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Interview with a 65- to 70-year-old woman

Fall prevention and improved balance with Tai-Chi

Photo of Hsiang-Ju Anna Chen
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Photo credit: https://osteoconnections.com/2014/12/02/taichi/

Gender: Female

Age: 65- to 70-year-old

Location: Brooklyn, NY

Live alone or with family: Live with her husband

The most dangerous factors that cause you to fall: sidewalks


I had an interview with M who is 65- to 70-year-old. M used to fall frequently. However, M successfully reduces the frequency of falls after she started doing some exercises. In the last six months, she only fell two times.

I am going to summarize the reasons that cause M falls and what exercise M does can help her reduce the frequency of falls.


The reasons that cause M falls in the last six months: unaware and the environmental factors

One happened at home and the other happened outdoors.  At that time, she was wearing loose socks and she turned around very fast and she stepped on the front of the socks. Thus, she fell on the floor.

The second time happened when she was walking down the stairs. Although she was holding somebody’s hand, it was too dark. She didn’t see exactly where are the stairs. Thus, the second fall happened. Fortunately, M didn’t have serious injury from the two falls.

M thinks the most dangerous factors that cause her to fall is sidewalks. Because sometime sidewalk is uneven or maybe it suddenly goes down and if she didn’t notice, she could fall. M thinks the uneven sidewalk is unexpected. On the stairs, she knows when she have to go down or up.



My thoughts:

From M’s case, she didn’t aware that loose socks and dark environment could be risk factors. Sometimes, risk factors are easily to overlook and cause an unintentional event.


So, how could M reduce the frequency of falls?

The answer is Tai-Chi. M started going to a Tai-Chi class once a week (hour and half). She thinks Tai-Chi is helpful for her to reduce falls because Tai-Chi can improve her balance and muscle. Most importantly, the price is affordable for an elderly because the price changes according to each participant’s income. (The center M goes gets some donation from others.)


Why M started taking Tai-Chi Class?

M started taking the class because a friend whose daughter was in the class recommended it and she also knew two other women who were in the class. It has been two or three years since M started going to the class.  And, yes, she feels safer now. M says "In class we imagine that our feet go two feet down into the earth, so I do the same when I am walking outside."


My thoughts:

Tai-Chi is a slow, smooth, and continuous movements exercise. How can those slow movements help strengthen balance control and coordination?


My research:

According to the Harvard Health Blog, those who did Tai-Chi were stronger and had much better balance than those who did strength-building exercises or stretching. In fact, their balance is about two times better than those in the resistance-training group and four times better than those in the stretching group.



What is a provocation or insight that might inspire others during this challenge?

Exercise can help elderly to prevent falls. Tai-Chi movements contain power and internal strength. Thus, Tai-Chi could be a good option.

Tell us about your work experience:

I was a programmer and business analyst in the financial industry.

9 comments

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Photo of Anne-Laure Fayard

Thanks Hsiang-Ju Anna Chen for sharing this interview. Many great insights. It's important to keep in mind that factors leading to fall can be really "minor" but should not be downplayed. I thought it was interesting that M fell a few times and that it led her to a change of behavior. Tai-Chi is indeed a great option. It also reminded me the radio exercise in Japan: https://challenges.openideo.com/challenge/fall-prevention/research/wake-up-hike-out-tune-in-move-it-learning-from-japanese-radio-exercise
Do you know if M goes alone? Did she mention the social component of doing Tai-Chi? Does she feel "safe" now?
I'm curious if the 65-70 range was an option you gave your interviewee instead of asking her age. A few other questions: did M lives alone? Did someone helped her when she fell? Was is after the second fall that she decided to do tai-chi? How did she come with this idea? Did someone mentioned it to her?

Spam
Photo of Hsiang-Ju Anna Chen

Thanks for comments. I've added more information in the article. And, yes, the 65-70 range was an option I gave my interviewee.
After M fell, she reported to her family member and she went to physical therapy center. M also received information on how to reduce risk of falls from the physical therapy center. From my another interview, I found physical therapy center is an important channel to convey knowledge and to prevent falls.

Spam
Photo of Anne-Laure Fayard

Great updates Hsiang-Ju Anna Chen I love that phrase "In class we imagine that our feet go two feet down into the earth, so I do the same when I am walking outside." It's interesting to see the importance of social connections to induce people to join classes where they exercise. It might also be that it gives her opportunity to maintain contacts. The role of the physical therapy center is also worth keeping in mind. Last, I think the role of M's family is also important. My guess is that people who have less social connections and emotional support might be more at risk of falling.

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Photo of Anne-Laure Fayard

Hi, you might want to check Peixuan' s interview with an expert on rehabilitation as there are some interesting connections with what you found in your interview: https://challenges.openideo.com/challenge/fall-prevention/research/interview-with-a-physical-therapist-about-elderly-falls/

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Photo of Bettina Fliegel

Hi Hsiang - Ju. Thank you for sharing this interview.
What stood out for me was that your interviewee "M" identified sidewalks as being the most dangerous environment in terms of falling, yet she fell twice and neither time was she walking on a sidewalk. It really highlighted for me that becoming aware of what the dangers are can be protective. I guess "M" is very careful on sidewalks. She was less careful with loose socks probably because she did not consider that a risky situation, although she probably does now, and avoids them. Did you ask her about that?
In an interview posted by Sanjana the person also tripped and fell due to clothing issues, loose pants and a scarf that got caught in a door. Learning about the circumstances of falls from interviews is helpful for thinking about how to tackle solutions to this issue.

Also I love that your interview highlights tai chi as a great exercise! I also liked the sentence that Anne-Laure highlighted - "In class we imagine that our feet go two feet down into the earth, so I do the same when I am walking outside." In some exercise classes I have taken the instructors also teach giving prompts and things to visualize. Applying them to real life, doing activity with intention, is great! I wonder if "M" applies this thought only when she walks on sidewalks because she has identified that as being dangerous, or if she does it everywhere? She mentions doing it outside.

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Photo of Anne-Laure Fayard

@Bettina Fliegel  you are right that being able to identify locations and circumstances that are more risky is important. Side walks, buses, and weather conditions (rain, ice) seem to emerge so far when it comes to outside. Inside: lack of light, going to the toilet at night, socks seem to be an issue. Clothing seem to matter. K, interviewed by Sanjana is wearing snickers and I've seen it mentioned in at least one more interview.

Spam
Photo of Anne-Laure Fayard

Hi, I thought Khuyen's post about sidewalk was interesting and echoed M's fear: https://challenges.openideo.com/challenge/fall-prevention/research/more-walkable-less-falling

Spam
Photo of Hsiang-Ju Anna Chen

Hi Bettina. I asked M today and she said: yes, it's true that she never considered that loose socks were a hazard and that she has become more careful about them since the fall. She was already careful about tying shoelaces, because people often mention them as a hazard.
M also said: the only time she felt unsafe was when she had to walk outside, so that is where she has used that image from the class.

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