How Fear Affects Wellness as We Age
How Fear Gets in the Way of Active Aging
A 2007 study about Aging in Place asked seniors, “What do you fear the most?” At the top of the list was “Loss of independence”. The study also found that seniors fear moving into a nursing home more than they fear death. 89% want to age in place and grow old without having to move out of their homes, but 53% feared that they would not be able to do so.
The unfortunate, ironic thing about fear is that it can prevent us from doing the very thing we need to do to "escape" the thing we are afraid of. For many seniors, the fear of losing their independence gets in the way of participating in activities that can actually support their independence such as exercise classes, strength training, and social gatherings. Here are a few reasons why and how active aging and wellness professionals can help.
The fear of falling.
Falls are the number one cause of hospital admission due to trauma, nonfatal injuries, and injury related deaths for adults ages 65 and older. So, there are good reasons to be concerned about falling. However, a fear of falling that keeps seniors less active does more harm than good.
Effective fall prevention usually requires seniors to become more active, not less. One of the most effective ways to combat a lack of muscle strength, balance, and limited mobility is through Progressive Resistance Training, or PRT. In clinical trial after trial, PRT has been proven to have a significantly positive effect on muscle strength. And muscle strength has a significant effect on fall prevention. One recent study focused on The Sunbeam Program found that PRT in combination with balance training reduced falls by 55%!
For seniors with limited mobility, the fear of falling is often centered around transitions between sitting, lying down, and standing. This is dangerous because it can cause seniors to remain sedentary when what they most need to do is practices sit-to-stand exercises over and over again.
The fear of falling can also have a significant effect on socialization. It’s one of the biggest reasons older adults start to self-isolate and limit their experiences. They stop shopping because they are afraid of other people running into them and causing them to fall. They avoid community events because of stairs or uneven walking surfaces. For seniors in assisted living, the fear can even extend to not wanting to walk to the dining room or group activities.
For caregivers, one of the best things to do is help seniors face these fears head on. When someone starts to pull away from activities they once enjoyed, address it directly and ask them what’s really going on. Initiate discussions about activities they used to enjoy but don’t feel they can do any longer.
For example, “I used to take a hike every weekend, but don’t anymore because the downward slopes scare me.” Ask in response, “What can we do to deal with that fear?”
Work with them to come up with a strategy that addresses the core problem. In the case of the hiker, perhaps someone can hike with them and offer support through areas that are challenging. Or, they can work with a trainer to build strength in muscle groups that can help them feel more stable.
The bottom line is to help distinguish between a genuine fear and an emotional fear that has a solution.
Fear of injury and pain.
While it may or may not be related to falling, many older adults allow fear of injury and pain to keep them from exercising or engaging in activities that might enrich their emotional, social, intellectual, and physical health.
For many of us, a large part of “normal” physical activity comes from work and hobbies that are part of our day to day life. Examples include occupations that are physically demanding, playing with our children or grandchildren, working in the garden, or completing household chores. As many adults age, they retire and begin to pull back from active tasks, fearing that they are in danger of injuring themselves if they continue. This is compounded when an individual is suffering from chronic pain such as arthritis.
How can active-aging professionals help seniors overcome these fears? First, it’s important to assess the individual’s overall fitness, including strength, endurance, and flexibility. Then, take the time to understand what activities the person is most interested in and use that as a leverage point for motivation. For example, for a senior who has stopped taking their grandchildren to the park, devise a plan for building strength and endurance specifically so they can resume long afternoons with their grandchildren in the park. Help seniors know how to listen to their bodies and understand the difference between soreness that is the result of healthy physical improvement and soreness that might be a precursor to injury.
As is often the case, education is vital to overcoming fear. For example, people suffering from arthritis might begin to limit their level of activity even though research shows that inactivity can actually worsen osteoarthritis pain over time, putting older adults at a much higher risk for losing mobility and independence. As caregivers, it’s important to help seniors understand that if they strengthen their muscles, the muscles will support joints, alleviating stiffness and pain.
Fear of specific activities.
Even the most active adults are prone to avoid beneficial activities out of fear. For example, someone who’s never lived near water or learned how to swim might avoid learning to swim laps even if their doctor recommends it. In cases like this, it’s important for active adult professionals to start cautiously and build slowly, increasing confidence with small steps forward. Steady progress is more likely when individuals can slowly gain confidence in their own abilities on a timeline that feels safe.
Besides swimming, activities such as yoga and tai chi can generate fear partly due to magazine and television ads depicting much younger fitness models in impossible poses or moving with unearthly grace. No one likes to feel silly, stupid, or clumsy, and the fear of appearing foolish in front of other people can stop many older adults from participating in classes or learning to use exercise equipment. One to one training sessions with qualified, compassionate trainers is often the best way to show someone the ropes of a new exercise program or activity, allowing them to build confidence with one person before moving on to group activities.
Shifting the conversation from illness and disease to optimizing health.
Just as the news is preoccupied with everything going wrong in the world, much of health and wellness is focused on preventing illness and disease rather than optimizing health. The problem with this is that fixations on preventing something bad can generate fear. Because the focus is on keeping disease at bay, it can have the effect of making us feel that doom and gloom are right around the corner.
In practical terms, seniors might be better served by conversations focused on optimizing their health and trying new things because of the possibility of well-being rather than as a defense for illness and disease. As active aging professionals, when someone says, “At my age, I’m not going to be able to continue doing this…”, we can encourage them by confronting that belief system head on and saying, “I don’t believe that. Here’s why.” Then, creating a fitness program that supports their ability to continue on doing the things they love.