For more information about fear and what causes it, read the first presentation in this series, entitled Part I of Focus on Falling: Defining Fear and Overcoming It with a Four-Step Approach.
Ms. Kleinman began her presentation by asking each group member to name a fear that they had related to falling. The responses included the following:
Several members expressed the fear of being alone when falling as greater than the fear of falling itself.
Ms. Kleinman responded that these were all common fears. This presentation was designed to help people understand the importance of this topic, including risk factors; emotions and how they relate to falls; coping with the fear of falling; ways to prevent falls; and how to discuss these issues with your healthcare team.
Falls are one of the main causes of injury for people over the age of 65. Older adults may take longer to recover from a fall than younger adults.
Myositis is a disease where loss of muscle strength is common, and loss of muscle strength increases the chance of falling. It makes sense, then, that improving muscle strength may help prevent falls.
It is important to note that falls can often be prevented and that many things can be done to reduce the risk of falling. Falling once also does not necessarily mean repeated falls.
Some of the risk factors for falls include:
The fear of falling can lead to less activity and exercise, which can then lead to a higher risk of falling. The fear of falling, then, can make you more likely to fall. This can then lead to isolation from others; low self-esteem; depression and anxiety; and the use of more medications.
Ms. Kleinman then went on to explain that some fear is useful and helps prevent us from taking unnecessary risks. However, sometimes fear can create what she referred to as “false alarms,” which can cause avoidance of everyday activities and the cycle of stress described above.
Ms. Kleinman suggested the following:
Do a self-assessment: try to identify what is happening to you. What is causing you to fear falling? Then, speak with your healthcare team - your physician, nurse, social worker, physical/occupational therapist - to learn what you can do to help prevent falls. It is also important to remember to be realistic about activities that you are able to do.
Another way to cope with the fear of falling is by building confidence. One way to do this is to take small steps toward your goal. For example, you might want to increase your endurance for walking. Always discuss this with your personal health care provider prior to starting a program to increase endurance or muscle strength. Ask your physician for a referral to a physical therapist who can best assess your needs. For example, you may begin by walking 1-2 blocks and then slowly increase as you feel more able to do so. This success will then help to build strength and confidence.
It is important to emphasize that fear of falling is a normal and common concern. Your doctor can help you prevent falls by reviewing your medications and your health needs and may also refer you to other healthcare professionals, such as physical therapists or clinical nutritionists. It is also important for you to communicate any changes in your health that could increase your risk of falling, such as balance problems, numbness, change in memory, change in activity level, or changes in vision and hearing.
Learn more about the Myositis Support Group, a free support and education group held monthly at Hospital for Special Surgery
Summary by Suzan Fischbein, LCSW, Myositis Support Group Coordinator