Through most of my life my idea of balance was a general notion of being able to be upright and steady. In a physiology course I learned that the organ that enabled balance was a complex vestibular body located in the inner ear. The other day, a physical therapist taught me that it is three pronged: vestibular, vision and proprioception. ARCs (age related changes) affecting balance tended to begin in one’s 40’s. And through it all balance seemed to me to be a generic, unitary function—being securely upright.
As the balance ARC crept silently into my life, I became increasingly aware of reaching out to put my hand on a solid surface to “steady myself”. But if I thought about it at all, it still was about uprightness and steadiness and found myself being curious about how it would manifest itself as the ARC progressed.
Well, that curiosity is now being satisfied. And (as with so many other realities of aging), it brought its surprises. It proved to be not just one entity. No, it was far more complex than that. It manifested itself in separate capacities which impacted specific daily activities linked to high risk locales. Different adaptive strategies were needed for each.
Six risk activities appeared to be altered by my Balance ARC, turning, centering, bending, dealing with darkness instability when moving about and now, even when standing.
Turning: when my head and body/feet faced in different directions and the difference was greater than 90° “tippiness” and physiological “near-fall“ sensations (an instant nasty gut reaction without the subsequent fall). The highest risk area proved to be my kitchen with work areas on all four sides. Adaptation: Say/think “Nose&Toes!” to remind me to keep face and feet pointing in the same direction. (blog 11/16/17) To move objects about, slide them on nearby/adjoining surfaces. With 180° or greater turns, find intermittent surfaces to allow for reorienting one’s feet.
Centering was essential when moving from sitting to standing, after turning, when picking up or carrying items, or being hugged. (9/5/18) Adaptations: Say/think/do “Center yourself!” before engaging in the affecting behavior. Brace the body before lifting an object large/heavy enough to pull one off-center. Hold objects close to the body when moving. Alert huggers to the risks of pulling one off center or brace part of the body against something solid before hugs. Most recently, even merely standing triggers teetering. Now that’s really scary for the increasing risks it portends.
Bending: during any activity below waist level, e.g. bed making, picking up/dealing with objects on low shelves or the floor. Adaptations: Brace one hand or body part against a solid object during the activity (e.g. lower legs resting against mattress in bed making, sit on walker to deal with things on lower shelves or picking up objects from the floor). Last resort: ask someone else to do the job.
Dealing with darkness: this challenge to balance occurs most for me in the living room where evenings are spent. Adaptation: Get up and turn on the wall switch before turning off the lamp. Turn on/off lights upon entering/leaving a room. Turn on night lights before retiring. Keep a working flashlight on the bedside stand in case of a blackout.
Needing hand contact with my walker or body contact with a solid surface in order to feel secure. Riskiest when getting up during the night and when moving about open space in the kitchen. Adaptation: Keep the walker within arm’s reach at all times. When both hands are needed for an activity, lean lower body on available solid objects (e.g. counters). Use a tray on the walker seat to transport objects about in open spaces. (4/26/18)
Being constantly mindful of my balance when I’m just standing still, even in the midst of everything or anything else, is a new reality that’s demanding adaptation. Hopefully an upcoming new physical therapy regimen will at least slow this ARC, perhaps even reverse it a bit.