Outside a bric-a-brac shop something caught my eye amongst the stuff spilling onto the footpath. ‘Funky vintage ladder $165.’ On closer look, it was pretty retro and a bit bent in the frame, narrow-based with smooth steps. I wondered whether it was on sale for climbing or decor.

Everybody has stories of older people toppling from ladders. Injuries sustained from even a minor fall can be surprisingly severe. A well-loved TV personality Molly Meldrum made upsetting headlines when he suffered a head injury from a ladder fall while decorating the family Christmas tree. 

Toddlers tumble over all the time. It can look disastrous, but nearly always, they bounce, maybe cry, then up again. Their young bodies seem to be geared for trial and error, in training for life as bipedal beings. 

I have a very fit-for-age friend K, who regularly attends a seniors’ circuit training class at Sydney University gym. Sparrow, a former Wallaby player aged over eighty, is the trainer. He has excellent results in improving health and fitness in his dedicated group of retired academics, who share a common history of sedentary work. Sparrow’s faithful wear workout t-shirts with these points of guidance printed large:

  Do your squats

  Get set to lift

  Seniors don›t climb ladders

I asked Sparrow about the last point, but he was adamant and reckons the body becomes much more brittle with ageing. Indeed those ladder accidents are a significant cause for hospital admission. The statistics are alarming and support his caution. In 2002, 3,374 Australian men over 60 were hospitalised for ladder falls. In 2012, the number was 4,945. 80% of these occurred at home. With the bulge in the boomer population, the figures are likely to get worse.(

It just takes one wrong step- from independence to disabled. Mostly these accidents are avoidable. In his book ‘Being Mortal’, Dr Atul Gawande explores the balance between safety and independence for seniors who live in residential care. In any duty of care scenario, safety always trumps. For seniors who live in their own houses, the pressures are different. Gutters get full of leaves, a high-up light bulb needs changing. What to do? A tradesman’s visit takes a good slice out of the pension.

K’s concerned family had removed her home ladder. I asked her how she managed the light bulb issue. ‘Oh, I just stand on a chair.’ Her casual attitude is scary but understandable. Chairs are everywhere, and it’s so convenient and quick to climb onto one for that just-out-of-reach little job. Let’s remember that the design of a chair is for sitting, not for standing on. A careless decision for quick convenience can have life-changing consequences in the blink of an eye.

In the quest for awareness, could there be a safer approach for those determined to maintain independence? A search came up with one- ‘a foldable non-slip, four-step, lightweight, approved, one-metre high stepladder with dual handrails’ for $70. That feels like an upgrade on the funky vintage ladder.

One other point. If the foot slips, a solid handhold can save the day. A Christmas tree looks lovely but offers no support in the fall, nothing for our prehensile monkey hands to grab and hold. The sailor’s traditional wisdom says, ‘One hand for yourself, and one for the ship’. 

Climbing is not against the law, so it’s up to individuals and families to future-proof our elders against injury from slipping, tripping or toppling, and the danger is not just with ladders. A person’s cognition, strength, balance and flexibility could be more vital than chronological age for capability. For instance, can they typically balance on one leg? A history of fits, faints or funny turns is more likely a contraindication to all forms of climbing. It can be complex, so sage professional advice is vital in such decisions. Prevention of injury from falls is a big key to healthy longevity.

The anatomy of any fall has three components- the initiating incident, the descent, and the impact. 

The initiating incident may come from wonky equipment or slippery shoes. Maybe it’s a health issue- an unstable knee gives way, or a giddy spell craning the neck to inspect the ceiling. 

Parachutists joke that descent is no problem. It’s the impact that matters. More commonly, the descent is sudden and without warning. It’s surprising when drunk people fall over, their relaxed floppiness can often protect them from injury. A constructive spin on this oddity is to consider the protective benefits of practice in martial arts and other forms of yoga. Anyone with this background has training that includes rolling, rounding the body and relaxing. For example, the old Chinese art of Qi-Gong is a safe, effective method of maintaining body health, and it’s never too late to start. Regular practice makes the body more resilient and less prone to impact injury. 

The Arthritis Association recommends Tai Chi for elder health. 

Whatever the answer, no one could argue with Sparrow about the need to keep fit. He often says, ‘You can never do too many squats.’ In other words, caring for the body through regular practice is the best investment in the self, climber or not.

Closer to home, an older retired country doctor told me he still climbs. He has become more careful and no longer climbs onto the roof. He won’t climb at all if he is home alone. He considers it essential to have someone who can hold the ladder and pass things up. If worse comes to worst, they can call 000.

On one occasion, he described slipping on the back stairs of his house, making such a clatter that his daughter came out to check, alarmed by the commotion. He had already checked out his arms and legs, and his neck moved ok. ‘Just bring me a mirror,’ he called to the confused girl. ‘Why a mirror, Dad?’ she asked, quite used to his eccentricity. ‘Your mother will insist that I see a doctor,’ he explained, ‘and I want to be able to tell her that I have.’ 

David Miller

Brunswick Heads

David Miller has been a long-time GP in the Northern Rivers. Since retirement, his interest has shifted from disease to health in ageing.

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