Summary
In this episode of the CareLab Podcast, occupational therapists Emilia Bourland and Brandy Archie conclude their two-part series by exploring the final two warning signs that an older adult may need more help at home: falls and decreased mobility. They explain why even seemingly minor falls or subtle changes in movement shouldn't be dismissed as "normal aging," and how early intervention can prevent more serious injuries and loss of independence. The discussion also highlights practical ways to recognize mobility challenges, when to seek occupational or physical therapy, and why addressing these concerns early can help older adults remain safe, active, and living independently for longer.
Key Questions Answered
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Why should any fall be taken seriously?
Even a single fall—or an uncontrolled descent like sliding down a wall or "plopping" into a chair—can signal underlying changes in strength, balance, vision, or mobility. Identifying these issues early allows for interventions before a more serious injury occurs.
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How do occupational therapists define a fall?
A fall isn't limited to ending up on the floor. Any uncontrolled descent from one position to another, such as dropping heavily into a chair or bed, can indicate reduced physical control and a higher risk of future falls.
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What are signs that someone's mobility is declining?
Warning signs include avoiding trips outside the home, driving less because it feels unsafe, creating a growing "command center" around a favorite chair, or limiting movement to avoid getting up for everyday tasks like using the bathroom or preparing meals.
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How can early intervention help someone stay independent?
Occupational therapy, physical therapy, vision care, home modifications, and other targeted interventions can address the underlying causes of falls and mobility challenges before they lead to major injuries or permanent loss of independence.
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What should families do if they notice these warning signs?
Start a supportive conversation, discuss the changes you've observed, and seek guidance from healthcare professionals. If you're unsure where to begin, resources like AskSAMIE can help connect families with the most appropriate services and professionals for their loved one's needs.
Transcript
Emilia Bourland
Hi everyone, welcome to CareLab. We are back today with part two of our episode series on five signs that someone might need more help at home. So I think we're gonna jump right in here. Brandy, take it away.
Brandy Archie
Okay, here's one of the really key ones, which is you're noticing that they are having falls. Not just more falls, but having falls. Okay,
Emilia Bourland
Any false.
Brandy Archie
any falls, any falls. And I say any falls and you're like, that's doing the most. Everybody falls sometimes. I'm like, nah, not really. And also
Emilia Bourland
Ha.
Brandy Archie
one leads to the next one. I mean, I can't remember the last time I fell. Maybe when I was roller skating at the roller skating rink, but other than that, like not really. And we start to have falls.
that's an indicator that some other things might be changing. Now they often are flukes in our minds, right? Like, I just happened to miss that step, or I didn't see that curb. But usually because you would have seen that curve or that step, it's because something else in our body has changed that made it so that it wasn't as obvious to us. And so we did miss that thing. And those are things to start paying attention to. Now I'm not saying if your mom
had a fall last week, you have to immediately move her out of her house and into yours. Like that's not what I'm saying. But I am saying that it is really important to pay attention to and to ask a bunch of questions about and to see what things we can do to prevent an another fall in the same way from happening.
Emilia Bourland
Yeah, what I would like to add to that is maybe even ex this is going to be so annoying. So I apologize for it in advance, but we really need to think about expanding our definition of what a fall is, right? So a lot
Brandy Archie
yeah.
Emilia Bourland
of times we we think of a fall as someone, you know, going from standing to the ground or,
Brandy Archie
Mm-hmm.
Emilia Bourland
you know, falling out of the bed or whatever it is. there are things that people don't often think of as falls that they really should.
One that kind of I think skirts the line for folks is like a lower to the ground. So a good example of s something that often happens for people who might be living on their own or living with someone who who doesn't necessarily provide assistance is like maybe they kind of lose their balance, they kind of lean up against a wall and then sort of slowly slide down the wall to the to the floor. That absolutely still counts as a fall.
if that wall had not been there, this person would have just gone straight down. And and even more importantly than that, there was a there was an uncontrolled like descent in one way or another, which leads to the other kind of way that we need to expand our definitions of falls. A fall is an uncontrolled descent from from one surface to another or from one position to another.
So if someone is standing and they go to sit on the bed and they fall the last, you know, few inches onto that bed and they plop on down, technically we should be thinking about that as a fall. Again, I know that's super duper annoying that basically what I'm saying is every time someone plops, it's a fall, but that is actually what's happening because the person does not have full control over their body for at least part of that descent.
And what does that mean? If okay, if someone's plopping onto a bed or plopping into their chair, maybe that doesn't necessarily pose an inherent safety risk right then and there in that moment, although sometimes it can, depending on the environment and the furniture we're talking about. But what it does show to us is that this person is not in full control of their body at all times. And so their risk for having a fall that takes them to the ground is much, much higher.
So that's actually a really, really great place to, if you notice that, to intervene beforehand. And to your early, earlier point, Brandy, it doesn't mean you gotta take mom out of her house and move her into assisted living or move her in with you. Like that's not it at all. What it is, is that means you have an opportunity to get some intervention that will fix that problem.
Before it becomes a really large issue that does genuinely lead to a decrease in someone's independence or a decrease in someone's, you know, daily ability to care for themselves. So kind of thinking about falls in an expanded way can be very, very helpful to preventing these really nasty falls that of course everyone is afraid of.
Brandy Archie
Yeah, that's such a good point because so often, unfortunately, and you could tell me how you feel about it in your career, the people that I
Emilia Bourland
Mm.
Brandy Archie
have worked with for the most part where falls was an issue, they came way too late. Right? Like the reason
Emilia Bourland
Way too late.
Brandy Archie
the reason I'm seeing that is because they fell and broke their hip, right? But prior
Emilia Bourland
Mm.
Brandy Archie
to that, they were already demonstrating those signs of weakness with the flopping, which means your quads and your hamstrings are not quite as strong as they used to be and cannot control you at that certain angle right before you sit down. Which means
If you squat to pick something up on the floor and you happen to go into that same angle, you might not be able to bring yourself back up and therefore you're gonna end up on the floor. And then maybe that time
Emilia Bourland
Mm-hmm.
Brandy Archie
we're breaking something or we end up on the floor and can't get ourselves up and now we have rhabdomyolysis because we've been laying on the floor for however many hours before somebody could get some help. So like
Emilia Bourland
Mm.
Brandy Archie
it might seem unimportant, but it actually is really important to notice these signs and
this broader definition of falls earlier because when you do and you go get some intervention, it actually can work well for somebody, right? We can do physical
Emilia Bourland
So well.
Brandy Archie
therapy and get stronger so that we can control our bodies. We can improve our balance and we can take a look at the environment and see if like what are the environmental triggers that have causing these trips and falls. Maybe it's vision related. We can deal with that. But when you wait until we're dealing with a hip fracture or a broken arm or a broken wrist,
Then we have to deal with that acute issue. And a lot of times the reason that happened gets not dealt with because it's not the acute thing, right?
Emilia Bourland
Mm-hmm. Yep, absolutely. There are almost no things that are underlying causes of falls that we actually don't have pretty good solutions for. And
Brandy Archie
Yeah, that's a good point.
Emilia Bourland
and the earlier we can intervene with those things, not only are those things, you know, it it's easier for them to take effect. It takes a shorter amount of time for that intervention to work because you're not so far gone. but you know, it also
takes less effort and energy on the part of the person who actually has to to do that work. It takes fewer resources. It's and not to mention it doesn't your whole life doesn't have to be interrupted because of some kind of catastrophic event. so, you know, really, really paying attention to how people are getting up and down. and if you are seeing any falls at all, don't don't take it for granted that you think it's just a one-off. Really
getting early intervention is so, so, so important. Okay, I think that brings us though to number five. Kind of we're sliding right into this, and this is decreased mobility. This might kind of sound like we're talking about the same
Brandy Archie
Like the same thing.
Emilia Bourland
thing as falling, but we're really not necessarily. So, some signs that someone might be have might be less mobile than they are. And we can think about mobility in a couple different ways. So
It could be that someone's less mobile in their community, that they are not driving as much or they're not safe to drive. By the way, we have a really great episode on driving evaluation that you should absolutely, as soon as you're finished with this episode series, you should absolutely
Brandy Archie
Yes, with Crystalina.
Emilia Bourland
go and check out. We have a driver rehab evaluation expert who is absolutely fantastic and gives really, really good resources on that. but so it could be.
That someone is less mobile within their community and so is not able to meet their needs in that way, right? That's one way we can think about decreased mobility. Another way we can think about decreased mobility is the signs that someone is less mobile around their home. Certainly falls, things like flopping and plopping are part of that. But it could also be that you're noticing that maybe mom or dad or grandma or grandpa have created a little nest around their favorite chair.
Brandy Archie
I call it the Command
Center.
Emilia Bourland
yes. okay. All right. I like that. That's better. I just call it a nest. But I like command center. Yeah. So that they don't have to get up as much. Maybe they're
Brandy Archie
Yeah. They're putting everything by the
Emilia Bourland
everything by them. Maybe they're drinking less water because they don't want to have to get up and go to the bathroom. this is another sign that someone is having a mobility issue as well. What else? Is there anything else that you would add to that, Brandy?
Brandy Archie
I would just say that like almost everybody has a command center at some point in their life.
Emilia Bourland
Mm-hmm.
Brandy Archie
The c the trigger is, is that command center growing? Are more things showing up there, right? And so not only is it some water and a remote control in a blanket, but it's also like my pills are there, there's a commode there, there's a urinal beside there, there's dishes from last night and today. There's, you know,
We're not even getting up and going to bed because getting up is hard or sleeping and laying flat is hard. So like the thing if you don't live with or whether you live with them or not, but the thing you might notice is that that command center grows. That nest gets bigger and you have more stuff around you. And that's telling you that their level of mobility is declining. And the reason that that is so important to deal with is almost exactly the same reason we talked about before about falls.
Which is that's a sign that other things are to come and if we can intervene at this point, then we can make a we can make a much bigger difference. And so I think getting out of the house for reasons that you want to, not just reasons that you have to, and that command center are like the two biggest ones. And if you notice those changes, then it's worthwhile to like have a conversation about about that. Hey, I noticed
Emilia Bourland
Mm-hmm.
Brandy Archie
you stopped going to the bowling alley.
on Fridays. What hap what happened with that? it's just too hard to get out or I don't like driving at night or you know, like it'll bring up topics that do actually have solutions for them. And we want
Emilia Bourland
Mm-hmm. Yeah.
Brandy Archie
our mobility to be high because the more mob more mobile we are doing the stuff we want to do and like to do, the stronger our bodies are, which allows us to do things we have to do.
Emilia Bourland
Yeah. I think before as we kind of close out here, if there's one final thought that I want to leave people with, it's that, you know, the the title of this series is is five, you know, signs that someone might need more help at home. And of course, that is absolutely true. But these are also signs that someone might need help in order to make these issues better. We should never assume.
That there is not a solution to a problem, or that there's no way to make these things better. Because actually the fact is that for every single one of these five issues that we've talked about, there are actually good solutions in place that that you can go to, you can go ask your doctor for an evaluation with OT, with PT, sometimes with speech therapy, right? Just ask, ask for those resources. And there are professionals out there who
Can come in and give you the specific solutions that are right for your loved one and help with those interventions. Because it's, you know, sometimes we take it as a foregone conclusion that as we age, we just we we're gonna decline and there's nothing we can do about it. Are is there decline as we age? Yes. Are there increased challenges we age? Yes. Does that mean that we have to take it lying down and just say, well, well, this is the way it is? Absolutely.
not we have really really good solutions for most of these things so be a squeaky wheel go out there you know advocate for yourself or advocate for your loved one and get the things that you need because I guarantee you there are providers in your community that would love to help you.
Brandy Archie
Hundred percent. And the other thing I would add to that is if that still feels overwhelming, meaning like what
Emilia Bourland
Mm-hmm.
Brandy Archie
doctor I go to, what thing am I asking for? Like I know exactly what my people need because I'm in medical field. So I'm like, I see
Emilia Bourland
Totally.
Brandy Archie
this problem, it goes to this expert. If you don't know that, that is okay and very normal, but that's actually what Sammy is built for. So if you go to Sam
Emilia Bourland
Mm-hmm.
Brandy Archie
ask Sammy dot com, there's a chat that happens on the left side of the screen.
And you can just like say what the problems are, and it'll be like, here's the resources that you should consider and email you that list so you can follow through with it. So, like, the point is to try to get you connected with the right resources for all these problems. We only gave you a couple of solutions for a couple of the problems we talked about, but there are so many and they are unique to each person's needs, and we know that's overwhelming. That's why there's whole professions that deal with it. So this makes it possible for you to.
Tap into that any time you want and then take some further steps and actions in order to prevent things we have in the future and also improve our quality of life as as things change, which is normal and fine. Let's just do it.
Emilia Bourland
Yep, let's just do it. All right. On that note, thanks for listening. If you got to the end of this episode, please make sure that you like, subscribe, share, follow, leave us a comment and a review. This is the best way for us to make sure that we're continuing to reach more people with this educational content. that we're trying to put out there genuinely just to just to make
People's lives a little bit easier and better. So thanks so much for listening. We'll see you right back here next time on Care Lab. Bye.
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