Fig Tree Articles

Falls prevention classes help re-engage people

Cindy Fine and Mark Haberman do falls prevention training.

Cindy Fine and Mark Haberman invite seniors to re-engage with the world safely and avoid falls by helping Aging and Long Term Care of Eastern Washington (ALTCEW) counter the myth that growing older means a person will be weaker, less active and stay at home sitting in a recliner.

Cindy and Mark train volunteers to teach seniors the "A Matter of Balance" curriculum through faith communities, senior centers, affordable housing centers and other organizations.

Cindy, program coordinator for a year, said that "A Matter of Balance" is an evidence-based falls prevention intervention that hospital staff and physical therapists began in 1995.

"Every 11 seconds, an older adult is treated in an emergency room for a fall. Even if there is no injury, falls impact quality of life. Because many older adults have an intense fear of falling, they limit their activities and social engagement, leading to more physical decline, depression, social isolation and feeling hopeless. Ultimately that fear may lead to loss of independence, said Mark, planning and resource director who has been doing the program with ALTCEW for three years.
Developed as a lay-led program in 2006, he said it is not primarily an exercise program, but is a program designed to change their viewpoints to realize that falls can be prevented, to set realistic goals to increase activity, to identify environmental adjustments to reduce risk factors and to understand how gentle movement increases flexibility, strength and balance.

Cindy said the first two of eight sessions establish cognitive restructuring of ideas about falling.
"Many expect older people will fall, but we challenge the belief that falls are a natural part of aging," she said.
After falls, many become more sedentary, thinking that's the best way to protect themselves. They may stop going out and step into social isolation that can lead to depression and more problems.

"Many believe fitness is for the young, but everybody can be stronger," said Mark. "Inactivity can mask as a best friend when it is the worst enemy, because when I do less, I'm weaker and at home more. Most falls happen at home."
Mark said a participant decided to have a joint replaced after the classes and then bought a bicycle. The program is a way to find one's way back into the world, he said.

Washington has one of the nation's highest fall rates, and Spokane, one of the highest in the state, Cindy said. It relates to health and poverty.

Mark said many delay housing transitions, staying in their homes until a crisis, because they cannot afford to move to a place more appropriate to their fitness and health.

Cindy, who grew up in Colville, earned a degree in journalism in 1978 at Eastern Washington University. She was a family advocate with Children's Home Society, an advocate for the Spokane Regional Health District's unintended pregnancy and needle exchange program, and an educator with Planned Parenthood.

Having an elderly mother, she was concerned about how devastating falls can be for older people.

Mark, whose degrees are from Morningside College in Sioux City, Iowa, and the University of Minnesota in church music and organ, worked 17 years as a church musician. Before he came to ALTCEW, he was a deacon, church musician and family minister at Coeur d'Alene United Methodist Church and did antipoverty work for 16 years with the Community Action Agency.

In that agency, his family, the American Guild of Organists, the church and the LGBTQ community, he knew people whose deaths were precipitated by falls.

With a social component in classes, Cindy said churches are a conducive setting, because members already know each other.

"It's good in-reach and good outreach," she said. "We seek people in churches to be trained as coaches so people can make their faith communities safer."

Nine "A Matter of Balance" classes will be offered this fall—at Southside, Corbin and Sinto Senior Centers, Northwood and First Presbyterian, and the Unitarian Universalist Church.Coaches lead in pairs. Cindy said co-teachers at First Presbyterian are Raeann Decker, a retired registered nurse and former parish nurse, and Patti Aspinwall. Raeann had taught nurses in critical care.

"People participate and share ideas, tricks and tools they use," Raeann said. "As a nurse, I had cared for many in their 80s who came in with fractured hips and did not live long after. It was sad to see something that could have been prevented caused their deaths."

ALTCEW continually recruits coaches, because coaches agree to lead two sessions. Some do it twice, and some six times.
In five years, ALTCEW has offered 50 workshops in the five counties ALTCEW serves, Stevens, Pend Oreille, Grant, Spokane and Whitman, reaching 500 people in classes of eight to 14.

They hope to double the number of coaches from 32 to 64. ALTCEW trains volunteer coaches several times a year. The first session introduces the curriculum, so volunteers can decide if it's for them.

"It is a specialized opportunity because it requires a significant commitment," said Cindy. "Coaches find a satisfying, life-changing experience."

The third to eighth sessions introduce a half-hour of low-impact exercises, adaptable to different levels. They include deep breathing, foot circles, turning the head, upper body exercise and side stepping. People determine their readiness. In discussions, they share ideas for problem solving, home modifications to overcome barriers and asking family for help.
"People learn they can be more active. Some join the Y and other exercise programs," Mark said.

"My faith commitment is about love, service and justice. Jesus spent a lot of time with people on the margins. Older adults are on the margins," said Mark, a UMC deacon who is appointed to serve with ALTCEW.

Believing it is important to connect the church to the world and the world to the church, he helps his congregation understand about poverty, aging and LGBTQ issues, and helps the world understand the importance of the church. What happens within the walls of the church should inspire people to make a difference in the world, he said.

Cindy, a member of the Unitarian Universalist Church for more than 30 years, has been involved in religious education and on committees.

At a summer conference of the National Council on Aging in Washington DC, Mark and Cindy became more aware that "we are in a silver tsunami." Previously, the young were the base of a pyramid with elders at the top, but now it's a pillar with the numbers of people over 65 rising.

For information, call 458-2509, email cindy.fine@dshs.wa.gov or visit altcew.org.