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Published By Dr. Rein Tideiksaar on August 29, 2017

It’s irritating when you open a magazine and a bunch of subscription postcards fall out and scatter on the floor. For frail elders with poor balance, this irritation becomes a health hazard, as they can fall if they bend over to pick up the cards that have fallen out of magazines.

Many elders take balance for granted. They navigate without thinking, effort or fear. However, for countless frail elders, the simple act of bending over (or even reaching up) to retrieve an object can be hazardous.

The ability to maintain balance when bending and reaching is dependent upon:

  • The sensory systems, which provide information about a person’s body position relative to the environment. The sensory systems include the sense of touch, the sense of sight, and inner ear (vestibular) sensors.
  • Muscles and joints, which coordinate the movements required to maintain balance. Muscles must be strong and joints flexible to help stop the body from falling.

All sensory inputs gradually decline with age. In addition, muscle strength in the hips and legs decreases, mobility in the knees and hips is reduced, and reflexes and reaction times are slower, leading to the reduced ability to catch oneself when falling.

Having one or more chronic health conditions also makes stability difficult to maintain. Common conditions include:

  • Diabetes
  • Parkinson’s disease
  • Arthritis

Improving Balance

If bending down and/or reaching up causes one to lose balance, a doctor’s visit is crucial. The doctor will evaluate the person’s balance and underlying cause.

Engage in exercises that strengthen balance. The best balance exercises for any individual are based on the person’s health and balance inadequacies. This discussion needs to occur between the elder and their doctor, who might ask a physical therapist for additional exercise advice. Specific exercises to improve balance may include:

  • Strength training
  • Stretching
  • Movement exercises (such as tai chi and yoga)

Environmental modifications to reduce the risk of falling while bending and/or reaching include:

  • Rearranging closet and kitchen shelves so everyday items are kept between a person’s hip and shoulder level, and are easy to retrieve.
  • Using a “reacher” or “grabber.” This device is ideal for people who have difficulty bending to pick up objects (such as spilled magazine subscription postcards), or reaching smaller items on high shelves. Bathtub/shower and toilet grab bars also can help a person bend and reach items safely.

Rein Tideiksaar Ph.D., PA-C (or Dr. Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant. Check out Dr. Rein’s professional profile on LinkedIn: If you have any questions about preventing falls, please feel free to email Dr. Rein at

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