What Goes Uncounted
Neither of us made it to this one, so rather than a record of the conversation, this is what we prepared while we were away: the person in most caregiving households who never gets asked how they are doing, and what the evidence actually says about preventing falls.
Opening Reflections
A note on what this is, so nobody is confused reading it.
Neither of us was able to be at this meeting. One of our members stepped in and facilitated, and we are grateful. We also do not know what was said, so what follows is not a record of the conversation. Whatever came up in that hour stayed in that hour, which is as it should be.
We did not want two weeks to pass without putting something in your hands, so we spent the time reading instead. Two threads came out of it.
The first is about a person who is in most caregiving households and almost never gets asked how they are doing. We have been calling them the silent partner. The second is practical, and timed to Falls Prevention Awareness Week, which runs September 21 through 25. It includes the dogs, because it turns out the CDC has actually studied the animal-underfoot problem and the numbers are not small.
Topics Discussed
The Silent Partner
In most caregiving households, two lives have been rearranged and only one of them gets counted. Nobody has studied that second person directly, but the adjacent research points at a cost that is real even when they do none of the care.
4 min readWhy No One Counts Them
The exclusion of the silent partner is not attitudinal. It is written into survey instruments, federal regulation, and benefit eligibility, in language you can look up. Here is where it is written, and where a person in that position can actually go.
6 min readFalls, and the Dog Underfoot
Falls Prevention Awareness Week runs September 21 through 25. The CDC has actually studied the dog-underfoot problem, and the numbers are worse than you would guess, particularly for women and particularly with age.
3 min readWhat Actually Prevents Falls
The evidence here is unusually strong, and a fair amount of common fall-prevention advice runs against it. Balance training works. A one-off home walkthrough does not. Vitamin D is not what most of us were told.
4 min readWhen Safety Meets a Person
Fall prevention advice assumes cooperation, and many people will not cooperate. What to do when the cane is refused, why fear of falling is its own risk, when to call for a lift assist, and why the caregiver has a fall risk of their own.
4 min readIn Closing
Both halves of this came down to the same thing, which is that the accounting is usually incomplete.
The person nobody asks about is still paying. The fall that never got mentioned to the doctor still happened. The exhausted caregiver catching someone mid-fall is at risk too, and nobody is counting them either. The dog is a hazard and a reason to get out of the chair.
None of that is new to anyone here. What was new to us, in the reading, is how much of it is measurable and written down, in regulations and survey instruments and clinical trials, by people who were counting something adjacent and never quite counted this.
We will be back at the next meeting, and we look forward to hearing what we missed. Thank you again to the member who held the space.
With care, Meg & Candice