This morning, first thing, I brought Joan a Sloth. She held it tightly.

It is possible to reduce the number of falls among the elderly, but nearly impossible to completely prevent them, according to doctors. Joan’s fall is typical of so many.

Falls are the leading cause of injury-related visits to emergency rooms, and the primary cause of accidental deaths over the age of 65. When I go to the doctor, the first question they ever ask me is if I have fallen in the past six months.

I haven’t, but I get the feeling I might one day. Falls now account for 70 per cent of accidental deaths in people 75 or older. More than 90 per cent of hip fractures occur as a result of falls, most occurring in people over 70.

According to the American Family Physician, one-third of community dwelling elderly people and 60 per cent of nursing home residents fall each year.

Elderly people are at the highest risk of falling – increasing age, medication, cognitive impairment, balance difficulties, postural control and what the doctors call “overall physical function.” When somebody falls, there can be all kinds of complications beyond the falling itself.

So when a Mansion resident falls like Joan did, and I ask the staff is she is coming back, they say they don’t know, because they really don’t. Sometimes they do come back, very often they don’t.

If Joan isn’t completely ambulatory, then by federal regulations (the Mansion is a Medicaid facility), then she must go to a nursing home.

Falls are rare at the Mansion, but they inevitably occur.

I went to see Joanie first thing this morning. The flower  vase with the smiley face I ordered was next to her bed, and so was the Teddy Bear I sent. I brought a soft and furry Sloth for her, I think she loved it, and a music box someone can wind up for  her.

Her new shoes are on the floor next to her bed.

Joan can’t read right now because of eye problems, but people will read the letters to here if they come: Joan, 7 South, The Glens Falls Center For Rehabilitation, 152 Sherman Avenue, Glens Falls, N.Y., 12801. Please don’t send any musical or other kinds of equipment, she can’t work them.

The letters are important for the Mansion residents, they let them know they are not forgotten.

Joan has a wonderful spirit about her, she is cheerful and willing to work. The physical therapist helped her stand upright, and I could see that this recovery will be a long haul for her, it was painful and difficult and she could hardly take a step.

It is literally one step at a time.

Joanie isn’t going anywhere for a while. She looks good, she is alert and responsive, but also confused about where she is and what happened.

She has no memory of falling and doesn’t seem to know why she is there. She understands that her leg hurts but doesn’t know why.

Red and I were drafted into make the rounds at the center, and we saw a dozen or so patients, as always, they are so glad to see a dog. I imagine they will be seeing a lot of us while Joan is there.

Joan and I sat together while we and breakfast and we talked in the circular way that she talked. But if you listen to Joan and get to know her, some very clear statements come up.

When she stopped eating, she turned to me and said “I need to see people that I know.” I said she has seen people she knows and more are coming. But it was clear Joan knows where she isn’t, if not precisely where she is or why. She misses the Mansion, it is what she knows.

In the world of memory care, so many live in a kind of cloud, walking somewhat in the dark.

The staff at the Rehab Center is loving and attentive, they are  taking close and good care of her. But still, she is in a hospital bed for much of the day…

At the Mansion, life is unpredictable, and constantly shifting. Joan has a lot of work ahead of her, and will need luck and encouragement. Feel free to write her, I will read the letters to her if all else fails.

Joan and I had a great visit, as always, she cuddled with  Red and I played Beatles music on my Iphone for 20 minutes. We laughed much of the time at one another’s jokes.

There is alway a smile close to the surface with Joan.

Then she had to go to physical therapy, and we had to go. As she was rolled down the hall, she turned in her wheelchair and waved. “Love you,” she shouted. “Love you back,” I said.

Please consider supporting our work with the Mansion residents.

I love the $5 and $10 donations tricking in from all over the country. We are raising money so the Mansion residents can buy inexpensive gifts for their friends and aides.

I have a lot of holiday ideas for the Mansion.

If  you are so inclined, please send your donation to Jon Katz, P.O. Box 205, Cambridge, N.Y., 12816, or via Paypal, [email protected]. Please mark the payment “Mansion” and thanks.

It is so much better to do good than to argue about it.