Los Angeles Jewish Home's Blog


How to Avoid Breaking Your Hip

For a senior, a hip fracture can be as life-threatening as heart disease or cancer. Sadly, nearly one in four older women who fracture a hip will die within a year. For men, the odds are even worse. A year after a hip fracture, one-third will not survive. Of those who do, many will not be able to walk without a cane or walker.

The reasons for such poor outcomes after hip fractures are not clear, however loss of mobility and independence play an important role. Immobility also leads to depression, a loss of motivation, and, in many cases, even the will to thrive and live.

Since we don’t want one, let’s look at ways to prevent these potentially devastating accidents.

Fall Proofing Your Home

Most falls occur in the homes, that were built without the needs of senior residents in mind. Many contain slippery floors and poorly-lit hallways, and stairs.

To fall-proof your home, start with your kitchen and your bathroom, the two most common sites for falls. Grab rails are a must in the shower and next to the shower, bathtub and sink. They don’t have to look industrial. There are nice designer shapes and colors from which to choose.

If you use throw rugs in the bathroom or kitchen, make sure they are fixed to the floor. Re-organize your kitchen to ensure that commonly-used items can be easily reached. And don’t store anything so high that you need to stand on a chair or stool to reach it.

Be sure hallways and staircases are well-lit and clutter-free. For more information on how to make your home safer, visit www.homemods.org.


Change Those Shoes

High heels and smooth-soled shoes must go. Personally, I prefer the security of shoes with non-skid bottoms. If you encounter a wet or slippery surface, your shoes can make the difference.

While you’re at it, retire those running shoes with lots of elevation. They simply put too much space between the soles of your feet and the surface on which you’re walking.

Improve Your Balance

There are several ways to improve your balance and thereby prevent falls. Perhaps the best method was devised by the Chinese, and is called T’ai Chi. The gentle motions of T’ai Chi have been shown in clinical trials to reduce falls and their resultant hip fractures in seniors.

If T’ai Chi is not for you, there are other balance exercises that a physical therapist can show you. Your physical therapist or physician can also coach you on how to avoid landing on your hip if you do take a fall.

Strengthen Your Bones

We all lose bone mass after the age of 40 or so. For women, this process accelerates after menopause due to a loss of estrogen. What can we do to slow down and even reverse this process so that we’re not at risk for fractures?

Surprisingly, the best way to strengthen bone is through exercise, both the aerobic and strength-training types. Just 30 minutes of walking at two to three miles per hour will build bone mass. Light weight training will strengthen your bones as well as improve your balance.

Get Sufficient Vitamin D

Another way to prevent fractures is by getting enough vitamin D, which has been shown to prevent falls. Your skin manufactures vitamin D after exposure to the UV rays in sunlight.

Unless you get out in the sun for a considerable amount of time each day, it is unlikely that you are getting enough vitamin D, and you will need to take a supplement of 1,000 IU a day.

Have a Bone Scan

If you are over age 50, you should have a DEXA scan. This x-ray of your hip and spine will determine if you have osteoporosis (severe loss of bone matrix) or osteopenia (moderate loss of bone matrix). If you do have these conditions, you are at greater risk for hip fracture.

There are several options for treating osteopenia and osteoporosis. Consult with your physician to see if estrogen, etidrionates such as Fosamax, SERMs such as Rolaxifene, calcitonin, or parathyroid hormone, are right for you.

Reducing the risk of a hip fracture and its consequences is something you can start working on today. By taking the steps outlined above, you should be able to protect yourself from this potentially devastating injury.

Dr. Ed SchneiderDr. Edward L. Schneider headed the largest private center for research and education on aging, the Andrus Gerontology Center of the University of Southern California, from 1986 to 2004. He is now Dean Emeritus of the Leonard Davis School of Gerontology and Professor of Medicine at the USC Keck School of Medicine. Dr. Schneider has written or co-written 14 books, including Ageless: Take Control of Your Age & Stay Youthful for Life, and published more than 180 scientific articles on topics related to aging.

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Unconventional Practices for Practical Purposes

It's always interesting to see how Eastern medicinal techniques make their way into Western practices. Today's posts in The New Old Age, an award winning blog sponsored by The New York Times, talks about the use of reiki in special care centers to help people with dementia.

Home Care Partners, a nonprofit home care agency in Washington, won a two-year grant from the federal Administration on Aging to give it a try and has just finished training 36 aides in reiki. Next year, the agency will offer reiki training to family caregivers and to workers at adult day programs.

“It relieves stress, it reduces anxiety and it can help diminish pain,” said Marie Muller, the agency’s education manager and a trained reiki master. “We hope that our clients with dementia who become agitated and stressed will find reiki calming” — and thus will be less disturbed when aides help them bathe or dress or eat.

Reiki is the ancient Japanese practice of channeling universal energy to heal or, at the very least, soothe a person in need. And in addition to senior care facilities, some hospitals are experimenting with the practice.

At Portsmouth General Hospital in New Hampshire, for instance, two staff practitioners and a half dozen volunteers offer free reiki to all patients, family members and staff, last year providing more than 2,100 sessions.

“People say they just feel comforted,” said Christina Niles, the hospital’s reiki director, citing patient surveys. “I personally believe reiki is healing. Not everyone at the hospital agrees, but everyone thinks that people feel better afterward.”

In a recent Jewish Home Feature Article, Dr. Edward Schneider explained that Eastern and Western medicine can complement one another. What would be interesting to know definitively, though, is whether reiki can physically heal, or whether the presence of a calm caregiver or peaceful music simply puts dementia patients at ease.

What do you think?

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Alternative Meds/Traditional Chinese Medicine

According to legend, Traditional Chinese Medicine (TCM) was invented 4,500 years ago by Huangdi, known as the Yellow Emperor, in collaboration with his physician.

To better understand this type of medicine, which is increasingly popular with Westerners, I visited China a decade ago.

On my trip, a TCM practitioner took me on a tour of one of the country's hospitals. In contrast to the smell of disinfectant encountered in American hospitals, wonderful aromas greet you when you enter a TCM hospital. Similarly, while the pharmacy occupies a small part of the first floor of many hospitals in the U.S., the pharmacy is the first floor of a TCM hospital. Shelf after shelf in the pharmacy hold the ingredients of Traditional Chinese remedies: herbs, animal parts, and chemicals.

Ingredients New to Westerners

Seahorses are considered a key ingredient in treatments for a number of conditions, ranging from impotence to heart disease. Rhinoceroses have been hunted to near extinction in order to acquire their prized horns, which are then ground into a powder, and used for a variety of ailments. Shark fins cooked in soup are thought to cure cancers. Tiger bones were used to treat arthritis until tigers were on the verge of extinction, so the Chinese government banned their use in 1993. Popular herbal ingredients include gingko biloba and ginseng.

During my tour of the hospital, I entered a patient's room and watched a Chinese practitioner as he sat on the bed next to the patient and administered a concoction of TCM ingredients. While Western medicine often treats patients with a single pill for a specific ailment, Traditional Chinese treatments consist of a tea with 10 to 20 separate ingredients.

I was very impressed by the “hands on” approach and the obvious caring relationship between the patient and the physician. But I was very surprised to see an intravenous pole at the other end of the bed with the modern antibiotic Amoxicillin being infused into the patient. I asked the doctor about this apparent incongruity.

“Here in China, we use the best of the West and the best of the East,” he said. I learned that treatments for serious medical conditions like cancer and heart disease are very similar to those used in the United States. However, for day to day preventive care, the Chinese take a different approach.

Examining Chi, Yin, and Yang

When a TCM practitioner is examining a patient, he will look at the hands, tongue, eyes, and skin of a person. In this way, he is looking at the patient's chi, or vital force. Chinese doctors are concerned about the flow of chi, and look for signs that it may be interrupted.

They also examine the balance of opposing forces in the body, the yin and yang. Yin is thought to be wet, slow, soft, and tranquil, and often described as a feminine force. By contrast, yang is hot, hard, dry, and aggressive, traditionally masculine attributes. In examining the balance of these forces, Chinese doctors may conclude that the patient's chi is not flowing properly. Over four millennia, they have come up with many ways to correct such imbalances.

Acupuncture and Acupressure

One TCM treatment is acupuncture. The Chinese believe that chi flows along meridians in the body, and that placement of acupuncture needles at specific points along these meridians can help restore the flow of chi, bringing yin and yang into proper balance. A few years ago, the National Institutes of health convened a consensus conference on acupuncture. It found support among American physicians for using acupuncture to treat specific conditions such as headaches and arthritic pain. Today, the practice is used with varying degrees of success. Fortunately, there is very little risk from having acupuncture as long as the needles are sterilized or disposable.

In addition to acupuncture, a TCM practitioner can use acupressure, which is pressure placed at specific points along the same meridians that are used in acupuncture. Other treatments include cupping, where a heated cup is placed over the skin; moxibustions, the burning of herbs close to acupuncture meridians; massage; and qigong, a combination of breathing and meditation exercises.

So, do I recommend that you try Traditional Chinese Medicine? For serious medical conditions, I would seek a physician trained in the latest Western medical practices. I believe that the main danger of seeking out TCM is that a patient might postpone receiving proven modern treatments for treatable conditions. But for those who want to see how their chi is doing, or whether their yin and yang are in balance, there is very little danger in trying Traditional Chinese Medicine.


 Edward L. SchneiderDr. Edward L. Schneider headed the largest private center for research and education on aging, the Andrus Gerontology Center of the University of Southern California from 1986 to 2004. He is now Dean Emeritus of the Leonard Davis School of Gerontology and Professor of Medicine at the USC Keck School of Medicine. Dr. Schneider has written or co-written 14 books, including Ageless: Take Control of Your Age & Stay Youthful for Life, and published more than 180 scientific articles on topics related to aging.

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