According to a recent piece in The New Yorker by the physician-journalist Atul Gawande, if you want to have better quality of life as you age, these three things will have a dramatic effect:

1. Practice yoga or any form of exercise that will help your balance
2. Try to limit your prescription medicines to no more than four
3. Lift weights

And why these three? The single most serious physical risk that the elderly face is an injury from falling. According to Gawande’s piece, “Each year, about three hundred and fifty thousand Americans fall and break a hip. Of those, forty per cent end up in a nursing home, and twenty per cent are never able to walk again. The three primary risk factors for falling are poor balance, taking more than four prescription medications, and muscle weakness.”  

My 94-year-old grandmother died in the hospital a few days after falling down the stairs. So when I read Gawande’s piece, I began to think more critically about other members of my family and how they had died.  

The second directive - limit your meds - also struck home for me.  A few years ago, when an elderly relative died, I discovered that she had a whole counter full of different medications, at least fifteen different drugs - any one of which could have made her jittery and dizzy. The combination of them all must have been numbing and disorienting. My relative had had several falling incidents before she died, and now I wonder if there wasn’t a relationship between her intake of medicines and the falls.  

Another friend, Beth, whose father recently died, told me a similar story. Her 84-year-old mother, who had been alert and energetic before her father’s death, slipped into a kind of lethargy that was predictable after such a shock but extremely precipitous, and had Beth exploring various nursing home options for her mother.

When Beth called her mother’s doctor, she discovered that the doctor had changed the dosage on one of her mother’s medicines not long before her father had died. The doctor had been unaware of her mother’s newly altered state - and after adjusting the dosage downward, Beth’s mother went back to her usual lively self. The crisis was averted.

Gawande’s piece was a wake-up call for me. I guarantee you that now I will be far more vigilant in getting specific details on the possible side effects of various kinds of drug interactions. And I will do everything in my power to make certain that I never need to be on more than four medications at a given time.