For most of us, freedom and mobility are inextricably linked, and baby boomers have always shown that they will accept nothing short of freedom. At the same time, mobility is something most people take for granted. You don’t realize its importance until your own mobility is threatened by a sprain, a surgery, an accident.
“You have to reinvent yourself,” says Athens boomer Ron Baker. “You have to find ways to maintain mobility as you age.”
Baker lost his ability to walk after he fell while overseeing a construction site after dark. He has since adapted to a power chair and a customized vehicle that allows him to continue collecting art and attending concerts – two of his many passions. Now Baker also helps other people continue to live their lives despite physical disabilities as a sales associate at Custom Mobility.
Falling is so easy
Falls are the leading cause of fatal and nonfatal injuries among older adults, according to the CDC, with 25 percent of people over 65 reporting falls in any given year. When asked how boomers can maintain mobility, Allison Donatelli, a physical therapist with Piedmont Athens Regional, immediately stresses the importance of fall prevention. “The stats are staggering regarding hip fractures,” she says. “Typically, they result from a fall.”
And falls are largely preventable. Donatelli advises people to begin prevention efforts by reviewing and managing their medications. Keep one list of all medications and use one pharmacy to help prevent drug interactions that could impair balance. She also emphasizes simple steps like assessing your home for tripping hazards, getting routine vision checks, never wearing bifocals on stairs, staying active and wearing good shoes.
Shoes play a key role in maintaining mobility. Nowadays comfort and athletic shoes are stylish so don’t be afraid to shop for shoes that are easy on your feet. Brad Frink, manager of Athens Running Company, says that an overwhelming majority of his shop’s new clients are wearing shoes that are simply the wrong size. Most people’s feet get slightly larger as they age so don’t be shy about getting your foot measured. Also, find a shoe store that can assess your gait.
Just as a shoe salesman can help you find the right footwear, a car salesman can help you find the right vehicle to help keep you safe on the road. New features in automobiles are accommodating various physical impairments. The AAA has created a useful website to help older drivers find cars that may best suit their particular needs. At SeniorDriving.AAA.com/SmartFeatures, drivers can choose among typical limitations such as arthritic hands, diminished vision or limited upper body range of motion.
While the best way to assess your driving skills is through a consultation with an occupational therapist, the University of Florida’s Institute for Mobility, Activity and Participation has created a free screening tool to assess your fitness to drive. It is available at Fitnesstodrive.phhp.ufl.edu.
Pride goeth before a fall
Even those of us who avoid major injuries often encounter mobility impairments as we age. One of the most common is osteoarthritis of the joints, which affects 27 million Americans. This wear and tear can occur in any joint, but the knees and hips are most common because of the weight they bear. Osteoarthritis develops over time, and there is no known cure. The best way to prevent it is to avoid excess weight gain and to stay active while avoiding injuries.
In cases of severe osteoarthritis, doctors may recommend joint replacement. In the last 40 years, the number of these surgeries has skyrocketed. More than 7 million Americans are now living with an artificial knee or hip, according to the American Academy of Orthopedic Surgeons. While physical therapy helps with full recovery, Donatelli notes that it can take up to a year, and every rehabilitation is different, perhaps requiring the use of assistive devices.
Whether recovering from surgery or an injury, struggling with arthritis or some type of balance issue, don’t let your pride keep you from using a cane or walker if your doctor recommends it. Harvard Health reports 30-50 percent of people stop using assistive devices before they should, but these simple tools can improve stability, prevent falls and take the load off areas of pain. A physical therapist can help you choose a cane or walker and ensure you are using it properly.
Jane Houston, 69, suffered a stroke five years ago, completed rehab, but stopped using her cane prematurely. After falling a few times, she realized her balance had diminished and decided to use a cane full-time. “I feel much more secure now,” she says. “It’s about more than looks.”
Canes are good for helping with balance but not for bearing a lot of weight. Walkers are the second line of support. Anna Roman, a sales associate at Care Medical on Prince Avenue, says Medicare covers the cost of a cane or basic walker, but there are extra expenses for a brake system or chair attachment. Regardless of which assistive device you might need, you should consult a doctor for a written prescription.
“Baby boomers have worn their bodies out,” says Baker. “They are pushing industries to create better mobility equipment.”
At his desk, Baker shows me a picture of a zero-turn-radius scooter that easily maneuvers around furniture. “Relationships are difficult enough without you damaging the family heirlooms. This equipment makes these transitions easier,” he says.
In addition to selling mobility products, Custom Mobility can help customers convert their vehicles to carry those products. However, Baker says people need to realize that insurance and Medicare don’t pay for vehicles, and not all vehicles can be converted.
Retired educator, John H. Davis, 73, got his minivan outfitted with a wheelchair lift, a transfer seat and hand controls. He doubled the cost of his car, but he says it was worth it. He’s able to get out of the house regularly to exercise at the YMCA, to attend classes at UGA’s Exercise Muscle Physiology Laboratory, and to participate at church and in the community.
After Davis was diagnosed with spine cancer 26 years ago, he slowly lost his ability to walk. At first, he walked with a cane, then two canes, then a walker and finally a power chair, which he’s been using for 15 years. He says his positive attitude, his wife’s help, and his faith have helped him adapt.
“We’re all put on this earth to glorify God. If all I have to do is sit in this wheelchair and smile, that’s easy!” Davis exclaims.
His humility belies his bravery and strength. While Davis says that Athens parking infrastructure is very accommodating to people with disabilities, he observes that other drivers often fail to park within marked spaces. That makes it difficult for him and others with mobility equipment to load and unload.
Baker agrees. “The number one problem is parking. The space between spaces is too narrow to deploy the ramp for a wheelchair.”
Baker tells a story about circling a lot at a local restaurant, unable to find a spot large enough for his equipment. And Davis recalls standing outside in the rain after church, waiting for someone to move a car so that Davis could get back into his van to go home.
“We look at this as being a minor thing: that a spot is too small to deploy a handicap ramp. That is a symptom of how our society is trying to hide itself from a practical need that we have as we age or become injured,” says Baker.
Despite enduring struggles that most of us cannot imagine, Davis says that he is constantly reassured by the goodness of strangers. “People are willing and determined to try to help you when you need help. I appreciate that so much,” he says.
Davis’s creed? “Be brave. Be stubborn. But don’t be so brave and stubborn that you hurt yourself. Know there’s always help if you need it.”
The fact is that most people outlive their ability to drive. Therefore, maintaining mobility also requires you to assess the environment in which you move. Paradoxically, many communities that cater to retirees are far from urban areas with public transportation. While such places might offer peace and quiet, they can become isolating if you can’t drive.
Public transportation predates the automobile in Athens, where mules once pulled street cars in the late 1800s. But public transit as we know it, “The Bus,” didn’t begin operating until 1976.
Athens Transit now runs 23 buses on 18 routes covering the 44-square-mile county. The University of Georgia also runs 32 buses in and around campus. “Together these two systems boast daily passenger boarding second only to MARTA in metropolitan Atlanta,” according to the ACC website.
Passengers over 60 pay $1 during peak hours and 85 cents during non-peak hours to ride The Bus. Frequent riders may purchase a pass for $18, which covers 22 rides. If you live along a UGA route, you can hop on board their buses for free.
According to Athens Transit Director Butch McDuffie, senior citizen and disabled riders purchased 7 percent more single trip passes and 49 percent more 22-ride passes this year than they did last year.
While ridership is up, not everyone lives along a bus line. For people with mobility impairments, Athens Transit also provides curb-to-curb transportation known as “The Lift.” But you must live within one mile of the fixed bus route and apply to ride. Now that all buses have handicapped access, The Lift is used less than before, according to the transit website.
Beyond public transportation, the Athens Community Council on Aging also provides a dial-a-ride transportation service to people 60 years and older. The service is free for riders meeting their low-income criteria and $10 for everyone else.
While some people move to retirement communities once they quit driving because transportation is part of the package, not everyone wants that option. According to the National Aging in Place Council, more than 90 percent of older adults would prefer to live independently in their own homes rather than move to senior housing.
Seeking a walkable community
When Bree and Richard Hayes, both psychologists, neared retirement, they began thinking about leaving their waterfront home in Mobile, Ala. They had raised four children in suburbs where they could “do nothing without a car.” Living 12 miles from the city, the empty-nesters too often found themselves foregoing sociability for remaining comfortably at home.
The couple decided to find a walkable community that would force them to get into the game. “We want to force ourselves to move, to walk to the grocery store, post office, recreation, restaurants, etc. We also want to conserve gasoline and reduce our carbon print,” says Bree.
So last June the Hayes moved to the Five Points neighborhood in Athens, where it takes them 15 minutes to walk from their house to a grocery store in the nearby commercial district. And Bree says the walk is a lot more fun that going to the gym. “I’m very sensory aware when I’m walking. You smell gardenias and honeysuckle. You see the beautiful new green of spring. You hear the birds hatching their babies. If you were in your car, you’d miss it all,” she explains.
Katie Throne, a realtor with Full Circle Real Estate, says that she’s seen a resurgence in older, in-town neighborhoods because walkability is so attractive. “Retirees want to be able to walk to restaurants and shopping,” she says.
Walkability generally means that streets have dedicated sidewalks and marked pedestrian crossings and that destinations are within walking distance. Is Athens walkable? Well, that depends on whom you ask and where they live. “Ideal Living” magazine included Athens in a list of “20 top walkable cities,” but “Walk Score,” a website devoted to making it easy for people to evaluate walkability, gives Athens Clarke County an overall score of 26 out of 100, a “car-dependent” ranking.
“The walk is a lot more fun than going to the gym.”
Some government officials and citizen activists want to change that. Tony Eubanks, steering committee member of Complete Streets Athens, says that streets need to be safe and convenient for everyone, regardless of their age or ability. Complete Streets Athens is a community advocacy organization “working to ensure safe, equitable, and accessible transportation choices.”
The first step in doing so is an honest assessment of our streets. The Athens-Clarke County government earlier this year hired a national engineering firm that specializes in bicycle and pedestrian transportation to perform a comprehensive assessment of the whole county. Once the assessment is complete, the firm and ACC staff will create a Bike/Pedestrian Master Plan.
Staying active and engaged in the community means residents must have a way of getting to public spaces and social activities, and communities are more vibrant when the citizenry has easy access to healthy food, shopping, healthcare, entertainment and outdoor recreation.
On Nov. 7, Athens voters will have a chance to vote on whether to improve sidewalks, trails, bike paths, and public transit. The extension of the one percent sales tax referendum will be on the ballot, with almost half of the total $109.5 million project list allocated for “car-less” transportation.
Mobility and community are interdependent. And understanding your community is key to getting around it.
“When you’re healthy and you’re getting to know your community, that’s the time to memorize it because if you do get infirm, you’ll know the path. I mean that metaphorically and literally. It’s a blessing to be able to do that,” Bree concludes.
On a bright morning in May, a little white Corvette with the license tag “OLDLDYZ” sped down Prince Avenue. It raced right past a bus stop, blew by Athens Piedmont Hospital, and barely beat a red light. I imagined older versions of Thelma and Louise were in the front seat, hatching defiant plans as they drove toward the dawning of a new day.
The moment was rife with symbolism as I was working on an article about mobility. Cinema-worthy defiance aside, most people reach a point in their lives when they can no longer take their mobility for granted. According to a Harvard Health Publication, “Mobility and Independence,” mobility limitations affect one-third to one-half of adults ages 65 and older. Since living well depends on your ability to move, safeguarding your mobility is a key healthcare goal.
“Most people, no matter what their health problems are, will tell you they’re doing O.K. as long as they are getting around,” says Bette McNeely, a retired geriatric nurse practitioner.
“People usually define their health by their mobility.”
“Getting around” sounds much simpler than it actually is. That process that most people take for granted requires muscle power, balance, working joints, vision, hearing, cognitive strength and a safe environment. Maintaining mobility means taking care of all of these things.
Health + Mobility
Any healthcare provider will tell you that exercise and a healthy diet are most important in maintaining your mobility and independence, no matter your age or health status. The
U.S. Department of Health and Human Services recommends 150 minutes of exercise a week. Load bearing exercise has the potential to worsen joint pain and injuries, but swimming, water aerobics, tai chi, yoga, stationary biking or using an elliptical trainer are all good alternatives.
While exercise is key to maintaining mobility, even the healthiest baby boomers need to slow down. McNeely, now 78, says she’s always been an athlete. But a smashed elbow and tendon tears in both feet taught her to “lower the bar.” For her, that meant playing
tennis with people in her own age group and shortening the number of hours she worked in her garden.
“You can be content with your aging and your function if you realistically lower the bar,” she says.
Even eye doctors will tell you to keep exercising. Gus Sams, an ophthalmologist with Athens Eye Doctors and Surgeons, says that preventative checkups, routine eye exams, a healthy diet rich in antioxidants, and regular exercise are the greatest measures you can take to maintain your vision, a key component in mobility.
Sams says that cataracts, macular degeneration, diabetic retinopathy, and glaucoma are the most common causes of vision loss in the aging population. These vision impairments can
dramatically limit your daily activities, but there are treatment options available. Cataracts can be corrected with surgery; glaucoma with surgery, drops or lasers. There’s no treatment for “dry” macular degeneration, but antioxidant vitamins can slow its progression. For “wet” macular degeneration, intraocular injections can reverse or slow the progression. Diabetes should be treated systemically, and the subsequent vision problems can be corrected with lasers or injections.
While vision is the most obvious sense we need for getting around, hearing is also an integral part of the neural processes that support perception and cognition. About one-third of people in their 60s and more than 80 percent of those over 85 have some level of hearing loss, according to Harvard Health.
Lawrence Crockett, an audiologist and clinic director of ENT of Athens, says the primary factors that lead to hearing loss are age, genetics and exposure to loud noise. Today’s world is noisier than it used to be, and Crockett says that if you’re using a machine, and you have to turn that machine off to talk to a person, you need to be wearing ear protection.
Damage to the inner ear can affect balance, but Crockett says that hearing loss, itself, is the problem that really affects mobility. “People start avoiding situations simply because they can’t hear,” he says.
Most people, no matter what their health problems are, will tell you they’re doing O.K. as long as they are getting around”
Bette McNeely, a retired geriatric nurse practitioner.
If you detect hearing loss, get an exam. Crockett says he’s been fitting hearing aids for almost 40 years, and “nowadays they are much better at helping people utilize the hearing they have left.”
Home + Mobility
Age-related health issues put people at increasingly greater risk of falling, and falling can pose a serious threat to future mobility. In fact, falls are the leading cause of death from injury in people over age 65. Each year, one in three people in this age group falls, according to Harvard Health.
“Once you fall, things go downhill,” says Pamela Turner, Associate Professor and Extension Housing Specialist with the College of Family and Consumer Sciences.
Safeguarding yourself from falling begins at home. Turner says that baby boomers should clear out clutter to keep from tripping. “That’s not always easy for this generation. They tend to have a lot of stuff,” she says.
Falls are the leading cause
of death from
injury in people over age 65.
Secondly, Turner recommends making sure you have enough light to see. Her mother added an energy efficient nightlight in the bathroom and now carries it with her when she travels. Turner also recently installed motion-activated solar lights along the walkways and stairs outside her mother’s home.
Finally, Turner says, “Don’t ever climb to change a light bulb or retrieve something from a high shelf when you are by yourself. Anybody could fall, but your balance isn’t as good as it used to be.”
Turner’s department has published an extensive home safety checklist. You can find it online at www.fcs.uga.edu/docs/Home_Safety_CheckList.pdf.
Driving + Mobility
For most people, mobility means more than moving safely around the house. For those like the women in the little white Corvette, mobility means driving … sometimes even fast.
Remember the sense of dignity and independence you felt when you first got your driver’s license? After a lifetime of driving, the action seems almost automatic, but it’s far from that.
Driving requires coordination of the senses, brain, and body.
When Tom McNeely’s diabetes began to affect his fine motor skills and reaction time, Bette gently confronted him with her concerns about his driving. She knew, based on years
of experience as a geriatric nurse practitioner, that her husband would need time to accept the fact he could no longer drive. “It’s not an easy process, and it can’t be dumped on somebody. You really have to prep them for the idea,” says McNeely.
She knew that Athens Regional Hospital (now Piedmont) offered a driving assessment, so she negotiated a deal with her husband. He agreed to a trial run of allowing her to drive him wherever he needed to go until he completed his driving assessment.
Once it was time for the assessment, McNeely and her husband met with occupational therapist Tracy Young, whom McNeely describes as “the most professional, empathetic health care professional I’ve ever worked with.”
Young explained every test before she administered it and let her patient know whether he had passed or failed and why. “Driving is very complex,” Young explains. “There are
many memory, thinking and multi-tasking skills involved. The clinical evaluation pulls apart all of those abilities and tests them.”
The clinical driving assessment at Athens Piedmont Hospital takes one and a half hours. If a patient passes all of Young’s clinical tests, she arranges an on-the-road driving evaluation. Depending on a patient’s performance, Young might recommend therapy to improve driving skills or modifi cations such as driving to local areas or only driving during daytime hours.
Based on McNeely’s husband’s performance in the clinic, Young advised him to stop driving altogether but gave him the option of taking the on-the-road test. “My husband surprised her by saying no,” says McNeely. “Tracy said, ‘Can I hug you?’ because not everybody has that reaction.”
Most people consider driving a physical act, but Young says that’s the least of it. “You don’t need a lot of strength to move a power steering wheel,” she says. “The cognitive part
of driving is what takes people out of driving way before the physical, generally.”
Therefore, Young advises baby boomers to add mental challenges to their aerobic exercise regimen. “Part of aging is decreased attention and multi-tasking skills. Go to classes, pick up a hobby, learn a language. Research shows those things keep us sharp,” she explains.
Most importantly, plan ahead. Statistics show that most people have to retire from driving the last 5 to 7 years of their lives. “I have to tell a lot of people that based on their testing, they have to retire from driving,” says Young. “And then we address, how are you going to get around in the community?”