By Dr GS Grewal

The first time your mother says, “Don’t worry, I’m fine,” after almost falling, you probably believe her. The second time, you become concerned. The third time, you start noticing things.

She holds the railing on the stairs. Your father gets up from the chair more slowly. They avoid going out alone. They are more careful in the bathroom at night.

And nobody says the word “fall.” That is often how the problem begins.

“I’m getting old. It happens.”

Older parents may not tell you they are becoming less steady.

Sometimes they don’t want to worry their children. Sometimes they are embarrassed. And sometimes they genuinely believe that becoming less mobile is simply what ageing looks like.

But here is the important part:

A change in ability is worth noticing—even when it looks small.

A fall in an older person can be more than a bruise. Falls can cause serious injuries, and the risk of serious injury increases with age. Poor mobility, reduced balance, physical inactivity, vision problems, certain health conditions and some medicines can all contribute to falls.

There is another problem families often miss.

Fear of falling can change behaviour.

Your parent walks less because they are afraid of falling. Because they walk less, they may become weaker. Because they feel weaker, they become even less confident. And suddenly, a short walk to the market feels like a major outing.

So, ask the question nobody asks

Next time you are visiting your parents, don’t just ask:

“Have you eaten?”

Ask something more useful:

“Can you get up from the floor without help?”

Can you climb the stairs comfortably? Can you stand up from a chair without using your hands? Can you walk outside without feeling unsteady? Can you get up at night safely? These are not embarrassing questions.

They are clues about independence.

And importantly, you don’t have to wait for a fall before looking for those clues.

Don’t wait for the problem to become obvious

This is where I believe families need to change the way they think about elderly care. We tend to take an older parent to the doctor when something goes wrong. A fall. A fracture. A hospital admission. A sudden loss of strength. But what if we looked earlier?

Early detection can help identify problems before they become bigger problems.

For this reason, I would strongly encourage families to consider a comprehensive geriatric assessment for everyone over 65, even when the person appears to be “doing fine”.

Such an assessment looks at the older person as a whole—not just one complaint. Mobility, balance, daily functioning, medicines, nutrition, memory, mood and other aspects of health can all be considered as part of understanding where support may be needed.

The purpose is not to label an older person as “unwell”. It is to identify small changes early and act before they progress.

Senior care should begin before the fall

The goal is not to make an older person behave like they are 30.

It is much simpler:

Help them remain as independent, confident and active as possible for the years ahead.

So, this October, ask your parents something different.

Not just:

“Are you okay?”

Ask:

“What has become difficult for you lately?”

And if they are over 65, don’t wait for a crisis to consider a comprehensive geriatric assessment.

Sometimes, finding a small problem early is the best way of preventing it from becoming a big one.

(The author is Director, Senior Care+ Programme, Pacific OneHealth, New Delhi)