Sunday, January 31, 2010

Impairments = Missed Opportunities

Reduced mobility creates hardships for seniors interacting with the world around them. When one experiences falls, broken hips, broken wrists, lower back pain and or a reduction in or cessation of driving, opportunities for interpersonal communications diminish.

My grandfather developed severe back pain brought on by a crushed disc in his lower back earlier this year. Lower back pain in the elderly is common, as a recent national survey proved that in “patients aged 75 and older…back pain is the third most frequently reported symptom” (Bressler, et. al., 1999). His back pain caused him trouble walking and difficulties rising from chairs, walking up stairs, walking to the phone, and getting in and out of vehicles. Additionally, just a few months prior, he suffered a fall that resulted in a broken wrist. The broken wrist reduced his ability to write and in combination with the loss of mobility from the lower back pain, he experienced a lack of communications with family and friends.

While the impairments in the ability to walk and write do not initially sound related to traditional communication barriers like hearing or vision losses, they have affected my grandfather’s ability to do many things related to interpersonal communication. He is no longer able to walk to the phone fast enough to answer it. When he finally does receive a phone call, he seldom holds the phone for long because of the pain in his wrist. When someone comes to his front door, he seldom makes his way across the house to open the door quickly enough. He no longer writes letters or sends birthday cards to friends and family. These impairments have led him to hire a caregiver to run errands for him, drive him and write out checks for him, though the caregiver’s assistance does not improve his communications with outside family, friends or society.

Further compounding the lack of communication that my grandfather experiences with avoiding calls and not writing, is the fact that he has ceased driving due to the lower back pain. Now that he must rely on the caregiver’s schedule for transportation, it has lessened his opportunities for outings and social interactions. “The older person who reduces or ceases driving bears the brunt of the changes that occur in terms of monetary, social, psychological, and emotional costs” (Burkhart, 2007). Knopp (2009) notes, that “isolation and loneliness experienced by nondriving seniors can result in deteriorated physical and mental health.” Plus, older drivers who generally drive on six outings per week usually reduce outings down to two per week when they become reliant on receiving rides from others (Burkhart, 2007). Hence by discontinuing driving, my grandfather has lost additional opportunities to engage socially with others outside his home.

Sadly, the number of seniors who do not drive is not as uncommon as one might think. “SCOPE, the community planning group, cites national research indicating that about 21 percent of Americans age 65 or older don't drive and that, on any given day, 50 percent are home-bound due to lack of transportation options” (Knopp, 2009).

Falls in the elderly are also not uncommon. Warshaw (2006) reports that “after age 85, over half of women will suffer a fall” while “31 percent in the 80- to 84-year age group” of men experience falls. The complications from falls include fractures of the hip, and forearm [or wrist] (Warshaw, 2006). Earlier this month, the Pope at age 82, fractured his wrist when he fell (B92.net, 2009). A good friend, Marie, who was in her mid-70’s when she fell on pavement broke both her wrist and hip. “Because bones become brittle with age, fractures are common among the elderly” (Joseph, 2008). Interestingly, Warsaw (2006) also points out that “after a few falls, some people become so frightened and anxious that they will not attempt to stand even when there is adequate help and support.” As people become afraid to stand or walk after falls, they are not likely to return to outings that require walking or standing which also decreases their opportunities for interpersonal communications with friends, family and society.

When Marie experienced the impairments of a fractured wrist and broken hip, I witnessed a loss in her interpersonal communications. Like my grandfather’s experience, Marie’s reduced mobility in walking and writing, resulted in her not taking telephone calls, seldom answering the door and the end of her writing to friends and family. Additionally, Marie had been a very social person before her accident and had engaged in many senior group tours overseas and spent much of her time out with friends shopping and dining out. Her reduced mobility led to the end of her overseas vacations as well as her social outings with friends.

When looking at the losses of mobility from back pain, falls, broken wrists and broken hips, compounded with the cessation of driving, it becomes clear that seniors and the elderly lose opportunities for social engagement as mobility is reduced and they become increasingly homebound. Thus, even impairments unrelated to hearing and sight can equal losses in interpersonal communications for seniors and the elderly.

References
Bressler, H., et. al. (1999, Sep., 1). The Prevalence of Low Back Pain in the Elderly: A Systematic Review of the Literature. Lippincott Williams & Wilkins, Inc. Retrieved from: http://journals.lww.com/spinejournal/pages/articleviewer.aspx?year=1999&issue=09010&article=00011&type=abstract

Burkhart, J. (2007, Jan. 30). Mobility Changes: Their Nature, Effects, and Meaning for Elders Who Reduce or Cease Driving. Ecosometrics Incorporated. Retrieved from: http://trb.metapress.com/content/dlk6vw1r15245554/

Joseph, T. (2008, July 28). Colles’ Wrist Fracture. Medicine Plus. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/000002.htm


Knopp, T. (2009, July 12). Nonprofit service helps seniors retain mobility. Herald Tribune. Retrieved from: http://www.heraldtribune.com/article/20090712/COLUMNIST/907121023/2080/OPINION?Title=Nonprofit-service-helps-seniors-retain-mobility.

Pope Falls and Suffers Broken Wrist. (2009, July 17). B92.net. Retrieved from: http://www.b92.net/eng/news/world-article.php?yyyy=2009&mm=07&dd=17&nav_id=60560

Warshaw, G. (2006, Apr. 10). Falls and the Elderly. University of Cincinnati. Netwellnes.org. Retrieved from: http://www.netwellness.org/healthtopics/aging/faq9.cfm

All content © Village Memorial. 2009-2010.

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