Senior Living Advice: Preventing the dreaded downward spiral


By BETH DOW, Home Helpers Home Care

We hear the same story often. It starts like this: everything was fine until … and then it just seemed like one thing after another – the downward spiral began.

As we age, we all know someone that was doing just fine the last time we saw them, but now due to one event and a sequence of following events, their lives have changed drastically. But is there a way to stop a downward spiral? While we can’t prevent many events that happen in our lives, there are steps we can take to prevent a downward spiral.

The most common event that begins a downward spiral is a fall. Thirty percent of people over the age of 65 and 50 percent of people over the age of 80 will fall once during the next year. More women than men fall, but only by about 3 percent. Women are most likely to fall due to a shift in body weight, while men fall as a result of loss of support from an external object – such as standing on that ladder their wife told them not to stand on.

While there may not be a way to prevent a fall once the downward motion begins, there are things you can do to prevent the fall in the first place.

The number one step you can take to prevent a future fall is to exercise and build up your core. Your balance is strengthened by a strong core. Especially for women, strengthening your core can help you safely recover from a trip or being off balance.

You also need to wear sensible shoes and really need to ditch the flip flops. Flat shoes with backs are much safer and can prevent falling. Check your medications to ensure they do not cause dizziness, remove hazards around the home such as cords and rugs. And light up dark routes of travel at night, like your route to the bathroom.

The second-most common event is hospitalization. One third of patients over 70 years of age and more than 50 percent of patients over the age of 85 leave the hospital more disabled than when they arrived. And 60-65 percent leave with a poorer nutritional status than when they were healthy.

People are most likely to be readmitted if they have been hospitalized more than 5 days; are discharged on a Friday; are non-compliant; and have inadequate transitional care once they return home.

To prevent a downward spiral after a hospital stay, you need to realize that getting out of the hospital is not the finish line. It is just the first step in a multi-leg relay. Studies have shown that the No. 1 factor in hospital readmission is what happens once the person comes home. Do they understand their medications? Are they doing what they need to do nutritionally to build up their strength? Are they compliant with follow-up doctor visits and recommended therapies? Are they testing for a UTI which are very common after hospital discharge? And do they have one-on-one care and support, at least for the first week after discharge?

The third cause of the downward spiral is the widowhood effect. One study showed that men were 70 percent more likely to die within a year of their spouse, while 27 percent of women are more likely to die within a year after the death of their spouse.
There are many reasons for this: the physical and mental toll being a caregiver places on a body, the impact of grief (lack of sleep, weight loss, withdrawal); the loss of social support, etc.

After the death of a spouse, it is important to get a complete physical. Be sure that health issues that may have been put on the back burner are front and center. Second, exercise and third, get around people. Social engagement is key to learning to enjoy life without your spouse.

A major event does not have to be the beginning of a downward spiral. Preparing ahead of time and vigilance after can stop the spiral from happening.

Beth Dow is a Dementia and Alzheimer’s Educator, CAEd and Geriatric Care Manager. She is also the owner of Home Helpers of GA & AL in Newnan. Readers can contact her by email at  [email protected].

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