The language of falls in old age

Photo of a foaming waterfall in native NZ forest setting: the Huka Falls
Huka Falls, near Taupo, New Zealand. CC BY-SA 3.0, Avenue (Wikipedia)

From falling over to having a fall: the language of falls in old age changes from an active verb to an ominous noun.

Children fall over laughing, fall off their bikes and fall out of trees. Often. They break their arms and legs and wrists and ankles but never, or almost never, their hips. And in the vast majority of cases those wounds healed quickly and well.

Young adults fall into debt, fall in with bad company, fall in and out of love, fall for a scam, fall out with friends, fall apart, fall from grace and fail to fall far from the tree. They fall over skiing or playing basketball or rugby or tennis. They fall over drunk, maybe. They fall off mountains and mountain bikes. Some, in the olden days, were labelled fallen women.

(They also visit the Huka Falls, Niagara Falls and Victoria Falls.)

Falling is usually a not-good thing, but at least the person concerned has done something to cause the fall. They are agents of their own fate.

From falling over to having a fall

Then when we reach a certain age, we don’t fall over any more.

We “have a fall.” As the language changes, the implications change. Falling is a normal, natural part of life and at least we learn from it. “Having a fall” is different. We’ve gone from a verb to a noun, from active to passive. The language signals that this is an event fraught with danger, bringing stress and fear. A crisis and an omen.

“Having a fall” implies that the person who fell is no longer responsible for this event. A fall is something they experience, something done to them — not something they do. It comes out of the blue, very often. It sometimes does seem like an act of God. A friend’s mother described her own fall in such a way: she didn’t trip, she didn’t slip, she didn’t twist her ankle, she didn’t lose her balance. No. One minute she was standing up normally, next minute she was on the ground. Her leg just gave way beneath her. It was not falling, but “a fall” that happened without any apparent cause.

I wish I dared to fall over at 82

I wish the distinction were not so black and white. At 82, I also wish that I could just fall over and get up again and again and again.

But I feel duty bound to be cautious. I don’t walk on a forest path in the dark. I touch handrails going up and down stairs. If a gale is gusting and I’m about to cross the street, I hold on to a lamp post until it’s over. Fact is, when vision and balance have changed — not for the better — I recognise the danger of falling is real. I’ve seen it happen to strong and healthy friends of mine.

They say that every year, 30%–60% of all people over 65 in New Zealand are likely to have a fall. So far I haven’t been one of them, except once when I was re-learning how to roller-skate. I was a bit tired and did a modest wee jump down a couple of steps. Result, broken wrist. I guess I was about 65 at the time, no idea.

How to prevent falls in old age

I don’t need to tell myself or you how to prevent falls in old age. Thousands of agencies do that, luckily. And we’re all doing what we can. At our community gym I do three different classes: Pilates, Pump, and Activate +. The emphasis differs between classes but they all help with strength, cardio and flexibility, and all the instructors include exercises in balance.

Every little bit of movement helps, and every old person I know is doing their best by doing what they like best. Walkers, hawkers, swimmers, spinners, dancers, lancers, skiers and tai chi-ers are all preventing falls in their own way. So are you when you’re standing on one leg while the kettle boils. Or squatting to play with a toddler. Or gardening. Or going downstairs for a piece of chocolate. Or getting rid of those high heels or that loose rug. Or simply paying attention.

I wonder what do you’re doing to minimise the risk of experiencing “a fall”? Because I know that if you’re over 65, you are doing something. And actively choosing to do something (instead of nothing) boosts our confidence and optimism about old age as well as our personal safety. Let us carry on being verbs, controlling what we can control. Yay for us, doing what we do!

Luckily, you can’t have a fall when you are already on the ground. Worth bearing in mind.

Rolling down a hill at 80 years old. This person IS wearing knickers, by the way.
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45 thoughts on “The language of falls in old age

  1. Sadje says:

    Still below 65 but I’m very careful specially in shower.

    1. Rachel McAlpine says:

      Paying attention! Well done.

      1. Sadje says:

        Thanks Rachel!

  2. I hear you, Rachel. I’ve found myself walking so much more cautiously in the rain here in Guro, especially at the kerbsides which seem to be a slippery shiny granite for some reason… I’m so aware of not wanting to fall, and so annoyed to be feeling so aware of this feeling…. grrr!

  3. Alan Ralph says:

    I’m 54 and doing regular exercise to keep my hips, knees, ankles and back in good nick. I occasionally suffer from ‘meandering foot’ where I’ll collide with something on the ground without intending too, not sure what causes that but it’s concerning. My big fear is my large feet losing their balance or grip on ladders or steps, so I’m careful when using those, particularly with they’re narrow.

    1. Rachel McAlpine says:

      The other day I was watching a three year old climbing up and down a big rope pyramid. She was so proud of her courage and skill. And now we need bucketloads of both.

  4. judibwriting says:

    As a former dancer, I used fall gracefully even as my neurological issues increased. My last fall was indeed “having a fall”, and was not because of inattention. I just fell. This time, no amount of adrenaline would tell my muscles what to do. I just fell hard and fractured my sacrum- the first time a fall caused more than just soreness. I am still as careful as always and the fracture has healed though my confidence has been recalibrated to accepting that there will be more hard falls in my future. I am only 70 but my body is in its 90’s in terms of osteoporosis, balance and strength. Living with the aging body and living as fully as possible no matter the physical limitations is why I always enjoy Rachel’s posts- bursting as they are with her engaging and creative approach to life.

    1. Rachel McAlpine says:

      How terrifying that fall must have been! I’m very free sleeved to know that the break healed and I know you are still out and about. But yes, commonsense demands caution at this point. And you show that joie de vivre (or Joe de vortex as my autocorrect would say) is still in the mix! X

      1. Rachel McAlpine says:

        Judi, I only just noticed that other wonderful auto-incorrect in my answer: free sleeved! I hope you concluded that I meant relieved. That is my best guess, anyway!

  5. Lifetime Chicago says:

    I just got home from the hospital due to a fall on Monday. I am 66 and retired from old job as paraprofessional and decided to work part time for Kindercare in the after school program. The gym floor was partially wet…I think…To make a long story short, I fell at the school gym on my second day with KinderCare. I was diagnosed with anterior dislocation of the hip. On Monday, I also hit my head during the fall but no concussion though I was throwing up alot. The ball joint of the femur was completely knocked out and they were able to knock me out and put it back in place with out intensive surgery. They think the pain and medication they tried to give me before pushing the ball joint was causing the vomiting. The pain really became better and I came home from the hospital yesterday. I have a walker but I don’t have other health issues and very active with walking and I can handle just fine. I was doing a walker run at the hospital. But I was planning on retiring, working on writing, and I thought the extra money would be helpful….but I am so grateful to God. I fell in the last job on a wet gym floor but no injuries…that I know of. Anyone can fall but this has taught the importance of taking care of you.

    1. Rachel McAlpine says:

      Oh that was far too dramatic an event! And not of your doing. I’m happy and impressed that you are back in action. Luckily this newly necessary mindfulness (which means paying attention) is all the rage this century, a point of pride, not shame. Stay safe and have fun. (I didn’t mean to be so long replying, sorry.)

  6. I’m not convinced about the knickers. I nearly fell over checking it out!

    1. Rachel McAlpine says:

      Dreams are free,Peter.

      1. You may get arrested if you start charging!

  7. alison41 says:

    Great post. And I related to all the comments. At 81, I’m super careful, but you have reminded me to do more by way of strengthening movements. And, the last pic – I also peered at the pic, and thought: huh? is she or isn’t she?

    1. Rachel McAlpine says:

      Black knickers next time 🙂 Or red.

  8. I rolled down a hill with a bunch of children when I was in my 70s. I proceeded to slice my hand open on the way down. I heard one of the children say, “What was that big blue thing rolling down the hill?

    1. Rachel McAlpine says:

      Oh no no no! But hey, what a way to go!

  9. Elizabeth says:

    My late sister broke her hip rolling down a hill with a puppy. Who knew it could happen? My focus is on balance and always looking where I am putting my foot when on a walk. That was my undoing last fall when I was trying to watch a hawk and walk. The sidewalk “came up to greet me.”

    1. Rachel McAlpine says:

      Oh no. My son said, “delete that comment (sister, puppy, hippy) because it doesn’t fit the narrative.” As for walking and hawking, no multitasking! (But what a thrilling reason for falling, at least.)

  10. Jan FitzGerald says:

    Great article, Rachel. I’m 71, and upon waking I lie in my bed and do a 90sec hip stretch each side, (knee clasped to chest, other leg bent) followed by a 20 sec sideways inner thigh/hip stretch each leg, then 10 reps of knee/leg stretching (you can hear the “snap” of lubricant in the knees coming into play, a good sign) before I get up. This all takes very little time. Before breakfast I walk into town and back and then I’ll find any excuse to go for a bike ride (on a cycle track) during the day.

    1. Rachel McAlpine says:

      How interesting! That sounds like the ideal program be for your personal body. Even hearing your knees snap must bring a little glow of satisfaction. Walking, biking — in the air, outside, watching for hawks and other birds… But see Elizabeth’s comment!

  11. brilliantviewpoint says:

    Great post, something we all think about. I was once in downtown Chicago, in the days of wearing a heels, my heel caught in between the sidewalk cement, I went flying face first down to the ground. I was in my 40s (now 59) then and I smiled when a cute little lady, maybe in her 70s, was the FIRST one to inquire as to how I was. Also, she was kind enough to bring me my shoe. She told me to “Be Careful, DEAR,” and she was right! I was more careful after that. 🙂

    1. Rachel McAlpine says:

      She knew all about it! What a good story. Thank you.

  12. Jan FitzGerald says:

    Elizabeth’s “hawking” noted. Fortunately the gannets from Cape Kidnappers colony diving for fish beyond the cycle track are worth a leisurely sit on a bench for a good half hour.

  13. Rachel McAlpine says:


  14. Nyla Carroll says:

    I fell whilst walking earlier this year and whilst ‘only’ 56, I truly realised just how debilitating the end result can be – I broke my elbow, then got a subsequent infection and spent 10 days in hospital. I’ve spent months trying to regain my strength and balance and can only imagine how much harder it will be in subsequent years, and the more so if I wasn’t already aware of the importance of being proactive. Great post Rachel and also loved the rolling down the hill – that looks dangerous in itself – I love how you are still living dangerously!

    1. Rachel McAlpine says:

      Seems that horrible incident at least served an educational purpose. Hard way to learn, but at least you are mended now, I hope?

  15. debscarey says:

    I’ve never had good balance, even as a young & fit person. Take that feeling into older years and vulnerability is an unwelcome constant presence. I’m extremely cautious if there’s no handrail or support when going up slopes or steps, to the extend that sometimes I refuse to take the chance. Himself still takes risks, and still falls. He’s younger than I am, but still… I know that getting up is now a big deal and I try not to be afraid of it, but when I’m honest, I have to admit that I am.

    1. Rachel McAlpine says:

      That fear (uninvited, unwanted) is, I suppose, a life -preserving instinct. I’d like to convert it into mindfulness, vigilance, something to be proud of.

  16. Joared says:

    My primary method for avoiding a fall is to ignore distractions and focus on my walking, never rushing as I also have to take slow deliberate steps; I use a cane. I have developed mobility issues in recent years so walking and doing exercises has become more limited. Falls I’ve had in past years resulted in learning experiences based on my analyzing why I had fallen. In one instance my foot slipped on a metal strip at my indoor entrance — so I make sure I don’t place my foot to stand on that strip any more. I took a stage fall as I learned during my early college years in drama, allowing my body to collapse downward — relaxation is key. I’ve not experienced any broken bones but being able to get up has required additional planning for anyone living alone who may have reached an age or stage with more limited physicality.

    1. Rachel McAlpine says:

      You reinforce what I’ve learned from others: when walking, just walk. There’s an acute and necessary mindfulness at work. I aspire to that and am improving. And after reading your words I’m going to ask an actor-director friend for a lesson in falling. I’ve read, “relax and cover your face”. But that’s just book knowledge. I need to practice…

  17. Lois Roelofs says:

    I fell and broke a hip when I was 64. Unaware, I had worn a sandal whose sole had split and then caught in a sidewalk grate in Chicago. Fast forward to now—at 80 I needed a hip replacement for arthritis and so the screws put in 16 years ago had to come out. I sailed through the hip replacement part of the surgery, but the “removal of the hardware” part caused a weakened area of bone that has now fractured for no obvious reason. I’m 6 weeks post op, and my walker remains my best friend! I’m hoping that someday soon I’ll be able to shag the walker and conquer my hugely amplified fear of falling!

    1. Rachel McAlpine says:

      Lois, at last I reply. I could blame my computer breakdown but also, I let my attention lapse. I like that you call your walker your best friend. I’ll try to remember that. That fear of falling : it must feel horrible. Happily i have seen people conquer it … but remain mindful. I’m learning from you and everyone who comments.

  18. Linda Raha says:

    I am not quite 65 yet, but I am getting closer! I have had one hip replacement and my other hip will need a replacement in due time. This is such a great and informative post. Every little bit of exercise helps. Thank you for sharing this! I helped care for my mother who lived to be in her late eighties until she passed away. We were so very careful that she did not take a bad fall. (She also gardened and went to the gym for as long as she could.)

    1. Rachel McAlpine says:

      Linda, hello. I think hip replacements have hugely improved our chances of living actively to a grand old age. Your mother sounds like a good role model for aging well, and your and your sisters played a big part in that.

  19. Jared says:

    Important to protect your head when falling to avoid it hitting ground/pavement/object which can result in closed head trauma. Head even just hitting the ground can cause cognitive issues including judgement with a person no longer able to live alone independently as occurred with one woman I know.

    1. Rachel McAlpine says:

      Our instinct when falling is to brace ourselves — which is how i broke my wrist while rollerskating. I understand its better to soften and (as you say) protect the head. If only I can remember this if and when i do fall over one day…

  20. msw blog says:

    Great post it reminds me a bit of a post I wrote a while back titled “Afraid of Falling?” You and your readers might enjoy it.

    1. Rachel McAlpine says:

      Thanks, but the article you refer to in your post is now gone, so perhaps you could explain the Dutch initiative in another comment? I am interested in classes on how to fall!

      1. msw blog says:

        Here is a link to the orginal article from the New York Times (NYT)

      2. Rachel McAlpine says:

        Thanks, so interesting.

      3. msw blog says:

        Here is the orginal link to the article from the New York Times

  21. CG says:

    You have made falling so much fun!

    1. Rachel McAlpine says:

      If only!

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