Senior Fitness and Fall Prevention: Strength and Balance Exercises for Aging in Place

 Senior Fitness and Fall Prevention: Strength and Balance Exercises for Aging in Place 

What if one simple movement could help you feel stronger, steadier, safer, and more confident in your everyday life?

Many older adults believe it may be too late to begin exercising, build strength, or improve balance — but this episode challenges that belief in the most encouraging and practical way. Aging well is not just about the number of birthdays we have celebrated. It is also about how we care for our bodies, how we protect our independence, and how we support our confidence through movement, mobility, and mindset.

In this episode of Senior PrimeTime, host Bonnie Keith is joined by Joyce Robertson, CEO of The Foundation for Senior Services, for a powerful conversation about senior fitness, fall prevention, strength, balance, flexibility, and staying independent as we age.

Our special guests, Dr. Susan Layfield and Dr. Desiree Williams, Doctors of Physical Therapy, share their expert insight on why movement matters so deeply for older adults. Together, they explain how even simple, targeted exercises can make a meaningful difference in daily life — from getting out of a chair more easily, to walking with more stability, to feeling safer at home, to reducing the risk of falls.

This episode explores important questions that many seniors, adult children, and family caregivers quietly wonder about. Is exercise really safe for older adults? Is it ever too late to start? Why is walking helpful, but often not enough by itself? What happens when strength begins to decline? And how can small changes in movement help preserve independence, dignity, and quality of life?

Dr. Layfield and Dr. Williams also discuss warning signs that families should pay attention to, such as shuffling, holding onto furniture while walking, avoiding stairs, struggling to rise from a chair, or becoming fearful of falling. These signs can often appear gradually, but they may be important clues that strength, balance, or mobility need attention before a fall occurs.

You will hear practical guidance on exercises and movement habits that can support safer aging, including sit-to-stands, balance work, strengthening movements, flexibility, and gentle practices such as Tai Chi. The conversation also highlights how movement can support not only the body, but also confidence, coordination, posture, brain health, and emotional well-being.

This is not a conversation about becoming an athlete or pushing beyond your limits. It is about learning how to move better, feel stronger, and take realistic steps toward greater safety and independence. Whether you are already active, just getting started, recovering from a setback, or helping a loved one navigate mobility concerns, this episode offers encouragement, education, and practical takeaways you can use in everyday life.

For family caregivers, this conversation is especially important. It can be difficult to know when to step in, what signs to look for, or how to encourage a loved one without making them feel limited or afraid. This episode helps reframe movement as a source of empowerment, not pressure — and as one of the most important tools we have for aging with confidence.

It is never too late to begin. One small movement can lead to more strength. More strength can lead to more stability. More stability can lead to more confidence. And more confidence can help older adults continue living with greater freedom, safety, and purpose.

  Senior Primetime: Embracing Movement and Fall Prevention in Aging Explore how staying active through mindful movement like Tai Chi and strength training can profoundly impact seniors' independence, safety, and mental vitality. Join Bonnie Keith as she hosts a powerful conversation with physical therapy experts Desiree Williams and Susan Layfield, uncovering practical tips to age gracefully with confidence.

Key Topics:

• The importance of senior fitness and misconceptions surrounding exercise safety
• The role of strength, balance, and flexibility in fall prevention
• How Tai Chi enhances mobility, posture, and cognitive health
• Practical home safety tips for fall-proofing and hazard removal
• Strategies to overcome fear of falling and regain confidence
• The significance of personalized physical therapy and mobile wellness options
• The impact of movement on conditions like Parkinson’s, arthritis, and cognitive decline
• Encouragement to start small: sit-to-stands, footwear checks, and balanced routines

Chapters

00:00 The Transformative Power of Physical Activity
06:47 Maintaining Independence Through Strength
11:51 Overcoming Challenges After Surgery
13:27 Beyond Walking: A Holistic Approach to Fitness
15:26 Recognizing Behavioral Changes in Seniors
20:29 Confronting the Fear of Falling
24:17 Home Safety: Preventing Falls
26:49 Personalized Physical Therapy Solutions
31:54 Building Lifelong Habits in Seniors
36:40 The Importance of Variety in Exercise
38:18 Physical Therapy for Various Conditions
45:49 Empowering Seniors: It's Never Too Late

go to:        https://www.seniorprimetimepodcast.com

 for more information and helpful downloadable resources

Connect with the Experts:

Foundation for Senior Services:   https://www.foundationforseniorservices.org

Dr. Susan Layfield:
Email: susan@layfieldpt.com   Phone: 818-521-4955

        Dr. Desirée Williams (A Plus Care):
        Website: apluscarela.com    Email: desiree@apluscarela.com 

 Phone: 323-918-5505 or 323-973-2473 

Additional Notes:

• Remember, most falls are preventable with a tailored approach.
• Starting with small daily movements like sit-to-stands can yield significant benefits.
• Staying socially engaged through physical activity supports mental and emotional health. 
• Tags:   Senior Fitness, Fall Prevention, Aging in Place, Tai Chi for Seniors, Dr. Paul Lam Tai Chi, Physical Therapy, Mobile PT, Home Safety for Seniors, Senior PrimeTime, Bonnie Keith, Balance Exercises, Foundation for Senior Services, Sit to Stand Exercise, Active Aging.
  Senior PrimeTime, Bonnie Keith, Foundation for Senior Services, Senior Fitness, Fall Prevention, Physical Therapy, Dr. Susan Layfield, Dr. Desiree Williams, A Plus Care, Mobile Physical Therapy, Home Health Care, Aging in Place, Tai Chi, Tai Chi for Seniors, Dr. Paul Lam, Tai Chi for Arthritis, Balance Exercises, Mobility, Cognitive Vitality, Healthy Aging, Active Aging, Independent Living, Home Safety, Hidden Home Hazards, Sit to Stand Exercise, Fab Four Moves, Senior Wellness, Senior Health, Fall Statistics, Fear of Falling, Mindful Movement, Orthopedic Specialist, Non-Impact Exercise, Strength Training for Seniors, Los Angeles Physical Therapy, Parkinson's Disease Rehab, Flexibility, 

Senior PrimeTime is brought to you by the Foundation for Senior Services and hosted by Bonnie Keith.
Each episode features conversations that help seniors and their families live with purpose, vitality, and confidence in Act Three.

Follow the show on Apple Podcasts, Spotify, Amazon Music, iHeartRadio, or YouTube Music so you never miss an episode.

Learn more:
 FoundationForSeniorServices.org

Transcript

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SPEAKER_02 0:04

Welcome to Senior Primetime, where real people and real conversations come together. Hi, I'm Bonnie Keith, Creative Visual Director, Industry Veteran, and your host of Senior Primetime. This podcast is brought to you by the Foundation for Senior Services, and I'm joined today by its co-founder and CEO, Joyce Robertson. Senior Primetime brings you certified specialists and trusted partners of the Foundation, focused on topics that matter and on living your best life at every age, especially in what we lovingly call Act 3. Today we'll be navigating Senior Fitness and Fall Prevention in a powerful conversation with our doctors of physical therapy, Desiree Williams and Susan Layfield. Together we'll explore how to step safely into your uncharted years through mind, mobility, and movement. Because senior fitness is not about doing everything perfectly, it's about learning how to move better, feel stronger, stay safer, and keep participating in the life you love. And with that, let's get started. Recent studies show that seniors actually are among the happiest groups of people on the planet. So today we're going to explore how to optimize your uncharted years with a masterclass in rewriting the rules of aging safely at home. We are going to show you how to stay strong, steady, and unstoppable. This is the ultimate guide to senior fitness fault prevention and the power of movement. And I am thrilled to welcome two extraordinary physical therapists, Dr. Susan Layfield, a certified orthopedic and Thai Chief Specialist who holds master's and doctoral degrees from USC, and Dr. Desiree Williams, a Hampton University doctoral graduate, former Miss Virginia, hello, and co-owner of the mobile practice A Plus Care. Together, they bring a beautiful blend of deep clinical wisdom and dynamic real-world experience to our discussion on senior fitness, fall prevention, and aging with dignity. So, ladies, thank you and welcome to the show. Okay, so with that, Susan, let's start with you. Tell us about your background and how you became passionate about senior physical fitness.

SPEAKER_01 2:39

Well, I owned a physical therapy practice and we treated many seniors as it turned out with orthopedic issues. And one of them that kept coming up was fall prevention. It wasn't something that we that anybody I knew was really uh promoting, but it was it was every day in our office. So we started a class called Fit for Life, and it was for fall prevention, and it was it was not a scientific study, it was more of a clinical study. And patients came in and would say, I tripped or I tripped last month and fell. I didn't fall this time. So it was very encouraging, very encouraging. So I then moved on, I sold my practice and still continued to treat seniors and so forth. And Tai Chi came up and I thought, okay, let me check this out because they do promote balance and so forth. So I took my first class from a physical therapist and then took back what the few things that I could remember from the first class I took and took it back to the clinic and saw that people enjoyed it. And I had fun teaching it. I had fun having them go through movements and so forth and watched them improve their balance, their posture, their agility, their strength, and so forth, which then carried over into more confidence with their activities of daily living. So I became certified and Tai Chi, and here I am.

SPEAKER_02 4:04

Fantastic. Well, we are blessed to have you. Desiree, could you share a little bit of your journey? What a journey, and what motivated you to focus on this area of all the things that you could have done with your life.

SPEAKER_00 4:16

Sure. I mean, when I first got into physical therapy, I actually did not think that I'd end up working with seniors. Um, I fell in love kind of with the power of physical activity and physical fitness in high school working with a special Olympics cheerleading team. Um, and so we were working with, you know, children with disabilities across the spectrum who were having trouble walking and running and speaking. Um, but we, you know, created this cheer routine and they'd come to cheer practice. And I saw over years that these, you know, students who had been in school for years and years working on these things were beginning to develop the skills to run and to speak and to be a part of something bigger. And so that was when I first recognized really how transformational physical activity can be in someone's life. Um, so that's where I kind of started this journey. And then when I moved to Los Angeles about nine years ago, um, I started working for other home health agencies. And I fell in love with this idea of working with my patients in the environment that they're spending the most time in, right? Uh and but further than that, I was finding that I was seeing these patients and I was pushing them beyond what they even thought their limits were. Uh so it really sparked something in me that I realized that a lot of people were sort of settling for the status quo. But similar to challenging these children with disabilities, you know, beyond what they think they can do, if you challenge someone just a little bit beyond what they think their edge is, they usually can rise to the occasion and they'll they'll surprise you and they often surprise themselves too.

SPEAKER_02 5:52

How can we help the senior community in uh knowing why physical fitness is so important as we age?

SPEAKER_01 6:03

We all want to continue doing the things that we enjoy the enjoy doing, even as we get older. And staying physically fit, emotionally fit, and mentally fit is really important. So I think that keeps staying fit keeps our bodies resilient, it keeps them mobile, and the mental activities keeps our minds sharp and keeps us emotionally alert. So I think that and nurturing our emotional well-being as well helps us adapt and stay positive with challenging events. So I think together, this this comprehensive approach to these different areas you know allows us to age gracefully and to stay active, uh, maintain our independence and to, you know, live life to the fullest, regardless of our age.

SPEAKER_00 6:51

Yeah, I mean, what Susan is saying is so true. I think, and I feel like I say this on like a broken record, even with my parents who don't love to be physically active, but I like to remind them that getting older is inevitable. We're all, God willing, going to get older. But losing your independence is not inevitable. So it's not getting old that's predicting you not being able to live independently and cook independently. Actually, the number one predictor of losing your independence is loss of strength.

SPEAKER_03 7:21

Yeah.

SPEAKER_00 7:22

So to me, that kind of says everything that physical fitness is so important because you've got to maintain your strength. Um, I also like to remind people that after the age of 30, and I don't want to assume anybody's age on this call, we're all over the age of 30. But over the age of 30, studies show that we naturally lose 3 to 8% of our strength each decade, which means if we're not actively working to get stronger, we're all actively getting weaker. And so if we put those two things together, that loss of strength leads to loss of independence, and that not working on your strength, you're automatically going to get weaker. You're just sort of asking to lose your independence if you're not consciously engaging in some kind of physical activity to maintain that strength. So I think more than anything else, all of our goal is to, you know, live independently as long as possible, to enjoy life as long as possible. And I think strength really plays a huge component in maintaining that.

SPEAKER_02 8:22

I completely agree with you. You know, they they say age is just a number, and I I believe it more now than ever because when I was in my 30s, not too very long ago, I felt old. I felt old in my 30s. Uh, and I was always active. I was a tomboy, I was an athlete, I was then I was a dancer in my acting days. But um I got very, very, very serious with my fitness in 2016 and started working out with some really dynamite personal trainers and basically doing strength training. So I have been known to do deadlift 135 pounds and I weigh 100 pounds. You know, I do chin-ups and pull-ups and crazy things like that. I know most people my age, over 30, um, can't do things like that. But I didn't start there. I just knew that I didn't want to become an age number. I wanted to defy that age number. And I really feel that I am defying that age number. And I just want to give hope to other people that they can do it too. But you got to start somewhere. Just have to take that first step. So, Susan, what therefore is the biggest misconception that seniors have about exercise?

SPEAKER_01 9:37

Two of the most common misconceptions that I hear on a regular basis is one that exercise is not safe for me, not safe for me. Okay. I have, you know, I have issues, they'll come up with issues. Um that it's not beneficial. It's not going to help me. And I think those two come from watching contemporaries that are pretty much in the same position they are. So back to what Desiree was saying, strength is absolutely crucial, right? But it's a lot easier to maintain it and chase it a little bit than go white jerk yellow self-kids so weak. Although I will say that if you're pretty weak, you're gonna see changes well before we know the muscle has truly hypertrophy, right? So there's a curve, there's a learning curve there that our nervous system goes through and so forth. So we can catch that easily, but we have to keep people motivated and change their minds. You know, there's multiple studies, well-done studies, that have shown that exercise can be of benefit and safe for any age. There's a study on the Harvard uh medical school special report on Tai Chi that summarized a review of Tai Chi studies, nine over 900 studies, and found that over 95% of these um studies showed an improvement not only in strength, but in balance, changes in diabetes, with sleep problems, with depression, with arthritis. I mean, it runs a gamut. Very, very encouraging. So, you know, our job is to change that attitude and give them something fun to address them where they are at to deal with the misconceptions and give them something successful that they can then want to carry on with.

SPEAKER_02 11:30

Many people just think again, oh, if they haven't done it in 30 years or 40 years, it's too late now. It's too late. It is not too late. I'm gonna scream that to the rooftops. I'm I am I'm the living example. It's not too late. You you just need to want to do it and you need to take that first step. Hop in here, Joyce, because Joyce is another example.

SPEAKER_03 11:55

When I listened to Susan and Desiree, it reminds me that four months ago I had my first attempt with a surgery and a hip replacement. And wow, that did me in. Never had anything, never thought anything would go wrong. Well, I'm aging, and all of a sudden I'm laid up after a hip replacement. I thought my life was over. I said, How am I gonna get strength again? How am I gonna move again? I remember talking with Susan and talking about I'm I'm gonna get ready to get back into Tai Chi. But what I went through those first months, just building that strength back and moving, I needed the accountability from some professionals. I needed my friends around to help me realize that I don't need to get depressed. I can bring that back, but I can't stop. And people were strong enough with me, and now I feel better than I did prior to waiting two years to have the hip replacement. And now I'm looking forward to getting into Tai Chi, which our foundation is so uh, we want to empower all seniors to really learn about balancing your body and balancing your brain. And Desiree and Susan are going to be helping us take that Tai Chi program forward as well as other activity movement exercises. I know I have to do it every day because, you know, Desiree, I think you said it. If you don't use it, you lose it. And I guess I realize that more now as I'm agent.

SPEAKER_02 13:23

And Desiree, same question for you with your with your patients, your clients, what are they, what stories are they telling you why they can't exercise?

SPEAKER_00 13:31

Oh man, the the excuses are endless from actually my mom's number one is she hates sweating. And I'm like, oh my gosh, we can get you in an air-conditioned room and you can lift weights without sweating. But I would say that to me, mine, I'm gonna take kind of a controversial stance here. Um and I think one of the biggest misconceptions is that walking is enough. Yes, controversial, because walking is great. I love to walk, walking is important. But I think sort of we've I don't know, walking has had like great PR over the past few years where everybody's like, oh, I'm gonna get in my 10,000 steps a day. And while I certainly encourage 10,000 steps a day, there are other components of fitness that everybody's forgetting. So in addition to your cardiovascular fitness, which is the walking can help with that, you also need to work on strength. You should be working on balance, and then you should also be working on flexibility or mobility, so the ability to get your body in different positions. And so if there's anything I kind of tell my seniors, because everybody's, you know, they want to brag how many steps they're getting a day, but they're not doing any weightlifting. They're not doing things like Tai Chi to maintain their balance and their mobility. So just a reminder that there are other things that you need to be doing too. You need to be doing some resistance training, you need to be doing some yoga or some tai chi for flexibility and balance. Um, there are other components, not just walking alone. And it sort of goes back to that idea of challenging yourself a little bit. Like as we're young and as we're growing, we're constantly putting ourselves outside of our comfort zone. We have no choice, right? And then it's like you get to a certain age where you're like, uh, it's a little too hard. I don't think so. I'm a little tired. I'm not gonna push beyond that. But you do it tomorrow. Yeah, exactly. You have to push your body and to push your mind. You have to consciously think of ways to challenge yourself.

SPEAKER_02 15:21

What are the primary physical changes that you see in your people that happen as we age that that does impact balance and mobility?

SPEAKER_00 15:31

This is sort of a loaded question. So I would say the most common changes usually family members see isn't somebody saying, like, oh, I've got pain, or oh, I'm I'm losing strength. It's it's behavioral changes. So, like if you notice that your mom isn't as active anymore, she's not socializing like she used to, you're noticing that there's sort of, we call it like furniture surfing. So sort of like maybe not using a walker or a cane, but around the house, they're grabbing onto the back of the sofa and then they're grabbing onto the kitchen counter to steady themselves. That could be sort of an indication that something's going on there. Um, they're avoiding stairs, right? That's a thing where you're like, ugh, that's all the way upstairs. I'm not, I'll get that tomorrow, sort of thing. So if you're seeing these sort of behavioral changes, these lifestyle changes happening, I think that's one kind of primary indicator that maybe it's beyond time for a physical therapist. But why I'm saying this is a loaded question is because there are so many things that physical therapists treat.

SPEAKER_02 16:27

But you're also saying that the that it's the family, they start noticing things and they what happens because very often the senior is like, I'm fine.

SPEAKER_00 16:36

That is the difficult thing, right? Is talking to your family member about what you're seeing and what you're noticing because they will not you know wave it off. But what I always encourage people is like, we're all paying so much for health insurance every year. I don't know about like just think about your health insurance premium. Most people have physical therapy covered. So if nothing else, one, use your insurance benefits. Two, it can also be a great opportunity for socialization. So if you're sort of bored sitting at home all day, you're feeling disconnected from society, which we see happen a lot as people age. It's also an opportunity to interact with someone new, someone young, someone with a new perspective. So it's a way to stay active in the world. So I think it's important for adult children to really think about the things that are important to their parents. Yes. And then highlight that in the conversation when introducing the idea of physical therapy. Um, because yeah, people who don't exercise or don't want to exercise, right? But if you can introduce a component that gets them to be able to continue to do the things that they love, then it sort of shifts the perspective away from exercising and back towards maintaining independence.

SPEAKER_02 17:45

Right. And they can't say, oh, I can't afford it. Because as you said, it's usually included, and I never even thought of that. Susan, what what about you? What do you see? I want you to talk about why fall prevention is such an important issue for seniors.

SPEAKER_01 17:58

Having an outpatient practice, we didn't see patients in the home. So Desiree can get she can get more down to the nitty-pretty with what's going on at home. We usually, well, we almost always only saw patients after they had fallen or had you know became ill or had surgery or so forth, and then did not regain their prior level of function. So it was a little bit different. I mean, it was more of an acute episode, so to speak. So they were what they were wanting to get back. It wasn't so much that family was pushing them to get. They would come in independently saying, uh, this is not good. Now, getting them to physical therapy, if they had fears or weren't didn't quite know what we were going to do, is probably another story. But we did see, we would only see the people that got to us, of course.

SPEAKER_02 18:45

The the statistics around seniors falling are absolutely staggering. One in four older adults report a fall every year, and it's the leading cause of broken hips. Is the fear of falling? Does that contribute to them falling?

SPEAKER_01 19:01

Absolutely. Yeah. So once you've lost confidence like that, because once we think we can't do something, we basically aren't going to do it, are we? Or we're going to start shuffling, or we're going to start looking down for furniture to hold on to or the walls and so forth. But one big thing is people start shuffling their feet and they start looking down, which then affects their posture, and we could go on and on about that. And physical therapy addresses all of that. But this the statistics are staggering. And back to your statistic, Bonnie, is that once you've fallen, you are twice more likely to fall again than someone that hasn't fallen. I mean, every 11 seconds a senior is seen in the emergency room for either a fracture or um head trauma, which is huge, um, or some other fall-related injury. And it is the leading cause of death and injury of us over 65. And one in five, 20% of falls results in a fracture. I mean, and we could talk about the dollars, and we but that all becomes just more academic, doesn't it, than than uh than really gets us, right? So it's billions of dollars, but the most important thing is people are losing independence. Let's go back to this fall prevention to maintain our independence. And the good news, in spite of these staggering statistics, is that most falls are preventable. It is a preventable issue.

SPEAKER_02 20:32

Yes.

SPEAKER_03 20:33

We talk about fear, and after my surgery, I was so scared of it. In fact, the person I was working with said, You're gonna be too don't be too scared. Being too scared, you're gonna, like you said, you're gonna fall again. So you have to get back into a rhythm where you're you're taking things a little more naturally and not being too too over intentional. And that's what I find found myself doing. And I'm I had to work through that. So, how do you how do you do that? How do you work through that fear and not take it to an extent that you're you're always scared falling?

SPEAKER_00 21:12

Yeah well, first I'm gonna tell a personal story. Um I actually had a fall. Um, so I had already had a knee surgery, a pretty massive knee surgery, and I was on crutches. Um, and this is sort of to speak to that fear of falling. Um, and I was crutching my way to physical therapy, and there was uh a ramp, and it was raining outside, and I had a huge fall, screwed up my knee surgery, had to get several more after that. And I know all these statistics about falling, right? And I I know all the information about falling and two things. One, my fall was preventable in retrospect. But two, I developed my own fear of falling at my age and at my strength level and with all the knowledge that I had. And then every time after that, that I'd approach a ramp or it was raining outside, I would I would feel. My pulse quicken and I feel myself start to like sort of sweat because I'm just thinking of all the worst, worst case scenarios. So that was something that I had to overcome after my fall was just having small successes over and over again. And I think that's that's the first thing. It's really easy to approach someone who's fallen and just say, oh, like you're you're better now, you're fine, it'll be okay. But it really is psychological. So it does take some time to do the thing over and over again and see, I mean, maybe 10, 15, 20 times that you can do it safely before you can let go of that thought that, you know, when I walk or when I do stairs, I'm going to fall. Um, so that's the first thing. And then the second thing, and this is to speak to Susan saying that most falls are preventable because most of them are. When I go back to think about it, I was not wearing the best shoes, right? So we we think about these common fall risks of loss of strength and that sort of thing, shuffling. Um, but one thing I also like to point out when I do like my fall prevention talks is footwear. So I was wearing tennis shoes. It's not like I was wearing heels or anything like that. But just like the tread on a tire wears out, the tread on tennis shoes wear out too, right? But they were like my old, faithful, trusty shoes. I've been wearing them for too many years, right? And it had lost the tread. And that in and of itself increased my risk of falling. And that's why my feet swept up underneath me. So there are a lot of things we can do to reduce risk of falls. Like Susan said, most falls are preventable. And one of those things is just to first check your footwear and make sure the tread on your shoes is good. If you no longer have great balance, you probably shouldn't be wearing heels. I've mostly retired heels in my life at this point. So that that's my little personal story.

SPEAKER_02 23:47

So, Desiree, through your mobile practice, A plus Care, you bring physical therapy directly into people's living rooms to help them maintain their independence, meaning the patients don't have to worry about transportation, go into a clinic. It happens right on their own rugs, in their own hallways. What are the top two or three most common hazard blind spots that seniors or their kids or adult kids miss when trying to safe proof a home? How do mobile physical therapy sessions help seniors practice safe mobility directly inside their unique home layout? Yeah.

SPEAKER_00 24:21

Um, I would say number one at the top of my list is rugs. Throw rugs. And it seems like the older a person gets, the more throw rugs they have in their home. I don't know if they're covering up stains. I don't know if they've just collected them in their travels. I'm not sure what the interest is in throw rugs. I feel like I've got very few in my home, but when I go into older adults' homes, they're everywhere. And often that's what's causing a fall. Like there are loose corners that are slipping underneath you. It's causing like a little lift on the floor that might go unnoticed. If you're using an assisted device, that becomes a whole other issue. So my the number one thing is throw rugs. If I could get rid of all the throw rugs in everybody's home, it would make me a very happy camper. So I would say that's one. Two is usually low light. So oftentimes the first place a patient falls is walking to the bathroom overnight. So getting up in the middle of the night, you think you know your way around the house, but you know, there's something on the ground that you didn't know, or you're tired. So uh I would say low light. So getting like night lights and putting that along your path. Even now they've got so many motion-activated lights, sensor lights that you can, you know, sort of light your paths on the way to the bathroom to prevent that fall. And the third in the age of technology is probably like cords, your iPhone charger, your iPad charger. So all those little miscellaneous cords that are just sort of in the way. So I would say those are the three biggest throw rugs, low light, and uh cords. What do you do to help them, once everything is cleared, safely navigate? You know, we can do strengthening at home. We can help them develop strategies and techniques to safely get in and out of the bathtub, in and out of the shower. So it's really so dependent upon the patient and what their primary concern is that uh I think that's another misconception with physical therapy, is that we're like a one size fits all sort of thing. But that's not the case. Like when we go into a home, I'm I have no preconceived notions. I'm coming to meet the patient exactly where they are, and exactly where they are is in their home. And so sometimes it's letting them guide what the issue is. Sometimes it's just me watching them navigate their space, and I might recognize an issue. There's just so many opportunities for people to grow and to improve. And I think because strengthening has not been a part of so many people's lifestyle, there's there's always, almost always room for improvement. They always need your help.

SPEAKER_02 26:57

Yeah, yes. Susan, let's talk about Tai Chi. Oh, let's why is Tai Chi especially helpful for older people?

SPEAKER_01 27:08

I know it's great for everybody, but especially for Tai Chi actually is excellent for everybody, from even the elite athletes apparently are doing more and more tai chi. So what is it about tai chi that is uh you know that that's so pertinent, right, for for any age and really pretty much any condition as well, because it's it's non-impact. It's a non-impact exercise. So it's relatively easy on the joints. As with all exercise, we we keep it within a pain-free range of motion. But it's and it can be done in a variety of support, right? From sitting to um support from a walker or a cane or a countertop to full standing independence. So it it really dresses a variety of environments and um health, starting where the patient is coming into us from, right? Starting at meeting their level of function. But we can also look at several we've already discussed, the fact that falls generally result from weaknesses, we've mentioned and discussed, but stiffness is a big deal as well. Because if we want someone to improve their posture, which definitely affects balance, and they are stiff and cannot correct their posture, a physical therapist is absolutely the only one, in my opinion, that's going to effectively, and I think Desriel will agree that it will effectively address flexibility, mobility, and so forth, so that we can the patient now then can obtain the posture that we want, the mobility that we want. So they can very much then benefit from the strengthening, from the posture training and so forth. And it's easier for them. So they're gonna be more apt to do it. We all know what it's like to be stiff. And if we were to be stiff all day, like we mostly are in first thing in the morning, we're not gonna move very well, right? But some people do remain very stiff, and that's where we come into play. One of the many, many, many, many wonderful things about physical therapy is that we really can work on flexibility, which then adds to better posture, which then adds to better balance and more benefit from the strengthening and so forth. I can't go on about that enough. And studies show that Tai Chi, this is Tai Chi alone, because of what it, what the benefits are, right? The the focus, the mind, the active relaxation, the weight shifting, the position changes, and so forth, along with lower extremity strengthening. I mean, I could go on and on about the benefits of Tai Chi. Some won't even make sense. You just think, huh? But falls can be reduced from 31 to 75%. Can you imagine 75% reduction in falls from Tai Chi? You know, based on the length of time. And and actually with a one-year follow-up on one study, it remained very, very high. Very high.

SPEAKER_02 30:12

What does Tai Chi teach the body something different than regular exercise?

SPEAKER_01 30:18

So it really addresses those areas that that do result in falls, like the weakness, the mobility, the poor posture, the fear, those kind of things. And it addresses and uh is very effective in improving all of those. So number one, it's non-I mean, it's it's a non-impact exercise, we as we said. And the Tai Chi movements mimic activities of daily living, like pushing, pulling, lifting, reaching, navigating stairs, getting up and down from a chair. So that's very applicable. And also then the mental part of Tai Chi helps keep us focused. And there are some hints now that it makes sense to me. If we've got more circulation going because we're focused on what we're doing, right? We're concentrating on what that next move is, our balance, our posture. Oh, I'll tell you, it goes on and on. Sometimes my head swim when the instructors from the classes I take, say, are you watching your posture? Have you got a difficult weight on that? And I'm thinking, oh, where's my arms? Where's my hands? But it's all doable. So we break it down so that people don't leave frustrated. Joyce, you know, right? It can be frustrating. Um, I'll show a form first, and then people I know go, oh, there is no way. We break it down movement by movement. So it is very doable, it's very learnable, and um, it it hits all of it. If we can see studies show that it has an impact on depression and on sleep habits, that's wild, isn't it? Yes.

SPEAKER_03 31:57

That's wild. Yes, yes, and don't you think that this can be ongoing in a senior's life where it's not just taking a couple classes, but actually the habit of Tai Chi that we've been talking about instituting an eight-week class for everybody to get started and continuing in some way. How do you build that in?

SPEAKER_01 32:18

So an eight-week eight-week class is a great introduction because then someone can leave when they've attended regularly, it'll be on a consistent basis. So you're learning as you go, and it's you know, at least weekly, if not twice a week, you have a good foundation. So hopefully by then the participant is like, whoa, I want to get better at this. I mean, I've been doing this since 2018. I take two to three classes a week to this day, and I am not exaggerating when I tell you, and I also teach it. I've still learned something new with every class.

SPEAKER_00 32:53

I was gonna kind of piggyback as someone who's done Tai Chi, but I'm no expert. But I think something that also is unique about Tai Chi that you don't see in a lot of other exercises is you sort of alluded to this, but like your right arm is doing something different from your left arm, is doing something from your different from your right leg and left leg. So in a lot of exercises you're doing in the gym, you might be doing bisectors and both arms are doing the same thing, and your arms are, I mean, your legs are not moving. But I think tai chi requires a part of the brain that again, many people as they age are not using, right? You're not participating in rec basketball at a certain age. So you're not necessarily coordinating one side of your body doing something with the opposite side of your body. So I think that's something that's very unique to Tai Chi that you don't see in a lot of other forms of exercises that, like you said, Susan, you can do at any age. It's you don't stop at a certain age because X, Y, Z happened. You can continue to use these parts of your brain that are required to for coordination and like you said, for focus. And that I think is unique to Tai Chi that you don't see.

SPEAKER_02 33:56

It's really easy to see how both of your fields connect to each other. I mean, Susan, you're building the foundational strength, mindful posture, Desiree applies it to the home and environment. Susan, how can someone take the principles of Tai Chi like posture and weight shifting and apply them to everyday tasks like walking across a dark room or stepping over a threshold?

SPEAKER_01 34:16

So we have to start. That's a very good point. So that would be the end goal, right? Yeah, we start very basically. So this isn't something, this is difficult to put into words, but you cannot learn Tai Chi overnight. You can't learn, I mean, if you're going to take into your body the concepts of Tai Chi, right? It's a learning process. And it's it's another form of a particular philosophy I learned in physical therapy called PNF. And it's based on function. So everything we do, as I just mentioned, is based on what we do during the day or parts of how we move during the day. So you can imagine that, you know, when we're born, we don't start walking. This is a process of learning, of tackling and getting into that nervous system all these different areas of function and keeping us independent. So luckily we don't lose that. We may be a little confused as we again slow down, we get stiff, we get weaker, but we can pick that up again quickly. So we meet them where we're at. So we will do just certain movements, but it they always include flexibility, a bit of challenge to our strength, weight shifting. So we're on both feet, but we're shifting weights side to side. You'd be surprised how difficult that is for many people. And then we add movement on that stable foundation. So we may start with we call it bare rooting, but you're picking up one foot, but it's very gradual. You just don't pick up your foot. It may take us a minute to get over to the point where we now ask somebody to pick up their feet. It's always with side support or with a walker at the beginning. So if they're not having to think about their balance, they're building that foundation. So when they do let go, they're they're balanced. There's so many parts of our nervous system to enhance that confidence, right?

unknown 36:09

Right.

SPEAKER_01 36:09

And to to uh alleviate that fear because fear, as Desiree said, and I know what that's like as well. I had an accident, and I still to this day I I look to make sure the traffic stopped and and and so forth, just as a safety precaution. We want to, you know, we want to avoid those, or we want them to get over that by being, again, confident. And Tai Chi is a great way to do that.

SPEAKER_02 36:34

And and Desiree, how do you incorporate holistic balance exercises like the one that Susan teaches or discusses into a patient's personalized home-based physical therapy routine?

SPEAKER_00 36:44

Yeah. Well, I have a background in not and I studied abroad in China in college. So that introduced me to Tai Chi many, many years ago. And at that time, every morning before class, we would go to the park and we do Tai Chi. And not just, it wasn't just us doing Tai Chi. I mean, there were kids doing Tai Chi. There were grandmothers, probably great grandmothers in their 90s doing Tai Chi. So I think Tai Chi is a really great approach for a lot of people. Um, and I also have a background in yoga, so I get bored easily, let's say it that way. So I need a lot of different ways to keep things exciting for myself. And so I think that's the same for a lot of patients as well. It's like if we're doing the same exercises, every time I see you, you're eventually gonna, it's like, what do you need me for anymore, right? So I think it's important to have these knowledge bases and other forms of activity because again, you've got to meet people where they are. They've got to be interested somewhat in the movements you're you're teaching them for them to do it once you leave the door. That's the goal, right? That everybody's going to adopt some sort of physical activity on their own. So I think it's important to keep yourself interested. I think it's important to, again, address these other components of fitness, not just strength, not just cardiovascular, but also your flexibility and your balance. So I think that's why it's so important to think of everything holistically. Like you can't get so stuck in one activity and one form of exercise that you're you're not seeing everything else around you.

SPEAKER_02 38:15

Do do these help conditions like Parkinson's disease and chronic pain and stuff too? Or is uh yes?

SPEAKER_00 38:22

So uh well, physical therapists, I think this is one thing that even my husband's a physician. I'm not sure he even realizes how many things that physical therapy can treat. But absolutely Parkinson's disease, vertigo or dizziness. Yeah. So there are interventions that physical therapists can do to help reduce the recurrence and to help you sort of deal with that vertigo and that balance. So, yeah, Parkinson's disease is a huge uh part of my practice. Um I specialize or have a certification in something called LSBT Big that's uh encourages large amplitude movements, which is often what's lost in Parkinson's disease. You see people sort of like shuffling and moving small, but it reintroduces big movements uh to sort of get you back to your normal walking and your normal way to speak. Um, even things like incontinence. There are physical therapists who specialize in pelvic floor PT, who can work on incontinence issues, lymphedema. Like, I mean, the list just goes on and on and on. So if you're dealing with anything, I would take a beat and think like maybe there's a functional way to deal with this and not just a medicine that I can take every day. There's often something functional, something physical that can be done.

SPEAKER_01 39:32

You know, one thing that I do add when I'm giving a lecture on fall prevention is to see a physical therapist if you have foot pain. If your feet are painful, because people don't know that we treat the feet, right? Yeah, or to treat feet, I should say. We all get stiff. And so I've told them, yeah, besides the shoes, right, Desiree, the shoes are the kind of shoe and so forth. If your feet hurt, see a physical therapist. And I see eyes just go, what?

SPEAKER_03 40:01

Somebody that might have plantar fasciitis, for example.

SPEAKER_01 40:04

Yep.

SPEAKER_00 40:05

Yeah, yeah, plantar fasciitis, neuropathy. Sometimes it's it's just you you've lost flexibility in your head.

SPEAKER_01 40:12

Women have wore heels for years, they end up with at least bunions, the minimum of bunions. Yeah. Not that physical therapy reverses bunions, but we can circle certainly work on mobility, which oftentimes can forestall, right? Surgeries and so forth. So big deal. And they don't, and people don't know we treat it.

SPEAKER_02 40:34

Susan, I think you talk about something called the fab four moves.

SPEAKER_01 40:38

So the fab four is our four exercises designed by a physical therapist for a quick, comprehensive workout. So they they start with strengthening, um, also with um weight shift, positional changes. So flexibility is is also part of the four exercises. So it is a great set of exercises that can be done anywhere. It doesn't take long to do them. You can do more repetitions and make it a little bit longer if you'd like, but it's a nice concise workout.

SPEAKER_02 41:13

A lot of people think of fitness just in terms of your muscles and the strength or or whatever. But we've we have already discussed the connection between physical movement and cognitive vitality. How does staying physically active, moving, working on your strength, working on your mobility and being flexible actually help protect against cognitive decline in conditions like my husband had dementia or Alzheimer's?

SPEAKER_00 41:36

Yeah, I mean, you can get into like the weeds of the scientific reasons behind, but I think if we're gonna like backpedal to the most basic, it's circulation, right? It's it's getting things moving that have been stagnant. So if you think about brain development and like neuroplasticity, we say if you don't use it, you lose it. And I know we say that ad nauseum, but but it's true. And it's like you've got to sort of challenge yourself one way or another for your brain to maintain the same mass that it's always had and the same health that it's always had. So you can't just expect to sit around all day and your brain remain healthy. You've got to be doing something to help encourage it that you still need those brain tissues. So if you're not actively using those brain tissues to do something, then your brain is like, oh, well, we're, you know, we don't need to send nutrients to the brain, we don't need to send circulation to the brain. She doesn't even use that. And she doesn't use me anymore. So it's really just a signal for your body to continue to work on those like synaptic connections just to continue to function and continue to remind yourself that you still need those things.

SPEAKER_03 42:48

Susan, you talked about Tai Chi. And if someone is permanently disabled with something, this is also good for disabilities. Can we also do Tai Chi for people that have disabilities?

SPEAKER_01 43:02

I have mainly worked with people with orthopedic issues, balance issues, deconditioned situations. But I do have a patient who has significant autism, and I do Tai Chi with him as well. He does not speak, but he understands. So he has more of an expressive aphasia. It warms my heart. What if you're wheelchair bound? Oh, wheelchair bound for sure. Because all of the Tai Chi that we do, I'm gonna say all, I'm trying to think of an exception, can be done sitting. Okay. We modify it a little bit, we can be done sitting. So we eventually teach a form, so this flowing form that puts all of the exercises that we've taught before into a routine, right? That that starts off with with very basic movements and then we build upon that. We have to match, right? So I also teach Tai Chi and assisted living. And the particular Participants haven't have cognitive issues. So I still will teach part of a flow, but I I verbally take them through every piece of it. And it's the very beginning, but they're still doing a flow. And they love it because they're moving. I mean, their arms, hands sometimes, are upside down, but so were mine when I was learning some of this. And they don't I love that part because they aren't so like, oh, where are my hands? Where where are my feet? They do what feels right to them. And it's not always perfect, but it's not when we're learning something. So it really warms my heart to see to see that. It's so fun to be, as Desiree, I think, will agree. It's great when we are challenged to start as we match our patients' start, right?

SPEAKER_00 44:50

Yeah, and maybe that's what keeps it exciting.

SPEAKER_01 44:53

Then I gotta think outside the box on this one, right? This is not gonna be one I see every day or a condition and so forth. So I love and I love mixing, I call it mixing the physical therapy with Tai Chi, but it's so fun to be able to do that because I can look at somebody and say, This is what I'm gonna emphasize. So maybe we'll do a little bit more of this positioning, this weight shifting today in my Tai Chi class.

SPEAKER_02 45:17

I wanted uh to know what do you want every senior who is watching this episode to remember? Let's start with Susan.

SPEAKER_01 45:26

So the one thing that I would very much like to impress upon every senior that may be watching this is that movement is like your daily nutrition. Okay, so your body needs strength and balance, right? It needs consistent practice. So that so we build it. And just like good nutrition, regular movements will keep us strong, it'll keep us balanced, and it'll keep us independent. That's my big desire.

SPEAKER_00 45:54

Aging is inevitable, losing your independence is not, and it's never too late. We've never too late. Yes, I've seen patients personally in their 80s and 90s. Studies have shown that patients in their 80s and 90s can still significantly improve their strength.

SPEAKER_02 46:09

So and what is one simple thing they can do today to reduce fall risk, whether it's throwing out that area rug or starting learning to do exercises, what's what's one thing?

SPEAKER_00 46:23

I will start deserving. Okay, I'm gonna give an exercise. I I think I've sort of already harped on footwear and rugs and all of those things that are important. But one exercise that I think is really approachable, if you can do it safely, is just doing sit to stands. Standing up and sitting down in a sturdy chair with no wheels, a sturdy chair. Standing up and sitting down as many times as you can in a row and doing that every day and trying to increase the number every day.

SPEAKER_01 46:49

That was going to be my exercise. Um I kind of add a little bit that because it reduces the risk of falling. The ability to get in and out of a chair, especially without using your hands, if you can do it safely, actually is the number one predictor of nursing home admissions is the inability to get out of your chair. Because what happens when you can't get up, we lose our independence. And the exercise alone it works on strength, it works on flexibility, it works on balance, right? And also works on posture because if you're not aligned correctly, it's not going to be an easy exercise to do. So I think as far as building confidence and kind of you know working on enthusiasm and so forth, that is a I agree with Desiree, that is one. That was hard though. One exercise. You get you get a free bang for your buck with that exercise.

SPEAKER_02 47:42

So you two are amazing and fantastic. And if anyone wants to get in touch with Desiree or Susan, all of your contact information is in the description, it's in the notes, it's on the Foundation for Senior Services website. Um, and and please, if you have questions or if you just want any advice, contact these two amazing doctors. I'm gonna ask you that if someone doesn't live near you or they're too far away or they're in another country, so if someone wants to start Tai Chi or look into mobile physical therapy today, what should they look for to ensure they're getting a safe, certified professional such as you guys? We want them to contact you, but if they they they can't for whatever reason.

SPEAKER_01 48:26

Boy, that's a that's a tough one. Um, I do have one suggestion though, and that is I take a class on Tuesday mornings that is at no cost. I did um discuss this with the instructor. It's on Zoom. And um, she said yes, she would welcome people if they were willing to join. It's it's a beginning class, it's meant for people that have not had experience with Tai Chi, and I'd be more than willing to give out that information if they'd like to contact Joyce or contact me.

SPEAKER_02 48:53

Fantastic, Susan. Uh Desiree.

SPEAKER_00 48:56

Uh I would say that all physical therapists are required to be licensed by the state. So the first thing you can do is just look up someone's license to make sure that they're licensed. Yeah. Um, I'm huge on reviews, so take a look at their reviews and make sure their goals are going to align with yours. And if it doesn't feel right, listen to your gut.

SPEAKER_03 49:13

So I'd just like to say, call the foundation too. If you want us to give you advice or expect uh somebody that you might think is good in your area, we might not be in your area, but we would certainly give you advice and give you uh any information you can about that individual because betting is really important to us when we're looking for professionals in the field. So we'll we'll be happy to help in any way we can to direct you.

SPEAKER_01 49:38

And and one last thought is that you know, PTs specialize in different areas. My specialty wasn't orthopedic with the OCS, the orthopedic um community, but you know, with orthopedics, you were working with balance issues, you're working with all ages and so forth. I have a good background in another treatment philosophy where we treat a lot of neurological patients. So those were great. But if someone called me, um, for instance, with with a pediatric, with a young child or so forth, or an elite athlete, I would refer them to other people. So we're not good, you know, we can't be good at everything, but we will refer appropriately when necessary. So that's always an encouraging thought.

SPEAKER_02 50:19

I just have so thoroughly not just enjoyed having met you, wonderful ladies, your professionals, you're you're amazing in what you do, and and your your heart comes through in your passion for helping people and your knowledge and your expertise. So I so thank you for being uh part of Senior Primetime and Joyce always. Joyce is the CEO of the Foundation for Senior Services, who basically brings us this podcast, and I host it and produce it. And with that, I want to thank you again so much for being here and for all of our listeners. Get up and move and don't think you're too old. You're never too old. You got to start today and take our heat and advice about fall prevention and viewers out there. Thank you for listening, and we will see you on the next episode of Senior Prime Time. Thank you. Thank you for joining us on Senior Primetime, where real people and real conversations remind us what's possible at any age. And a very special thank you to Dr. Desiree Williams and Dr. Susan Layfield for sharing their insight on senior fitness, fall prevention, and the power of movement. Today's conversation reminded us that staying strong, steady, and independent can begin with one safe step, one intentional movement, and the belief that it's never too late to improve. If you'd like to learn more about in-home physical therapy, mobility support, fall prevention, or Tai Chi for balance and well-being, Susan and Desiree's contact information is in the description below. If this episode inspired you, please like, subscribe, follow, and share it with someone who may need encouragement to keep moving safely. And remember, keep moving, keep believing, and keep stepping safely one strong step at a time. This is Senior Primetime. Your place for real people and real conversations. See you next time.