Falls are common and can be dangerous — so why are we so embarrassed about them?

On a sunny day in 2021, I tripped on the sidewalk and caught air. Either I stumbled over uneven pavement or lost my footing. All I know is, one second I was walking, and the next, I pitched forward with my hands out like a sloppy superhero taking flight. As I plummeted towards the ground, arms and legs outstretched, fear and panic seized my brain.

I crashed onto my hands and knees in a crawl position. Pain shot through my body. I was relieved I hadn’t hit my head or knocked out a tooth. But more than anything, as a middle-aged woman in decent condition, the mortification of eating it in public overshadowed the agony.

No one rushed to my aid, leaving me both disappointed in humanity and hopeful that nobody noticed. I dusted myself off and hobbled to the car. Save for some scrapes on my palms and throbbing knees, I was fine. Still, I wondered why my first impulse was embarrassment. Why is it so hard to admit we’re hurt? Everyone falls — and yet, we’re conditioned to jump up and shout, “I’m OK!”

Physiology is partially at play. When a fall is about to occur, a surge of adrenaline triggers the fight-or-flight response. Blood rushes to the muscles and organs; the heart rate quickens as the body braces for impact. Muscles tense and the arms and legs extend while the brain sends serotonin and histamine to staunch the pain.

What the brain can’t seem to quell, however, is shame. “It comes down to this concept of successful aging,” says Drew Maygren, a geriatric psychiatrist at Kaiser Permanente in Oakland, Calif. “You want to limit your physical and mental deterioration and find satisfaction in life. A fall signals a failure at aging successfully, and if there’s an injury, it can inhibit your ability to experience what brings you joy.”

We constantly compare ourselves to others, and fear judgment, especially as we grow older. A public display of weakness suggests we don’t belong to a group of our hardier peers.

A week before my tumble, I FaceTimed with my 83-year-old mom. Seated in a desk chair that dwarfed her tiny frame, Ma ran a hand through her blonde bob, and mentioned feeling lightheaded from her blood draw that morning.

For most of my life, my petite mother loomed large. A New Yorker with a feisty nature, Ma prided herself on her ability to make telemarketers rue the day they dialed her number. “They’re afraid of me,” she’d boast.

I knew she’d eventually slow down, but three years of pandemic isolation, chronic back pain and food sensitivities had expedited her frailty. That day, before we hung up, I urged her to grab a snack for a blood sugar spike. Ten minutes later, she called back, holding an ice pack to her bloody lip.

“I fainted and hit my face against the kitchen table leg,” she said, her voice low.

I zeroed in on the pink bump forming on her forehead and tried to remain calm. “You need to go to a doctor; you could have a concussion.”

“Edward’s at work,” she said, referring to her husband. “I don’t want to bother him.” Her refusal to call her husband set off alarm bells and made me worry that she shouldn’t be left alone.

“So much for my iWatch,” Ma quipped. Her Apple watch had a fall-detection feature that alerts 911 if the wearer is unresponsive after a fall. Chances are, she wasn’t out long enough to trigger the alarm.

Ma avoided severe injury that time, but she needed help, even if she wouldn’t ask for it. Only later, after my tumble, did I rethink my mother’s urge to downplay the whole affair. Nobody wants to appear burdensome or lose their independence. “I’ll have patients who are very reticent to admit to cognitive or functional decline due to the fear that they’ll lose their driver’s license or someone else will start making decisions for them,” Maygren says.

Nevertheless, keeping quiet isn’t the solution. Falls are the second leading cause of death worldwide. One in three adults age 50 and older dies within 12 months of sustaining a hip fracture from a fall. That’s my age group. For folks 65 and older, the timeline shortens to three months. Breaking a bone isn’t the lethal aspect of a fall. It’s the blood clots that form in the leg veins and travel to the lungs that can cause a fatal pulmonary embolism. If I’d broken my hip that day, I might be dead by now. Note to self: Get affairs in order and take calcium.

In Ma’s case, I found a caregiver to assist her. She didn’t protest. My mother always wanted “a staff.” Thankfully, Ma has long-term care insurance to cover the cost of her helper. Many folks do not. A large segment of the older adult population struggles with financial insecurity in addition to health challenges.

I’m childless, by choice, as are several of my close friends. Without kids to check on us in our twilight years, we’re on our own. My friends and I have committed to looking out for each other and joke about shacking up together a la “The Golden Girls.” It helps to bond over our shared insecurities to diffuse the stigma of aging, although right now, we’re all self-sufficient. That won’t always be the case.

By 2030, more people will be over 65 than under the age of the 5 in the United States. Despite medical and technological advances that contribute to increased longevity, our society in many ways lacks care, compassion and resources for older adults. The pandemic only illuminated the grave disparities in health care due to inequality and structural racism.

So how do we prevent falls and age with dignity? For starters, we can eliminate tripping hazards in our homes, install good lighting, wear sensible shoes with non-slip soles, do 30 minutes of physical activity every day, take vitamin D and calcium, check medicine side effects for dizziness, and test our vision and hearing. We should also allow ourselves the grace to ask for and accept help when it’s offered.

After a recent visit home, my brother and I hopped in an Uber to the airport. Ma, bundled up in a fuzzy robe and Ugg boots, stood beneath her crepe myrtle tree holding onto her caretaker Vanesa’s arm for support. She waved as the Uber started to pull away and I watched her and Vanessa turn to walk inside, their clasped hands swinging back and forth. I don’t know how long I have left with Ma. I hope many more years. For now, I’m just happy I found a nice person to lend her a hand.

As for me, my fall opened my eyes to my own inevitable physical vulnerabilities. Since then, I’m more mindful walking down the street. I avoid uneven pavement and refrain from looking at my phone. I tap dance and weight train to improve muscle strength and balance. Fingers crossed these preventive measures keep me safe for many decades to come. In the meantime, I plan to enjoy every day that I’m vertical and do my best to watch my step.