My father has lost his balance and fallen serveral times and when I watch him get up and try to navigate a narrow space his balance seems worse. So I asked him the other day, “If you could do something to improve your balance, would you?”

He looked cautiously at me before he answered, as if I asked a trick question – which in a way I did. He’s recently resisted his practitioner’s advice for physical therapy. He tends to rise too quickly, losing his balance and given that he has osteoporosis, I’m afraid he’ll have one-too-many falls and break a hip. But he’s 82, and he’s used to doing everything himself – even if he shouldn’t. In fact, he’s proud of his stubborness, wearing it like a shield, as if that can protect him from the vicissitudes of age. “Sure I would – but I wouldn’t do any physical therapy or anything like that!”

Well, I’m not sure what’s left that doesn’t involve actual physical movement – a pill? And then he proceeded to give me the reasons for some of his more recent falls: “My foot caught on the rug,” (when he fell onto the glass coffee table trying to negotiate the narrow space between the table and the couch) or “I was leaning too far over,” the time he fell off the ladder trying to clean out the gutters.

I’ve been thinking a lot lately about the impact of hip fractures on the elderly and the one statistic that sticks with me is that mortality increases in the elderly within 1 year of hip fractures- in fact 1 in 5 people over the age of 65 will die within the first year.

There are things that can be done to minimize his risk for falls, things such as adjusting the furniture, installing grab bars, securing scatter rugs, etc. Those are the environmental changes we can make. We can take meds for osteoporosis, and we can make sure our other meds are correctly dosed. But the environment and medication management are just  2 legs of the tripod – the 3rd leg is the physical training we can do. How much better would it be if he also did targeted exercises to improve his balance so that a stumble doesn’t end in a disaster?

Multiple studies have shown that muscle strengthening and balance retraining work. In fact I found almost 3,000 articles archived at PubMed when I typed in “fall prevention research in the elderly” in the search box.  For some practical advice, there’s, “Fall Prevention in the Elderly: 5 Steps You Can Take to Help Your Loved One Avoid Falling at Home.”

But all the research in the world amounts to a hill of beans if you don’t implement them. So Dad, it’s about the strategic choices you can make now so that we can keep you around -with your mobility intact – for many years to come.