Marilyn Davidman knows from experience that one bad fall can put you down for the count when you least expect it. A friendly greeting from two boisterous dogs landed her on the ground with a fractured wrist.

“If I had been steady enough to keep my balance, that might not have happened,” she says.

An active tutor who takes a good number of classes and volunteers in the Albuquerque Oasis office, Marilyn is simply too busy to let getting tripped up trip her up.

“I have a lot of good reasons to stay on my feet,” she says.

Marilyn turned to Oasis for help. She took a Better Balance class as part of an Oasis fall prevention program supported by a grant from Blue Cross Blue Shield New Mexico.
She’s glad she did. In addition to having more stamina, she has a better understanding of muscle movement and how she can prevent future falls. 

“It makes you feel like you are not alone,” she says. “There are people there with you trying to do something about it.”

Older adults like Marilyn across the country can avoid costly injuries that threaten their independence through prevention programs supported by partnerships between community-based organizations like Oasis, healthcare providers and managed care. These alliances are a path to lower healthcare costs, improved population health and better patient care—a health policy model known as the Triple Aim.

A common problem

One in four adults ages 65 and older will fall this year. Those who fall are more likely to fall again, and each fall increases the likelihood of more serious injury or death. Falls also impact individuals and families by affecting independence and mobility.

It can be difficult to pinpoint the reason for a fall. It could be due to a change in gait or balance, muscle loss, home environment, medications, vision or hearing changes or even a fear of falling. This fear can be present even if someone hasn’t experienced a fall.

Lois Brazil is one of those people. She didn’t fall, but a car accident that resulted in a concussion left her sidelined from one of the things she loves most, swing dancing. A Tuesday night regular with a local dance club near her home in Florissant, Missouri, Lois found herself scared to get back out on the dance floor.

“I was afraid I might fall,” she says. “People offered to take me, but I would make excuses. I quit going.”

Encouraged by family to do something to get her confidence back, Lois started taking A Matter of Balance classes offered by Oasis. The classes proved to be the turnaround she needed to overcome the fear that was getting in the way of a social life. Her Tuesday night dance card is full again.

“I’m grateful to be back in the ‘swing’ of things,” she says.

An answer to rising costs

The community-based model addresses another serious factor: falls are costly. An estimated $67 billion will be spent on falls by 2020. 

According to a study by the Centers for Medicare and Medicaid Services, A Matter of Balance saves an average of $938 per participant in healthcare costs.

Oasis is expanding evidence-based programs like A Matter of Balance in places where adults live and work by collaborating with libraries, senior residences, community centers and houses of faith. These familiar neighborhood settings attract diverse audiences, and maximize weekly attendance so participants get the full benefit of programs that have demonstrated positive results.

Leading the way in Missouri and beyond

A report from the Centers for Disease Control and Prevention identified falls as the leading cause of unintentional injury deaths among seniors. In 2014, falls were the major contributor to hospital charges for injuries to seniors in Missouri.

In 2015, Oasis received a grant from the U.S. Administration on Community Living to offer A Matter of Balance as part of Missouri’s statewide fall prevention efforts. Since receiving the grant, 18 partners have hosted 83 workshops reaching 945 Missourians. With 82 percent completing the program, that’s a savings of approximately $726,950 in healthcare costs.

Juliet Simone, MPH, is community health manager for St. Louis Oasis evidence-based health programs, and state coordinator for the Show Me Falls Free Missouri Coalition. She says the success in Missouri has laid the groundwork for broader impact across the country.

“Oasis took on this effort to learn firsthand how networks of community partners can collaborate to reach more adults with evidence-based health programs,” says Juliet.

The U.S. Administration on Community Living recognizes the role community-based programs can play and has provided grants to many states to expand capacity and increase sustainability. When New Mexico was awarded a statewide fall prevention grant, Albuquerque Oasis applied lessons learned from Missouri to build fall prevention programs in the state.

Fall prevention programs are increasing at other Oasis centers as well. In San Diego, balance and exercise classes helped Leanna Clark recover from a fall and get strong enough that she no longer needs a cane. 

“For me, exercise has become as irresistible as a box of chocolates . . . I’m kind of addicted,” Leanna says. “I’m the oldest student in my class and I enjoy the independence I have regained.”

Common sense

Falls are costly – in dollars and in quality of life. But falling is not an inevitable part of aging. Through grant funding, Oasis is demonstrating how we can keep more adults on their feet so they can stay active, healthy and involved in their communities.

The bigger opportunity lies in building innovative partnerships to expand these programs. With the ever-changing healthcare environment, we know that health providers alone cannot serve the growing older adult population. 

Through contracts with health providers and managed care, community-based organizations like Oasis can reach older adults earlier and on a broader scale to prevent falls and reduce costs for everyone.

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Peter Bolland enjoys the engaged audiences at San Diego Oasis

“They are buying into the work before you say the first word,” says Peter. “Our discussions get really exciting because these students bring with them a life of insight that is thrilling for me.”

For five years, Peter has been a mainstay at San Diego Oasis. A philosophy professor at Southwestern College, as well as musician, artist and columnist, he is also frequent lecturer on any number of spiritual and mythological subjects. He says he takes away just as much “homework” or food for thought as anybody in the room.

“The questions they ask are really helpful for my writing process and I leave the classes with the dialogues continuing in my mind,” he says.

Peter’s experience with OASIS has helped him reshape how he perceives his own aging process.

“I’m coming to appreciate more and more the power of community,” he says. “We’re social creatures and something happens when we gather. It’s really interesting to see students realize that their presence in the room has benefit to others in the room. That’s what I love about OASIS.”

You name it

With Oasis, there truly is something for everyone: book clubs, dancing, cooking, history, music lessons and helpful information about practical matters, like estate planning and understanding Medicare.

“You name it,” says Simona Valanciute, San Diego Oasis executive director. “We probably have it.”

While the variety is certainly part of the appeal, the high quality of instruction keeps learners coming back for more. Classes are led by instructors who are experts in their fields: healthcare professionals, historians, attorneys, musicians, artists, former professors, writers and thinkers.

Robert Tórrez brings history to life in Albuquerque

A core group of people frequents classes at Oasis Albuquerque taught by Robert Tórrez, who served as the New Mexico State Historian for 15 years.

Robert still writes a monthly column, “Voices from the Past.” Naturally, his classes cover local history and his specialty, the judicial system, what he calls “wild west stuff.” His wealth of knowledge comes from years of access to the New Mexico official archives, which go back as far as 1621.

His tours, most to his hometown and other surrounding small towns in Northern New Mexico, are just as enjoyable for him as those he’s leading.

“These tours usually sell out,” he says. “Most are national historic districts, and with a tour, you get to show more than pictures. I point out personal things. We see weaving, dyeing wool, old railroad yards. This kind of experience allows people to see history in a different way.”

Jerry Pruzan offers expertise from the ranks

Oasis centers often have a built-in resource for quality programs: the participants themselves.

Jerry Pruzan is an Oasis tutor and takes Spanish and other classes from time to time. He also brings something wonderful to  Washington Metro Oasis: tours at the Library of Congress and the Supreme Court. A retired attorney, Jerry serves as a docent for both institutions and offers his expertise through Oasis, where the tours fill up quickly.

“Both are really interesting, and I think the Supreme Court is especially so because it’s somewhat mysterious,” says Jerry. “I’m able to facilitate a behind-the-scenes look that not many people get. It’s popular because people want to be a part of history.”

“Sometimes I look at my calendar and it’s booked! I love it,” Jerry says. “So many people think of retirement as life winding down, but it’s actually the beginning of a new life.”

The breadth and scope of programming at Washington Metro Oasis shaped in part with assistance from Jerry’s wife, Marcia Pruzan, who serves on the program committee. Her involvement with the National Institute on Aging and Montgomery County, Maryland’s Commission on Aging and Aging Services has helped her stay abreast of issues relevant to older adults and she often works to connect high-quality lecturers to the Oasis lineup. She is happy to help connect the dots, finding the best people willing to share what they know.

“We have such an engaged population here,” says Marcia. “The classes are packed. The intergenerational opportunities, keeping people involved…Oasis offers all of that. Older adults are an untapped resource.”

These instructors were featured in the 2015 Oasis Annual Report.

These feet were made for walking!

The walkers of Albuquerque Oasis wanted to become informed about fall prevention, and yes, how to transition the body from a fallen position to upright, so we can continue walking. A three-part workshop taught by Ben Thomson of Thomson Training Solutions was the perfect opportunity to learn more.

The workshop includes elements of psychology, massage therapy, holistic health counseling and martial arts to help individuals obtain higher levels of confidence and mobility. There was a lot to learn, but these key takeaways are helpful for walking of any kind.

Breathe.
A calm mind and body focused on breathing, relaxation and easy motion will have fewer accidents. So center yourself and breathe deeply. Try breathing from the pit of the stomach and in through the nasal passages to filter and clean the oxygen, then slowly release the breath out of the mouth. Practice may be necessary.

Think about your steps.
To keep the mind from wandering, walk with a longer stride and count to five and then count backward…five to one. Or count by sevens to forty-nine forward then backward. This kind of activity simultaneously keeps the mind and body busy. If walking in the park or mall, look ahead twelve feet, see what is up ahead and along the way. Potential obstacles in view, look down and see where your feet are in relation to the terrain. Raise your eyes and keep walking.

Be mindful of your body in your space.
Another important factor is proprioception or the awareness of where you are in your space, and the sense of the body parts in relation to each other. Do a home test: close your eyes and alternate touching your nose with your right index finger and then with your left index finger. See if your finger knows where your nose is located. The ability to navigate through a dark room is a good indicator of your proprioception.

Know how to rise.
If you are tired of walking, sit on a bench or the ground. Learn to rise up from a sitting position. Spread the feet apart and use legs and lower body to stand up. Breathing becomes very important here. Inhale when preparing to stand. The energy force will help elevate your body. If a fall happens, wait a few seconds, check your moving part and slowly turn on your side into the most comfortable fetal position.

The Center for Disease Control offers a number of additional tips for preventing falls, including:

• Get some exercise. Lack of exercise can lead to weak legs and this increases the chances of falling. Exercise programs can increase strength and improve balance, making falls much less likely.

• Be mindful of medications. Some medicines—or combinations of medicines—can have side effects such as dizziness or drowsiness. This can make falling more likely. Having a doctor or pharmacist review all medications can help reduce the chance of risky side effects and drug interactions.

• Keep vision sharp. Poor vision can make it harder to get around safely. Older adults should have their eyes checked every year and wear glasses or contact lenses with the right prescription strength to ensure they are seeing clearly.

• Eliminate hazards at home. About half of all falls happen at home. A home safety check can help identify potential fall hazards that need to be removed or changed, such as tripping hazards, clutter, and poor lighting.

Oasis offers a number of classes designed to help prevent falls, including Better Balance, Matter of Balance and Free From Falls. Check out your local Oasis catalog to sign up today.

Betty Higbie is an active member of a walking group at the Albuquerque Oasis and a frequent guest blogger.

Oasis members meet on wheels and feet!

Recently, wheels transported our group to Elena Gallegos Park, near the Sandia Mountains and the Aerial Tramway. The area was aptly described as “the most beautiful backdrop a city ever had,” by Phil Tollefsrud, a dedicated conservationist involved in the establishment of the park.

As our feet propelled our bodies along the smooth paths and rocky terrain, our minds were free to wander. Or better yet, let the Oasis Guide direct our thoughts back in time, to visualize the early beginnings, 1600 CE (Common Era). To the west, the Rio Grande River snaked around to supply water for the Tigua Indians. The river valley and grasslands provided food and shelter for animals and the inhabitants who skirted around volcano cones, roaming the mountains, mesas and plains.

We learned that later, the “Cities of Gold” seekers came, followed by farmers and warriors. The land was divided and allotted. Faithful soldiers and rich people were granted or bought specific parcels. Elena Gallegos’s ancestors owned a parcel of acreage from the Spanish Land Grant, but failed to pay taxes. Court orders and battles continued for decades, then centuries. Albert G. Simms acquired a portion in the 1930s and later willed it to an Albuquerque private school. The city eventually acquired the park site.

The rasping call of a jay in the scrub oak snapped my mind back to present time. Colorful ceramic tiles on posts near shaded resting areas were designed by Margy O’Brien. The half- mile Cottonwood Trail leads to a pond and bird blind where Teach the Mind, Touch the Spirit tiles are displayed. This peaceful spot is a pleasant place to recharge. Endorphins released by physical exercise create happy feelings and relieve stress! Soaking up Vitamin D is another benefit from the outdoor experience, as long as sunscreen is used properly. Healthy diet and exercise help reduce brain cell shrinkage experienced in the glow of the “Golden Years.”

Up the slope, to a level space at the beginning of the 4.5-mile Pino Trail, is a rock garden. Billie Walters sculpted The Five Stones of Elena Gallegos to commemorate the life of Tollefsrud. The thirty-eight copper pins, one for each year of the conservationist’s life, are in a smoothly chiseled circle on the first prominent boulder. The other four boulders bear abstract symbols and metal motifs of the nature he loved.

If you are in the area, let your wheels and feet take you to the Elena Gallegos Picnic Area/ Albert G. Simms Park, for the mesmerizing views of Albuquerque, the Jemez Mountains and Mt. Taylor, an extinct stratovolcano. It’s worth the trip!

Oasis members meet on wheels and feet!

Recently, wheels transported our group to Elena Gallegos Park, near the Sandia Mountains and the Aerial Tramway. The area was aptly described as “the most beautiful backdrop a city ever had,” by Phil Tollefsrud, a dedicated conservationist involved in the establishment of the park.

As our feet propelled our bodies along the smooth paths and rocky terrain, our minds were free to wander. Or better yet, let the Oasis Guide direct our thoughts back in time, to visualize the early beginnings, 1600 CE (Common Era). To the west, the Rio Grande River snaked around to supply water for the Tigua Indians. The river valley and grasslands provided food and shelter for animals and the inhabitants who skirted around volcano cones, roaming the mountains, mesas and plains.

We learned that later, the “Cities of Gold” seekers came, followed by farmers and warriors. The land was divided and allotted. Faithful soldiers and rich people were granted or bought specific parcels. Elena Gallegos’s ancestors owned a parcel of acreage from the Spanish Land Grant, but failed to pay taxes. Court orders and battles continued for decades, then centuries. Albert G. Simms acquired a portion in the 1930s and later willed it to an Albuquerque private school. The city eventually acquired the park site.

The rasping call of a jay in the scrub oak snapped my mind back to present time. Colorful ceramic tiles on posts near shaded resting areas were designed by Margy O’Brien. The half- mile Cottonwood Trail leads to a pond and bird blind where Teach the Mind, Touch the Spirit tiles are displayed. This peaceful spot is a pleasant place to recharge. Endorphins released by physical exercise create happy feelings and relieve stress! Soaking up Vitamin D is another benefit from the outdoor experience, as long as sunscreen is used properly. Healthy diet and exercise help reduce brain cell shrinkage experienced in the glow of the “Golden Years.”

Up the slope, to a level space at the beginning of the 4.5-mile Pino Trail, is a rock garden. Billie Walters sculpted The Five Stones of Elena Gallegos to commemorate the life of Tollefsrud. The thirty-eight copper pins, one for each year of the conservationist’s life, are in a smoothly chiseled circle on the first prominent boulder. The other four boulders bear abstract symbols and metal motifs of the nature he loved.

If you are in the area, let your wheels and feet take you to the Elena Gallegos Picnic Area/ Albert G. Simms Park, for the mesmerizing views of Albuquerque, the Jemez Mountains and Mt. Taylor, an extinct stratovolcano. It’s worth the trip!