who are grieving often cry easily and can have:

·       Trouble sleeping

·       Little interest in food

·       Problems with concentration

·       A hard time making decisions

In addition to dealing with feelings of loss, they also may need to put your own life back together. This can be hard work. Some people feel better sooner than they expect. Others may take longer. Family, friends, and faith may be sources of support.

As time passes, the intense pain will lessen. A person who is grieving will have good and bad days. Mourning can go on so long that it becomes unhealthy because the person grieving may be sinking int serious depression and anxiety. If you notice this advice them to talk with their doctor.

Support may be available until they can manage the grief on their own. Consider getting them to join a grief support group. Sometimes, it helps to talk with people who also are grieving. If they cannot help by check with hospitals, religious communities, and local agencies to find out about support groups. Choose a support group where they feel comfortable sharing your feelings and concerns. Members of support groups often have helpful ideas or know of useful resources based on their own experiences. Online support groups make it possible to get help without leaving home.

Mourning takes time. It’s common to have rollercoaster emotions for a while. After years of being part of a couple, it can be upsetting to be alone. Many people find it helps to have things to do every day. Whether the person is grieving is still working or are retired, suggest that they write down their weekly plans. Some ideas you could give include:

·       Take a walk with a friend.

·       Visit the library.

·       Volunteer.

·       Try an exercise class.

·       Join a singing group.

·       Join a bowling league.

·       Offer to watch the grandchildren.

·       Consider adopting a pet.

·       Take a class at a nearby senior center, college, or recreation center.

·       Stay in touch with family and friends, either in person or online.

·       When they feel stronger,  think about getting their legal and financial affairs in order. For example, you might need to:

o   Write a new will and advance directive.

o   Look into an enduring power of attorney for legal matters and a representation agreement (In BC only) for health care, in case you are unable to make your own medical decisions in the future.

o   Put joint property (such as a house or car) in their name.

o   Check on changes you might need to make to health insurance as well as your life, car, and homeowner’s insurance.

Having a social life on their own can be tough. It may be hard to think about going to parties or other social events. It can be hard to think about coming home alone. They may be anxious about dating. Many people miss the feeling of closeness that marriage brings. After a time, some are ready to have a social life again. Here are some things to remember:

·       Go at a comfortable pace. There’s no rush.

·       It’s okay to make the first move when it comes to planning things to do.

·       Try group activities. Invite friends for a potluck dinner or go to a senior center.

·       With married friends, think about informal outings like walks, picnics, or movies rather than the couple’s events that remind you of the past.

·       Find an activity you like. The key is to have fun and meet people who like to do the same thing.

·       Take the time to develop meaningful relationships with friends and family members of all ages.

·       Many people find that pets provide important companionship

Taking part in studies can cause stress

A friend of mine had a stroke about a year ago, and as a result of the stroke, he has some problems remembering things. His best friend told me that L had huge gaps in his long-term memory. When they talked about things they had done in school, My friend could not recall any of the events. He could recall other events. So, because he was concerned about his memory He registered for a study for stroke victims at UBC. He goes off twice a week to take part in the study and spends about, from what I understand, 10 hours a week going through tests and interviews. UBC is about an hour and a half drive one way from where he lives. He is spending about 16 hours a week, including travel time on this study.

He is very worried that he is getting Dementia and his interpretation of his results lead him to think the worst. Last week he was telling us that he had been interviewed for an hour and a half and had been asked a lot of questions, like count back from 100 by 7’s. The questions asked were from a test called MMSE. The Mini-Mental State Examination (MMSE) is a tool that can be used to systematically and thoroughly assess mental status. It is an 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. The maximum score is 30.

This is a test where the doctor asks several questions and your answers are scored to give an estimate of your cognitive fitness. Some MMSE questions:

1. I would like you to count backward from 100 by sevens. (93, 86, 79, 72, 65, ...) Stop after five answers

2. The examiner names three unrelated objects clearly and slowly, then asks the patient to name all three of them. The examiner repeats them until the patient learns all of them, if possible. Number of trials: _______

3. Spell WORLD backwards.” (D-L-R-O-W)

4. “Earlier I told you the names of three things. Can you tell me what those were?”

5. Show the patient two simple objects, such as a wristwatch and a pencil, and ask the patient to name them.

6. “Repeat the phrase: ‘No ifs, ands, or buts.’”

7. “Take the paper in your right hand, fold it in half, and put it on the floor.” (The examiner gives the patient a piece of blank paper.)

8. “Please read this and do what it says.” (Written instruction is “Close your eyes.”)

9. “Make up and write a sentence about anything.” (This sentence must contain a noun and a verb.)

When looked at across time Scores in this test range from zero to 30, with a score of 26 and higher generally considered normal. The range of scores for healthy people is about 27.4, compared with 22.1 in people with mild cognitive impairment (MCI) and 16.2 in people with Alzheimer's disease.

The problem is that he has not been given a score and the researcher suggested to him that he should have an MRI scan of his brain. The researchers at UBC had done one already, but, as he explained, they could not share his results with him or it would skew the results.

These scans may also be used to check for evidence of other possible problems that could explain a person's symptoms, such as a stroke or a brain tumour. I suspect they did an MRI scan to:

·   see if he actually has dementia or what else may have caused his stroke

·   provide detailed information about any damage that he may have suffered as a result of his stroke

The researcher also told him that he did well on the test, but of course, he only heard part of the discussion and focused on the wrong part.

My concern is that L, who is prone to worry, will stress more than he needs to. His memory losses are not as severe as he thinks they are. He still has good concentration and a good attention span, his language skills and communications skills have not deteriorated and he has a good grasp of time and place.

L has to keep in mind that he is part of a study and he will undergo tests which will involve a series of pen-and-paper tests and questions. These tests will assess a number of different mental abilities, including:

·       short- and long-term memory

·       concentration and attention span

·       language and communication skills

·       awareness of time and place (orientation)

I admire him for taking part in the study, but I hope he will decide not to self-assess his results on the tests because he, like many of us, will underestimate how well he is doing and this may cause him stress.