How to Avoid Falls, the Leading Cause of Death for Older Adults

Falling is more than a bruise to our dignity; it can lead to disability, bone breaks, brain bleeds, loss of independence, and premature deaths. Learn the risks and how to avoid them. https://bit.ly/4eGaYnO

In this Episode:
01:51 - "The Apprentice"
04:15 - Recipe of the Week: Brownie Cookies
06:55 - The Importance of a Will
15:50 - How to Prevent Falls
40:33 - "Fear" - A Poem by Kahlil Gabran
42:30 - Outro
 
Falls are a leading cause of bone breaks and brain injuries for people over age 65 living in the United States, which is more than 14 million elders, or about 1 in 4 who fall each year. According to the CDC, about 37 percent of older people who have fallen have an injury that required medical treatment or activity restrictions. 95 % of hip fractures result from a fall. For older adult falls are common, costly, and preventable. 

We cover several hidden dangers to look for as you age, and also life habits that can bolster your defense against falls.

Chapters

• 0:00 Intro
• 1:51 "The Apprentice"
• 4:15 Recipe of the Week: Brownie Cookies
• 6:55 The Importance of a Will
• 15:50 Tips on How to Prevent Falls
• 40:33 "Fear" - A Poem by Kahlil Gabran
• 42:30 Outro

Transcript

How-to-Avoid-Falls-the-Leading-Cause-of-Death-for-Older-Adults

This podcast does not provide medical nor legal advice. Please listen to the complete disclosure at the end of the recording. Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement.

I'm Marianne Matzo, nurse practitioner, and I use my experience from working as a nurse for 46 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City, here to offer an every-person viewpoint to our podcast. We are here because we both believe that the more you know, the better prepared you are to make difficult decisions when a crisis hits.

So welcome to this week's show. Please relax, get yourself maybe a hot drink and a warm cookie, and thank you for spending the next hour with Charlie and me as we talk about what you can do now to prevent an early death from falls. In people who are over the age of 65, falls are the leading cause of injury-related death and the seventh leading cause of all deaths.

Like the BBC, we see our shows offering entertainment, enlightenment, and education and divide that into three halves to address each of these goals. Our main topic is in the second half, so feel free to fast forward to that ragtime-free zone. In the first half, Charlie has our recipe of the week and a cautionary tale about wills.

You better think. Think about your wills, sister. And in the second half, I'm going to talk about fall prevention.

It's not just about falling and not being able to get up. And in our third half, Charlie has a poem about fear. So, Charlie, seen any good movies? I saw a very interesting movie.

It's called The Apprentice, but the performance of Jeremy Strong as Roy Cohn, man, what a great actor this guy is. I heard he was really outstanding. Yeah, he really, really is.

He's on Broadway now, too, isn't he? No, he was over the summer in a play called An Enemy of the People, this play's over a hundred years old. It got extended. He won a Tony for it.

What a remarkable actor. As for the movie itself, it's really interesting because it starts off with the young, impetuous Donald Trump, before he became Donald Trump, that we all know now. Before he became the Donald? Yeah, yes.

And just that trajectory, how Cohn basically was the one who made him into the Trump that he is today, and this is all in public record, and how at the end, Trump had no more use for Cohn and just blew him off. And had it not been for Roy Cohn, there would never have been the Donald Trump we know today. So, yeah, it was good.

It was good, not great, but Jeremy Irons, Jeremy Strong in it is just wonderful. Terrific actor. Is that in the theaters or is that on? Yeah, so it's already out.

I don't know if it's out nationwide, but yeah, it's out. Okay, cool. We'll put that on our maybe see list.

Okay. Folks, life is full of choices. Should you bake brownies or cookies? Our recipe this week allows you to have two, two, two tastes in one.

Brownie cookies give you the fudginess of brownies with the crisp of a cookie. This easy brownie cookies recipe is everything you want it to be. A quick, decadent, chocolaty treat with crisp cookie edges and a fudgy brown center.

All thanks to a box of brownie mix. Marianne made these with dark chocolate brownie mix and she can't stop thinking about them. Marianne, are you thinking about them right now? Right now.

All right, babe. Let me tell you. Let me just say, I made these and they make maybe two dozen.

And I looked at them and I said, these look like they're going to be good. And you have to freeze them before you bake them so that they don't like run all over the pan. So frozen overnight and in the morning I was like, should I bake all two dozen? And I thought, Marianne, you know yourself.

So I baked six and froze, you know, you roll them in the balls, froze all the rest. So the six came out, let them cool a bit and I ate one and I thought, oh Lord Jesus, this is good. And it didn't take long for Dave and I to eat the six and I thought, I can't imagine what, I mean, I know exactly what would happen if I had made the two dozen.

And so I make six at a time and I still have like maybe six frozen in the freezer because they are literally, you would just like sit and shove them in your face. They are so good. With a glass of cold milk? David does the cold milk.

I just can't, I don't wait. I just, cold milk would take too much time. That's just taking away from the, yes, I understand that.

All right, very good. In the time he takes one cookie with milk, I could be having two, you know. And then more for you.

Yes, I follow that. Yes. So folks, you heard it here from the source.

Everyone will be wowed by the decadence of these cookies at your next funeral lunch. And speaking of funerals, dying without a will, known as dying in testate, means that your assets will be distributed according to the laws of the state you live in, which may not reflect your personal wishes. Die without a will and the process will be time consuming, costly, and stressful for your loved ones.

By creating a will, you can specify who will care for your minor children, plus ensure that your assets are distributed as you intend. Which brings us to the first woman inducted into the Rock and Roll Hall of Fame and winner of 18 Grammy Awards during her 76 years, Miss Aretha Franklin. Miss Franklin had two wills.

Her 2010 will called for an even split of her entire estate. You got your cars, your furs, your jewelry, properties, as well as royalties from the music. It also mandated... Not many shoes though, Charlie.

What? When I saw, not many shoes. When I saw her perform, she had no shoes on. Really? Yeah.

I'll tell you, when I'm doing a talk and I'm behind a podium, nine times out of ten, my shoes come off. And at the end, I have to scramble to find them and slip them on. But no, she would perform without shoes.

I like Aretha. So you better think. Royalties from the music, shoes.

Ah, yes. The will, the 2010 will, also mandated that sons Keykaff and Edward take business classes or get a degree to benefit from it. The 2014 will did not have that stipulation.

That document, found in a couch, indicated that three of Franklin's sons, Keykaff, Edward, and Ted White Jr., would receive equal shares of her music royalties, while Keykaff would receive her cars, including a Mercedes-Benz, two Cadillacs, and a Thunderbird convertible. Multiple documents written by Ms. Franklin, who did not leave an official will, were discovered after her death in 2018. Among the people with claims on her estate were four sons, a niece, and the federal government, who said she owed $7.8 million in taxes.

Franklin's lawyers had repeatedly asked the singer, quote, constantly, to create a trust, but, quote, she never got around to it. The 2010 document, which was signed and appears to be notarized, indicated White Jr. would receive joint ownership of Franklin's home with Keykaff, in addition to weekly and monthly allowances paid out to each of Aretha's four sons. It was dated and signed in 2010 and found in a locked cabinet.

Now, the 2014 edition was discovered in a spiral notebook under the cushions of a couch in Ms. Franklin's suburban Detroit home, about a year and a half after she died. Though many of the documents were difficult to read, a jury concluded that the 2014 notebook was her true will and valid, settling the dispute between Franklin's sons. Aretha had signed at the bottom, with a smiley face written inside the letter A, her signature, according to the Associated Press.

Now, according to the MBW Lawyers blog, here's where the Queen of Soul went wrong. She failed to be clear about her final wishes. The handwritten wills had notations that were hard to decipher, and she did not properly store the will.

With RESBCET, here are some options on where to store your will and other estate planning tips. Number one, do not store your will in the couch under the cushions. Keep it in a secure but easily found location.

How about a safe deposit box? The downside is you have to plan in advance to give access to the box. Without permission, in most cases, you cannot get the will without a court order. How long do you think that'll take? Next, the executor, that's the person who takes care of someone's estate when they're dead, can keep a copy of your will in a fireproof and waterproof safe at home, but make sure there's a duplicate key, or that you give the combination code to your executor, personal representative, or some other trusted person.

Remember to create a duplicate set of original documents, one for yourself, and one that you leave with your attorney. Tell your family you did this, and remind the attorney to contact you if she or he moves or closes up shop. You could store your will in a local court.

Again, you need to let someone know your will is there. There's also electronic storage, but, and there's always a but, otherwise your pants fall off, most states do not yet recognize electronic wills. This means you will still need to have the originally signed copy of your will, even if you store a digital copy.

Plus, and there's always more, there's a chance your document could be compromised in a data breach. Additionally, leave a letter of instruction that indicates a will exists. Put together a binder, and in it, include a letter written clearly with a list of important information, where you bank, passwords, credit cards, so they can be canceled, etc., and your will.

Tell your executor or someone close where to find the binder. If you change your will, remember to put the updated will in the binder. Which brings us to updating your estate documents.

Like the song says, you better think what you're trying to do. It's okay to change your mind about what you want to leave, or write a new will, but be sure to destroy any previous wills or notes. Review and update your will every few years, or whenever there is significant change in your life, such as the birth of a child or a new marriage.

Otherwise, an ex-spouse could inherit your money and or property because you forgot to update your will. After all that, get a will. If you die without writing your will, and it bears repeating, that's referred to as dying intestate.

State law dictates who is entitled to your assets. Without a will, your assets could be given to a relative you haven't spoken to in years, or don't even know, or like. Don't assume that your children, siblings, or parents will distribute your assets as you would have wanted.

When there's money involved, infighting among family members becomes a sport. Think Roman gladiators. Having a will and letting people know where it's stored doesn't guarantee that relatives won't go to battle, but it might prevent a costly all-out war.

Remember what Aretha put her family through. Plan ahead. Write a will.

Don't leave Earth without it. Please go to our webpage for this week's recipe for brownie cookies and additional resources for this program. Everyone Dies is offered at no cost, but folks, it's not free to produce.

Please contribute what you can. Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone. You can also donate at www.everyonedies.org or at our site on patreon www.patreon.com and search for Everyone Dies.

Marianne? Thank you, Charlie. That was really interesting. Falls are the topic of our second half.

Falls are a leading cause of bone breaks and brain injuries for people over age 65 living in the United States, which is more than 14 million elders or about one in every four people or about one in four people who fall each year. For older adults, falls are common, costly, and preventable. According to the CDC, about 37% of older people who have fallen have an injury that required medical treatment or activity restrictions.

95% of hip fractures result from a fall, and falls also are the most common cause of traumatic brain injuries. A fall is defined as an event that occurs when a person accidentally drops down to the ground or another lower level. Sometimes a body part strikes again an object that breaks the fall and may break your bones at the same time.

Many older adults are hesitant to report a fall because they think falling is a normal part of the aging process. It's not. Or because they fear being restricted in their activities or institutionalization, which is a very real consequence of a fall.

When falls are not reported and preventative measures are not taken, people are at risk at falling again. The most consistent predictor of falling is a previous fall. But falls rarely have a single cause or risk factor.

A fall is usually caused by a complex interaction among the following. So the first is called intrinsic factors. These are risk factors related to how our bodies are functioning, like age-related decline in function, like loss of muscle, decreased physical exercise, decreased reflexes, dementia, loss of balance, and the side effects of medications.

The risk of falls increases with the number of medications that we take. The second factor is what's called extrinsic factors. And these are environmental hazards.

Environmental factors can increase the risk of falls independently, or more importantly, by interacting with intrinsic factors. Risk is highest when the environment requires greater postural control and mobility. For example, when walking on a slippery surface and when the environment is unfamiliar.

Like if you're relocated to a new home or even say staying somewhere unfamiliar and you get up to go to the bathroom by road and end up falling down the stairs because you go to where the bathroom is in your house, but it's different in someone else's house. And I say that as an example because I know of a case where that happened. It's not funny at all.

So those are extrinsic factors. The third is called situational factors. And these are factors related to the specific activity or circumstances of an activity.

For example, certain activities or decisions may increase the risk of falls and fall-related injuries. Examples of this are walking while talking. Now, you might say to yourself, well, for Christ's sake, I can walk and talk at the same time.

Well, maybe you could when you were younger because your body was in a fitter shape, maybe had more muscle. But as we get older, and I know you're going to think I'm out of my mind, but this is true and there's research data to back this up, you need to pay attention to what you're doing when you're walking. So you might have a walking buddy and you guys are, you know, yammering away with each other and you don't notice that there's a, you know, a hole in the ground, a rock on the road.

And you say, a rock on the road. Listen, I have fallen on rocks. I've stepped, my foot went off balance, and I have fallen.

Now, maybe I'm particularly clumsy. I don't know. But there are things that, you know, if you're chatting away with someone, you're not going to notice.

So I would strongly encourage you to, if you're walking, walk, if you're talking, talk, and don't do the two things at the same time. And maybe not chew gum either. Another is being distracted by multitasking and not noticing an environmental hazard like a curb or a step.

Yes, I've missed steps and fallen because I was, once I did that, I was carrying stuff in my hands. I think my brain was concerned about having the stuff in my hands and I missed a step and it was not a good fall. It was a real mess.

I mean, because I spilled everything everywhere. Another is rushing to the bathroom, especially at night and when not fully awake or when lighting may not be, where lighting may be inadequate. So you can fix this like right up front.

I have lights that are battery operated that you can stick or screw onto the wall that are off except when you walk by, there's a sensor and it turns on. And I have them in the path to the bathroom. No, I've never fallen going to the bathroom, knock on wood.

But if you don't have good lighting and somebody's left their shoes in the middle of the way between your bed and the toilet and you fall over them, not only will you curse whoever left those shoes, but you could really hurt yourself. So in the first place, I mean, I, you know, I hate that I get everything on Amazon, but I got them on Amazon. These really great little lights.

I put them along the baseboard, you know, sort of like landing a plane between the bed and the toilet and they just turn on bling, bling, bling, bling. I have one like right next to the toilet too. And because I don't want not being able to see something to be the reason that I or David fall.

The rushing to the bathroom part. Here's the thing. When we're young, we can rush to the bathroom and make it and be fine.

As we get older, though, in our head, we're, we still have the timing of when we were 30. We say, yeah, I feel the need to go to the bathroom, but I got at least another 15, 20 minutes before I have to get there. The reality is, is that even though your brain is 30, your body is still whatever age it is on your birthday.

And if you try to rush to the bathroom and you get to that point where, oh my God, I really got to go. You could end up falling and then not only have you fallen, but whatever you were going to the bathroom to do maybe in your pants. So the message to that is when you get the urge to do whatever get up and go.

Don't wait because it could really cause a problem. Another is rushing to answer the phone. Now some of you might be really good.

You keep your phone in your pocket. That's really great. Especially if you fall, then you've got your phone in your pocket and you call somebody.

If you're like me, you put your phone somewhere and you a couple times a day at least say, David, would you call my phone? I can't find it because it's somewhere. God knows where. Or you hear it ringing and you say, oh, where is it? And you start rushing around looking for it because for some reason you feel that you need to answer that robo call.

So, A, don't rush around answering the phone. If you've got a pocket, put it in your pocket. Or one thing that I do is that the people that I care about have their own ringtone.

So when I hear if a certain song plays, I know who's calling and I could decide if I'm rushing. If it's anybody else, they just have the generic ringtone and they can leave a message. That's what it's there for.

Another is not paying attention to where your pet is laying and tripping on them. I had a black dog for many, many years and in the night, either David or I would trip on him as we would go to the bathroom because we couldn't see him. I need to put one of the, should put a sticky light on him so he would light up.

But I have, I personally know way too many people to count who have tripped over dogs, ended up with broken hips, nearly dying. I have one friend who was out walking her dog with her mom. Mom tripped on the leash of the dog, fell, hit her head, and died.

So I'm not making up these stories. I'm just not that creative. Your pet, as much as we love them, are a trip hazard.

Because inevitably, wherever you are, they are and they're under your feet. And so you need to, before you turn around or you go to move, you need to identify where's the dog, where's the cat, or the guinea pig, or whatever it is that you have. Dementia can worsen many of these hazard situations that lead to falls.

Impaired cognition, judgment, and hazard awareness can cause older adults to become distracted, rush, and not notice environmental hazards, significantly increasing fall risks. So what can you do to prevent a fall? We have lots of references for you in the show notes. You probably know these things, but I'm going to tell you anyway.

One standard suggestion includes fall-proofing your home space, making sure that all stairs have handrails, they're well lit, eliminating most throw rugs, and keeping walk spaces clutter-free. And actually, I gave you a reference for a room-by-room list in the show notes to fall-proof your home. Second, you know I'm a nag about footwear.

Choose the right footwear. Make sure that the shoe that you put on fully supports your feet. Wear non-skid, rubber-soled, low-heeled shoes.

Don't walk on stairs or floors in socks or in shoes and slippers with smooth soles. You can slip. And I know you say, I've been wearing these shoes for the last 40 years and I've never fallen.

Yeah, and you were younger 40 years ago. And you know, you might use a new product on your floor. Let me tell you, stuff happens.

Put shoes on. Put your shoes on whenever you're out of bed. The third is careful management of medications, especially those that can cause dizziness and confusion.

And what you need to do is, if your health care practitioner is suggesting that you go on a new medication and you say, okay, I agree. That's what I need. You need to ask the question, is this going to cause dizziness? Is this going to cause confusion? Is this anyway going to potentially lead to a fall? Just ask.

They'll tell you. Be sure that you have regular vision and hearing checks. Even small changes in sight and hearing are linked to an increased risk for falls.

When you get new eyeglasses or contact lenses, take time to get used to them. I've had so many times when I wore glasses that I'd get a new pair of glasses and I'd walk out from the office and there was a step down into the parking area. And I would force myself to stop and look at that step because I was having trouble seeing.

My brain was saying, what's this? This is something new that I'm trying to look through. And I wasn't used to it. And I don't know how many people fell off that curb, but I could see it as a great fall risk.

Wear glasses or contact as your doctor advises. If you have a hearing aid, be sure it fits well and wear it. A lot of people don't wear their glasses for whatever reason.

And if you can't see it, you can't avoid it. So be sure that you're able to see. The next thing is to stay as active as possible.

The World Health Organization recommends that adults undertake 150 to 300 minutes a week of moderate intensity aerobic activity, which can help prevent falls. Now, it's a lot because I kind of did the numbers in my calculator and I thought, oh my God, if that's, you know, being on a treadmill, that's a lot of time. But according to this recommendation, all physical activity counts and can be done as part of work, sport, leisure, or transport, meaning walking, wheeling, cycling, and household tasks.

So all activity counts. Physical activity is anything that's moving your body. Older adults should also include activities involving balance and coordination, as well as muscle strengthening to help prevent falls.

Now, when your muscles are weak and you start to fall, you can't stop yourself and you just end up on the ground. I had two years of a disintegrated ankle, probably heard me talk that I had my ankle actually replaced recently. And in the period, in those two years, I fell a lot.

And it frightened me because I know the risks of falls and I was afraid I was going to break something. But again, knock on wood, I never broke anything. But because that ankle was disintegrated, if I started to go over, I just went over like a tree.

There was no way to stop because I didn't have, because my ankle was severely compromised. Now I'm in PT and going to the gym and doing all that other stuff. And I can feel the difference in terms of being able to check and balance because I have a brand new ankle, it's strong, and I can stop something that like if I run into something or trip on one of the dogs, I can stop and prevent myself from falling.

So that's where that balance and coordination comes in. Weight training can also prevent premature death according to a study by Shalindera and colleagues. A 15-minute weight training routine using common gym equipment will build strength at any age.

And all of these machines can be found at any gym. And you might have heard me before talk about, I joined a senior center, health center, and it just was built probably maybe a year ago. And every one of these machines that I'm talking about, these are exactly the machines that they have in there.

So I'm thinking, I'd like to think that they looked at the research and made sure that these were the ones that were in there. But they also have free weights and all that other stuff. But this routine literally takes 15 minutes.

It builds every muscle and challenges every muscle in your body and can help prevent falls. And there's a link, so you can go and look at this whole thing. What they want you to do is complete each exercise slowly and smoothly, lifting the weight for 10 seconds and lowering for another 10 seconds.

Now, I watched the other people lifting, and some people do it this way. Many people just go, and they're not stretching the muscle and challenging the muscle, which is what you're supposed to do. You need to do it slowly.

You need, as you're lifting the muscle, as you're lifting the weight, you can do that a little faster. But then as you come down with the weight, that's where you do it really, really slow to challenge that muscle. And you repeat this until you can't lift again.

All facilities have some sort of trainer, so if you're not sure how to use the machine, just ask them. They're happy to help you. So the machines that you want to use are the chest press.

I'm going to give you the list, and you can replay this and write them down if you want. Or you can look at the article that's in your show notes. So the machines you want to use are the chest press, the pull down, the leg press, the abdominal flexion, back extension, and the hip adduction and abduction.

In a study by Steele, it was found that during the first year of lifting, most people's strength grew by about 30 to 50 percent based on the weights that they could manage during each workout. 30 to 50 percent in a year, that's really good, and that's going to make a difference for all aspects of your health, including whether or not you fall. You know, Charlie, Elvis can't help falling in love with us, but we can manage our risk of falling down.

Falling is more than a bruise to our dignity. They can lead to disability, bone breaks, brain bleeds, loss of independence, and premature death. When I've cared for people who have fallen, most of the time the fall is a result of a choice related to our wanting to prove that we could still do something for ourselves, and it can appear after the fact to be a truly dumb decision to have been made.

And I don't mean dumb dumb, but it's like we're all gonna die, yeah, but you don't want people standing around at your funeral saying, did you hear what she did? And then she fell, and now she's dead. Is that like the dumbest thing you ever heard? Like I don't want people saying that. I want them to eat those really good chocolate cookies, say how good I look, and you know, say isn't it wonderful that she lived to 220 or whatever odd age I lived to.

So we talk about dumb ways to fall. For example, I had an elder neighbor when I lived in New Hampshire who would crawl on the roof in the winter to scrape off the ice. He wasn't stable on dry land, let alone on an icy roof.

I had an aunt who would crawl on a stepladder to dust the knickknacks on her upper shelves. When she fell off the ladder, I couldn't help but wonder if her resulting loss of independence was worth the dusting that she was doing. I know in my head I'm more flexible and stable than what I actually am, and I regularly ask myself if crawling up on a chair or ladder is worth the potential of a fall and all that goes with it.

And I frequently decide it is not. Or I decide that although it's quicker to crawl on a chair to reach a high spot, I force myself to get my stable ladder with handles to hold on to to do what I've decided to do. And I literally went, I think I went to Lowe's so I could look at the ladders and kind of stand on them and picked out one that it folds completely flat when it's put away.

But when it opens, the steps are nice and wide so that I feel like I'm on a firm platform. It's only maybe about four or five steps tall, but all along the side and across the top there's a railing that I can hold on to so that I feel stable. I can have my hand on something while I'm doing whatever with my other hand.

So I force myself to get that ladder out and hold on to it while I'm working. It takes more time to get it out and put it away, but nothing compared to the time it may take to recover from a broken bone, physical therapy, and whatever else could happen because I was in a hurry. It's really about the choices we make, so please make good ones.

Charlie, thoughts or questions? Well, like Betty Davis said, old age ain't no place for sissies. Yeah. Yeah, that happened with the falls and everything with both my mother and father.

And then with my father, ultimately, yeah, he just could not wrap his head around the fact that he was not able to walk anymore. And then he said to me, that's it, I'm out. And I know what he meant.

And 10 days later, he was dead. Yeah, he just shut down. It was a peaceful death, but still, it was just, yeah, I was listening to you.

The streets, there's so many sidewalks around New York, which are uneven. A little piece of cement is jutting out because there's a tree nearby, and the roots have pushed up. I always have to be careful with that.

And if I am daydreaming or thinking about something else, I have tripped a couple of times. One time, I actually fell. Yeah, I can't be daydreaming anymore.

My reaction time is just not as fast as it used to be. Well, you can still daydream. You just can't daydream and walk at the same time.

That's what I'm saying. I'm just talking about walking. Of course, I daydream a lot, which is good.

You just need to be aware of your surroundings. And as you say, to exercise, even just some simple activity, but you gotta move. Be careful when you move.

You've got to move it, move it. Yeah. Okay.

And we have a podcast about that. Oh, that's right, yeah. Sam, you'll put that in the show notes, so if you need more information about exercise, we do have a podcast about that.

Okay. In our third half, in Cahil Cabram's poem, Fear, the river serves as a metaphor for the human experience of facing fears and embracing transformation. The river, on the verge of entering the vast ocean, hesitates and reflects upon its journey thus far.

The path it has traveled with its challenges and beauty is now behind. Going back is not an option, for there is no retreat in the journey of life. To move forward, the river must confront its fear and dive into the unknown.

Through this courageous act, fear dissolves and the river realizes that it is not about disappearing, but about embracing its true essence and merging with something greater, the vastness of the ocean. This poem reminds us that fear can be transcended when we have the courage to embrace change and become part of something more significant than ourselves, fear. It is said that before entering the sea, a river trembles with fear.

She looks back at the path she has traveled from the peaks of the mountains, the long winding road crossing forests and villages, and in front of her, she sees an ocean so fast that to enter there seems nothing more than to disappear forever. But there is no other way. The river cannot go back.

Nobody can go back. To go back is impossible in existence. The river needs to take the risk of entering the ocean, because only then will fear disappear, because that's where the river will know it's not about disappearing into the ocean, but of becoming the ocean.

And that's it for this episode of Everyone Dies. Thanks for listening. Tell your friends.

This is Charlie Navarette, and from musician Moby, ultimately we die and are returned to this universe. So why are we so worried about likes on Instagram, gray hair, and flabby stomachs? We should have a little more lightness of being. And I'm Marianne Matzo, and we'll see you next week.

Remember, every day is a gift. your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies, or by other members is solely at your own risk.