Reply to John Bishop, Barb B, and others with balance issues: The SINGLE most important thing you can do is find a vestibular therapist (a PT with special training to teach better balance), listen to what he/she tells you, and practice exercises every single day.

As we age, we all lose some balance--that is, our inner ear, our primary balance system, doesn't work as well. The natural thing to do when your balance is compromised is to use your second balance system, vision, but that's the worst thing you can do. Every time you move around or even move your head, you lose your focal point and, thus, your balance. Using vision is why many docs recommend night lights for older folks, but that simply teaches you to rely on vision instead of what your feet feel. Get rid of the night light and walk through your house at night with all the lights out (assuming that you've checked for anything loose on the floor that the cat placed to trip you). A vestibular therapist can teach you to use your third balance system, proprioception, which is the feeling/information you get from your feet, ankles, knees, hips, etc. Simply put, if you stand on a windy point, you will automatically lean into the wind just enough to stay balanced: that's proprioception. You need to learn to pay attention to what your feet can tell you. Yeah, I know...who ever thought your feet know anything!!

The good news is that a month or less of really working on VRT (vestibular rehab) will definitely improve your balance and your eye/hand coordination. In addition, VRT isn't hard and can be done anywhere without special equipment (although there are some simple things you can use at home). The bad news is that you need to do some VRT every day for the rest of your life. Yes, every day, no matter how busy you are. A mere 5-10 minutes a day will make a huge difference in your life. You'll feel confident moving around because you'll know where you are in space. You'll be able to reach for the pen or pencil on your desk without "homing in on it" by spreading your fingers and closing them until you touch the object. You'll stop slicing your fingers instead of the veggies!

In addition to your primary inner ear balance system becoming less effective with age, you also may lose some sensation in your legs and feet, so you'll need to work to reestablish your ability to "feel" with your feet. Even though I had done daily VRT for over 30 years (after I lost hearing and balance function in one ear), when I went bilateral I scheduled a "brush up" visit with a VRT specialist. I learned that the old exercises weren't working as well because I'd lost a fair amount of sensation in my lower legs and feet. For me, the best exercise is to walk the quarter mile on our gravel road to reach the mailbox...with my eyes closed, for the most part, concentrating on what my feet can tell me. When I start to veer away from the driving surface, my feet can feel the loose gravel along the edge, warning me that I'm no longer on the main road surface. Lots of VRT exercises can be done while just living life, like adapting my daily walk to the mailbox. It's good to turn out all the lights at night before bed, finding your way by "listening" to your feet. Sometimes, it's good to work on a specific skill, like stepping up and down, eyes closed. I have a small platform that's about 6" high that I made for this, especially useful because we have no stairs in the main part of our home to give me regular practice on stairs. Even though I'd done some VRT daily for decades, a month of additional work really made a huge difference in confidence. At 78, I hike in rough country without trails and wade rivers. When I'm in a wilderness situation by myself with no cell reception, I am more careful than I was at 40, but I'm not fearful.

So, tune up your balance system by learning to "listen" to your feet. You'll be surprised at how much more comfortable you are moving around. You'll be able to know where you are in space, and it's a very good feeling. Stairs or a steep drop-off alongside a trail will be a challenge instead of a source of great fear. If your dog or cat walk across right in front of you or surprise you by being right behind you when you start to step back, you won't almost fall but will be able to recover easily. Try it!