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Meet David

What matters most to an individual human being isn’t fully transparent.  Their biggest hopes and dreams and darkest fears are often enshrouded by outer facades.  In a time when westerners are faced with wearing masks as a society for the first time that I know of I met a neighbor of mine, let's call him David.  He’s considered an older adult according to the CDC, some may call him a senior.  To me, he’s like Bruce Willis in the movie “Unbreakable”.  Except having a fear of water, David is actually afraid of falling like Mr. Glass, another character from Unbreakable.

For this story’s purpose, David is 95 years old, still married, a die hard (no pun intended) Packers fan, and a resident of Louisville, Colorado.  I lived in Madison, WI for a few years where Packer’s fans are a lot more common than Denver so I was pleased to meet a fellow fan.  Team loyalties aside and professional sports events still in question, I met David in March of 2020 as I was walking to my mailbox at my apartment complex.  I noticed an older man that was doing something that he does every day.  Throw out his daily trash and pick up daily mail.  Sounds routine right?  Well not exactly.

I’m a bit of a detail oriented guy and I noticed immediately that he was using a shiny red rollator style walker (meaning 4 wheels, hand brakes, and a resting bench).  What I noticed next was remarkable.  He was doing what few walker users do in practice.  He was staying close to the wheels of his walker meaning that his feet were never far away from the walker.  Being too far away makes an out of balance situation where a fall isn’t just likely, it’s eminent.  He was also standing more upright than most, another common walker misuse where too much weight is placed on the handles and a balance issue is created.

David also demonstrates the other high risk situation shown in the graphic when too much weight is placed on the handles and the center of gravity is over the wheels of the walker and not the feet of the individual.

With his remarkably high quality walker skills, the recent shelter in place and social distancing rule in place, I was naturally curious about his mindset related to COVID-19.  In all honesty, I’m a bit of an extrovert and often say hello to my neighbors and strike up conversations when the mood suits.  Keep in mind that at this point in Colorado there were no specific older adult shopping hours and places of business were still open including offices, retail etc, and facial masks weren’t a recommendation in Colorado nor in most states.  However, social distance rules were rapidly becoming a daily routine for most Coloradans.

One in Four Fall from This Annually

At the time I was throwing out my own trash and when I got within about 8 feet of this gentlemen, I said how’s your day going so far?  David replied, it’s been fine how about you.  I then said, good, but I’ve never seen somebody use your walker quite as well as you.  David replied, “I fell really hard once and sustained a massive head injury.”  He proceeded to pull up his shirt sleeves to point his wounds from two years ago.  Even though I was at the recommended 6-foot safe social distance at this point, I could see his bruises and scars like they happened yesterday.  I asked, “what about COVID-19, is that not your biggest concern currently?”.  He said, "my biggest daily fear has been falling for the past two years.  It will be the death of me.” A few days later I installed the Beta version of StrideTech Go on his walker and accompanied him on a simple walk as he threw out his daily garbage.  His comments are remarkable.  My doctor says they're never going to go away so I learn to live with the bruises.  That alternative is just too drastic. (he smiles and chuckles).

This fear is not unfounded.  According to the APTA 1 in 4 older adults fall each year and the fear of falling is indeed quite real.  I paused to take in his comments into my subconscious mind and fired off another question.  “How did you get so good at using your walker”?  He replied, “when I fell, I injured my head so badly that the neurologist thought my brain couldn’t sustain another shock like that one and suggested that a PT be dispatched to my home to train me on safe walker usage.

Nearly 60% Are Doing it Wrong

Unfortunately, David’s experience is quite unusual in multiple ways.  First, few people that are told they must use walkers get any training on the safe use of walkers and don’t have anybody or anything making sure they are doing it right.  According to the CDC in 2014 a projected $50 billion was spent on fall related injuries.  It’s estimated that between 4 and 6 million US citizens actively use walkers, but even with walker usage, falls are common.  This is supported by a study from the American Physical Therapy Association found that 58% of falls were associated with incorrect walker usage.  Furthermore, of those that survived their fall related injuries, 71% of the patients received walker retraining. (Source: Characteristics of Individuals Who Fell While Receiving Home Health Services)

In a study of safe walker usage, up to 80% of walker users never received direct consultation and potentially proper training on safe walker use. (Source:  Assessment of Rolling Walker Used By Older Adults in Senior Living Communities.

Fear of Falling, It's a Thing

Thinking back to COVID-19 for a moment, I considered Paul’s comments.  He actually was more worried about death from falling than getting sick.  Rational thought and feelings are personal and are in a constant state of flux.  They're what help us keep us safe and grounded.  For David, I’m reminded that regardless of what’s going on in the world around us, we always have an inner world that matters most.  For David, fear of falling at least for the moment is his number one fear and I could tell from his tight grip of his rollator, it’s the thing that’s giving him comfort in a time when our new norms have perhaps created feelings of discomfort and dismay.  David’s case has some remarkable takeaways.

The Inevitability of Time and Gravity

While the fear of falling for older adults is a very real concern, walkers in their current form are often handed to users with little training and no real time feedback on quality of usage.  As we face a new world with the fear of no guaranteed vaccine for COVID-19, recommendations for mask usage in public, and concerns about privacy and contact tracing consider David’s fears for a moment.  In his entire life of nearly 95 years, what has seemingly sped up and increased in strength from his perspective?  Simply put, it’s time and gravity.  The impact of time and gravity during aging are more likely to be the death of David rather than another aliment such as COVID, cancer or COPD.  I’m 100% concerned about those whose lives, livelihoods, and liberties have been affected by COVID-19.  We’re all deeply affected by this and will be for years to come.  However, as I close my thoughts for you today, I harken back to that one brief moment with David when he opened my eyes to his greatest fear.  I’m hopeful that more attention will be drawn to the needs of our global older adult citizens who battle time and gravity minute by minute and step by step.

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