IFA Guest Blogger: Marguerite Oberle Thomas, Consultant -Liaison, Fall Prevention Community of Practice. Thomas, a senior, has worked in Injury Prevention since 1996.
Fall Prevention Month is a November campaign initiated for the fourth year by pan-Canadian partnering organizations that assist intermediaries who work with older adults and those at risk of injury due to falls. Why do we need to promote Fall Prevention Month? The motto says it all “It takes a community to prevent a fall: We all have a role to play”. When someone falls, it affects the individual, the family, the community and the health care system. The partners and contributors who make it happen in Canada recognize that fall prevention is an international issue and invite advocates everywhere to adapt and utilize the ideas and resources created over the past four years.
As both a senior and someone still in the workforce, the first hurdle for many seniors is to acknowledge that falls are not an inevitable part of ageing and that there is much that can be done on a personal, home and community level.
On a personal level, there are some things that cannot be changed such as your genetic background and past history of falls. However, general health is most important and helpful strategies include:
Less well known is the role of hearing checks. People fall when they misstep while concentrating on blocking out noise while listening to what they want to hear. Fear of falling is a huge factor as well, as it can inhibit the free and vigorous movements that keep our muscles strong. Mood and mental ability need to be considered. Medical conditions can loom large. Conditions that affect balance, strength and flexibility are all risk factors as are certain medications and the use of alcohol or cannabis.
On the home front, the first step would be to obtain a home safety checklist. Many of these available online or are located at your local health care centres. Lists should include all the rooms in your home with suggestions for improvement. Considerations include:
Most pertinent this time of the year is safe winter walking. Helpful tips include:
In the community and public places: Speak up, be proactive, and support Age friendly Communities. Biggest personal tip: Slow down and think ahead. It is often several factors that make a fall happen and hurrying is a major culprit. Stay safe and enjoy the social and physical wellbeing that comes from being active and avoiding falls.
What is Diabetes?
Diabetes mellitus (diabetes) is one of the most common noncommunicable diseases globally and continues to increase in numbers and significance. Diabetes is a chronic, systemic disease where the body can either no longer produce (Type 1) or make good use of (Type 2) the hormone insulin, which regulates blood sugar levels. Risk factors for developing diabetes include family history, overweight, unhealthy diet, physical inactivity, and increasing age.
When a person with diabetes has higher than normal blood sugar (HBA1C) levels because they have not been managing their condition, this can damage blood vessels and nerves over time. Long-term complications of diabetes include:
These complications can lead to negative health outcomes such as vision loss or blindness, kidney failure, heart attack, stroke, and limb loss.
Diabetes in older age
Diabetes is one of the top causes of disability and death in older age, much of this resulting from the complications listed above. However, some older persons living with diabetes may have full or good functional ability while others may have functional impairments or other chronic conditions and/or frailty. Both health status and function impact an individual’s ability to manage their diabetes as well as their access to quality health care.
How should older people with diabetes manage their condition?
Older people with diabetes should continue to maintain a healthy diet, exercise regularly, and monitor blood pressure. However, optimal blood sugar levels may be different in older age because there are increased risks for hypoglycemia and resulting falls – which can lead to further functional decline.
Health care providers and older people who have diabetes should work together to develop an individualized care plan to determine their optimal glycated hemoglobin (A1C) levels based on whether the person has other comorbidities or functional impairments to be mindful of in their diabetes care.
To prevent and manage complications of diabetes, older persons should:
Read more about guidelines developed specifically for the care of older persons with diabetes:
What does this mean for health systems and public policy?
To help people with diabetes continue to do what they value as they get older, diabetes management should be:
Health systems should re-align to accommodate increasingly complex care needs, acknowledging that some older people who have diabetes may have one or more other chronic comorbidities or functional impairments. For example, the World Health Organization has proposed guidelines for Integrated Care for Older Persons (ICOPE), which outline the necessary elements of integrated care at the community level.
It is also worth noting that diabetes is associated with living with a lower income. The consequences of both diabetes and poverty manifest in later life – and this should be mitigated by offering supports specifically for persons with diabetes who are living in poverty to enable better self-management and access to care.
The IFA works to help older persons promote and maintain their intrinsic capacity across the life course by facilitating knowledge mobilization and promoting collaboration among leading experts:
 WHO World Report on Ageing and Health: http://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf;jsessionid=439C267FD3B1DB056D3EBFD35955551A?sequence=1
Ageism, whether explicit or implicit, is pervasive in society. Through stigma, prejudice and age-based discrimination, ageism negatively impacts older people at both the individual and institutional level. Ageism involves the stereotypes, prejudice and discrimination experienced by individuals on the basis of age, often negatively impacting health and wellbeing.
On International Day of Older Persons, AGE Platform Europe launched a 70-day campaign culminating on the 70th anniversary of the Universal Declaration of Human Rights against ageism to illustrate the harmful effects of ageism and how it impacts people across the life course. Focused on raising awareness of these issues, the #AgeingEqual campaign has a different theme to highlight just how widespread ageism is in society.
This week the campaign is focused on addressing ageism and sexuality. Focusing on the experiences of older people of diverse sexualities, LGBTQI people can experience unique challenges as they age. Not only do these communities experience the harmful impacts of ageism, but this is in addition to experiencing a lifetime of different forms of oppression including homophobia, heterosexism, transphobia and sexism.
Recognizing that the diverse nature of older people is often under-represented in policy dialogue and programs, the IFA joined with partners SAGE and Egale Canada, as well as an international working group, to address the inequalities experienced by these populations.
Want to get involved? Sign the Older LGBTQI People Call to Action!
Interested in learning more about the experiences of older LGBTQI people? Recordings from past webinars on topics addressing inequalities felt by older LGBTQI people are included below.