Vision changes as we age can increase the risk of falls
Anyone around 40 years old and in a restaurant with dim lighting trying to read a small, printed menu knows what I mean. When a friend lends you their “cheater glasses” that are magnifiers, you can suddenly read the whole menu and be aware of these changes.
Most older people experience regular changes in their eyes associated with aging. They may need increased light calls. For example, a more senior person requires four times lighter than a younger person in the same setting.
T
hough we might need brighter light, sensitivity to glare can also limit your ability to see clearly. Familiar sources of glare include highly polished floors and shielded lightbulbs’ reflection of light on all shiny surfaces.
Accuracy of vision reduces modestly after age 60. He can make it hard to see curbs or steps and challenging to differentiate between a puddle or a hole on a sidewalk. This can lead to increased fall risk.
Aging eyes can have difficulty adapting to light and dark such as walking into the bathroom at night and turning on the light. Contrast sensitivity is reduced, making your ability to see textures and patterns.
Reduced depth perception can make it difficult to determine how close or far away an object is to you. Depth Perception results from poor vision or loss of vision in one eye. This can make the detection of the height of a curb difficult. It can also make ramps and slope angles challenging to discern, leading to loss of footing and possible falls. Not all ramps have slow graded grades, as ADA recommends, and these steeper slopes can create higher risk.
Macular degeneration can cause spots in the central vision that give empty holes in ones viewing of what they are walking on; this can make it difficult to walk across the parking lots or cross streets safely.
Ways to reduce the risk of falls due to vision changes.
Get an annual eye exam to correct refraction problems with glasses, or get new glasses. Discuss with your doctor the pros and cons of progressive lenses or bifocals. Many seniors have trouble adjusting to progressives and have a clear vision with bifocals. Going down the steps or looking down with progressive lenses is a problem and increases the risk of falls.
If you have more than one pair of glasses, make sure you label them to quickly see which is for distance and which is for reading. This is important when you’re trying to go down the steps with a set of glasses for reading, making it challenging to navigate the steps safely.
Optimized lighting would include higher wattage lightbulbs, more direct light on reading materials, and reduced glare. Installing night lights to navigate the bathroom or the kitchen in the dark is essential. There are Motion sensors with night lights that automatically light up your path as you move toward them. These don’t create too bright of light to shock your eyes.
Improve contrast by using color contrast fluorescent tape to signal each step’s edge, the bottom of a stairwell, or at the top of the handrail. This can also be used to see floor height changes by using tape or contrasting board rugs at the threshold changes.
2019 Medicare changes for the Opioid Epidemic
WWSPT has received information on new Medicare policies to combat the opioid epidemic which will affect our patients therefore we wanted to give you a summary what to expect and how it might affect you. Medicare also wants to have patients consider other options they cover for pain control which includes Physical Therapy, electrical stimulation, behavioral Health integration services, and psychiatric services.
We are all aware of the countries epidemic of Opioid abuse which includes 2 million sufferers of pain, more simply stated 6 persons of each 1000 beneficiaries. Surprisingly, opioids are the most commonly prescribed class of medication in the US which contributes to the problems. Accidental prescription opioid overdoes has quadrupled from 2000 to 2010 and continued to rise. There is also a large problem with misuse which primarily includes resale of individual tablets on the black market.
Medicare has a plan to address the national concerns about this crisis. This is a 3-pronged approach:
- Prevention of new cases
Starting January 1, 2019 Medicare will employ safety alerts to pharmacy with a 7 day supply limit for opioid naïve patients (those not using opioids). If the patient needs more than this amount the prescriber will need to write another prescription. This will be important in any total joint surgeries or other post-operative recovery periods.
- Treatment of patients who are addicted
Medicare will identify at risk patients by their opioid use and look at use of multiple doctor and pharmacies prescribing these medications. It is best to have one pharmacy for all your medications
- Use of data from across the country to target prevention and treatment
Opioid medications linked to substance abuse:
Fentanyl Hydrocodone Oxycodone Oxymorphone Hydromorphone Meperidine
Physical Therapy is a great option for getting pain relief instead of use of Opioids!! And Medicare covers our services, so consider contacting WWSPT for an evaluation.
How much does exercise help a body?
Let’s count the ways the body benefits with exercise:
Before starting an exercise program, especially if you have been sedentary, (a couch potato), consult a doctor to make sure you do not have any underlying conditions that could be a problem. Once you have been cleared, commit to an exercise program, start slow and gradually increase intensity. Make exercise a priority, maybe get a buddy to make it more enjoyable as well as accountable, then pick the days and times you will exercise and stick to it for life. I personally prefer to work out first thing in the morning, then there are no excuses. Workout/exercise three to five times a week, by six weeks, you should notice a positive difference in how you feel. At first you may experience some soreness, but all that means is you are working your body in ways it is not used to, which is great!
The benefits of exercise include but are not limited to the following: Improved sleep, improved gastrointestinal motility, improved brain function, more energy, stronger heart and lungs, stronger bones and muscles, improved posture, better balance, improved mental state, etc. The list goes on and on. Pick an activity you like and stick to it, or mix it up, just do something!
Some examples of great exercise include walking, swimming, dancing, biking, yoga, weight lifting, circuit training, Tai Chi, martial arts, boxing, gardening, hiking, etc. Again, the list is endless. The best exercise/activity for your body is the one you will do. – commit to doing. The body was meant to move, so move it. Right now there are more opportunities to exercise for people of all ages, so take advantage of them. Groups are great because they add a social component, which adds to the fun and accountability. The better shape you are in prior to an injury or illness, the better you are able to deal with and/or recover from it. George Bernard Shaw once said: ”We don’t stop playing when we grow old, we grow old, when we stop playing.”
A physical therapist can help you get moving again, especially if you have any problems with your balance, joints, muscles, or endurance, that keep you from participating in various activities with confidence. So, the best exercise/activity is the one you will do. The body was meant to move, so move it.
As always, check with your doctor first, then get moving, and get more out of life!
Prevent Injuries While SHOVELING Snow!!!
There is a significant snowstorm sweeping across the U.S. and headed for the East Coast and this area …
During winter, it’s lovely to see the snowfall and get the warm feeling of walking in the winter wonderland. But Shoveling Snow is another thing, we all know has to be done. When I see people cleaning their driveway, the Physical Therapist in me quickly notices how a person is using improper body biomechanics while shoveling snow.
Snow shoveling injuries are one of the most common injuries during winter months. This happens due to repeated bending and twisting motion of the spine while lifting and throwing the snow. According to research, most common back injuries happen with carrying the load with bending and twisting. The American Journal of Emergency Medicine recently published the results of a 17-year study that documents the most common injuries associated with shoveling snow. The study found that 11,000 people were hospitalized per year, and 195,000 across the whole span, due to accidents stemming from snow shoveling.
There are two important things which one needs to keep in mind while shoveling snow. Correct shovel and proper body biomechanics while shoveling. Picking the right kind of shovel is very important. Lightweight shovel with a plastic blade and adjustable-curved handle allows you to keep the weight close to your body, requiring you to keep your knees bend and very slightly arching your back in order to keep a shovel on the ground.
Ergonomic lifting techniques:
• Warm up and stretch before you start shoveling.
• When gripping the shovel, keep your hands about 12 inches apart to provide greater stability and minimize the chances of injuring your low back
• Bend at your hip, while avoiding arching your back and stand with chest pushed out pointing forwards.
• Tighten your stomach muscles as you lift the snow. Lift with your legs—not your back. Do not twist your body. Dump the snow in front of you.
• Keep the heaviest part close to your body and lift smaller quantity, walk to a new location rather than reaching or tossing.
• If you are turning as you dispose of the snow, don’t twist with your lower back. Open up your hips and let your feet pivot as you throw the snow. Twisting while lifting can cause injury to your back, gluteal muscles or hamstrings.
One shovel full of snow can be up to 20 pounds. Never try to remove deep snow all at once, use the smaller weight of the loads. Avoid lifting snow by pushing it instead. Pushing snow is much easier than lifting and can reduce the risk of injury. If you feel the pain of any kind stop immediately and seek medical assistance.
Take Care of your body! Practice #Ergonomiclifting
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