Chronic Disequilibrium of Aging

If you are reading this, you have had a balance exam and it has been determined that you may have unsteadiness or disequilibrium, which could be caused by numerous weaknesses in the balance system. In order to maximize your ability to function independently, we will need to work together to optimize your treatment in many different areas. These areas of concern are described below:

1. Get a new eye exam. Many patients have dizziness, which is aggravated by a change in their eyeglass prescription, which is long overdue. Please schedule an eye examination and update your eyeglass prescription. Have copies of this report sent to my office.
2. Complete a Fall Prevention Checklist. This list is of paramount importance as 85% of falls happen in the patient’s own bedroom and bathroom. Most of these falls are easily preventable if only you will work with the checklist and avoid common hazards, which account for most falls. To see a fall prevention checklist, click here or go to: The Fall Prevention Checklist (pdf only).
3. It is completely understandable that you may be hesitant to use a cane or a walker, but the use of a cane or walker in and out of the house can make up for your decreased ability to “catch yourself” when you are near the limit of your balance. A cane or walker is your best friend.
4. Review your medications. Please make an appointment with your Primary Care Physician to review your medications and eliminate any medications which may not be essential. We find that many older patients with balance problems have accumulated 8-15 medications, most of which are no longer necessary and which may be contributing to decreased alertness, increased incoordination, or both.
5. Footwear: Wear firm-soled shoes that have a good grip and some ankle support. Shoes with sponge soles, like running shoes, can decrease your ability to feel the floor and are not particularly good for balance.
6. Physical Therapy: In many cases, physical therapy specially designed to retrain balance connections in your brain can be very effective. Physical therapy for balance problems should be done by a physical therapist who has a special interest in balance problems, because physical therapy programs vary dramatically for different kinds of dizziness.
7. Physical Fitness: It is difficult to have good steadiness and balance if we are extremely weak. Building muscle tone takes work. Special exercise programs designed for persons of all ages and physical abilities are available. Most centers that offer “cardiac rehabilitation” are also prepared to help patients like you who do not consider themselves physically able, but who need and will benefit from exercise.
8. Balance Testing: At times, balance testing can help provide additional information about potential treatment options in your case. Your physician should be able to prescribe the appropriate testing for your problem.