Chapel Hill: Opinion

Aging in Community: Staying on your feet as you get older

By Carol Giuliani

Maintaining or improving your balance and strength are critical factors for prolonging your independence and ability to age in place.

Fall-related injuries, such as hip fracture, can have a serious impact on an older person’s life. Research clearly shows that improving strength and balance can help prevent falls, keep you socially active and having fun. As a physical therapist with over 30 years of experience, I know it is always better to prevent a fall than recover from one. So stay on your feet: no falls, no fractures, no nursing home!

A great example of this is Mrs. P., 82, who used a wheelchair because she could not get out of her chair. I met her during a Senior Fitness Test, and the one thing she wanted to do was “to get out of that chair”; otherwise, she was going to have go to a nursing home.

I modified her wheelchair seat with a 4-inch foam pad and right away she was able to stand with minimal effort. She couldn’t believe it, “I did it! It’s a miracle!” I made her a deal: she was to try to stand up without her hands from her newly modified wheelchair five times a day. In just a week, she said “OK, watch this,” and stood up and sat down three times in a row without using her hands. Four weeks later, she has less pain, can use her walker again, and continues to exercises seven days a week.

You need a plan and commitment. Treat your activity program like a reward. Put it on the calendar! Consult your health provider, then start out with realistic weekly goals, such as planning to take an exercise class at the senior center 2x/week and walk 10-15 minutes 3x/week on alternate days.

Be patient and progress slowly. No weekend warrior pain or injury, which will just set back your progress. Too much, too fast can cause injury and is a common reason people stop exercising. Start slow and gradually progress.

Pick activities that you might enjoy. Your program is for YOU, so choose wisely. If you are not a group person, do your own program by using exercise machines, or your own individual routine. You might garden, clean house, or take the dog for a walk every day.

Exercise with friends. Support and camaraderie really make a difference. Having a workout partner is one of the most effective ways to be accountable and have fun. Group physical activities like pickle ball, dance, or Tai Chi are good alternatives to individualized programs and are great for improving your balance.

What does the Orange County Department on Aging offer to help you become more active?

▪ Exercise classes, activities, wellness events and clinics

▪ One Stop Shop senior wellness clinic providing free consultations with a social worker, pharmacist, occupational and physical therapist

▪ Free Senior Fitness Testing by appointment at both senior centers. A physical therapist will test your upper and lower body strength, flexibility, balance, and endurance. You will get feedback, a copy of your test results, and ideas for a program to fit you

▪ Access to the Seymour Center fitness studio and personal trainer in Chapel Hill and the SportsPlex in Hillsborough

▪ Physical therapy appointments at both senior centers

Carol Giuliani, PT, Ph.D., is a professor in the Division of Physical Therapy, UNC School of Medicine. Her clinical and research interests focus on improving mobility and preventing falls to allow older adults to aging in place. A key factor for achieving this goal is developing partnerships with community stakeholders such as the Orange County Department on Aging.


For more information about Orange County Department on Aging programs and services, please visit or call the Seymour Center, at 2551 Homestead Road in Chapel Hill, 919-968-2087; or the Central Orange Senior Center at 103 Meadowlands Drive in Hillsborough, 919-245-2015. Visit us online at