Hamptons hospital adapts fall-prevention classes for aging Spanish-speaking population 

Marleny Nieto, an immigrant from Colombia, has lived in East Hampton, New York, for decades — working as a hotel housekeeper until her retirement, while raising two daughters. 

The 68-year-old was active until she fell down the stairs and broke one of her vertebrae. Nieto, who lives alone, said that she was so worried about falling again, she became very cautious and barely went out.

But things turned around for her after she signed up for a free class for Spanish speakers on fall prevention at a local church, which has been a big boost for her — she said that her fear has gone, and she’s ready to socialize.

“If someone asks me to go to the movies, I’ll go,” she said during the final class in the series on a recent Tuesday afternoon. “If they say, ‘We’re going to go dancing,’ I’ll dance.”

Nieto was among a small group of Latinos in their 60s and 70s in the eight-week class called “A Matter of Balance,” which has been taught nationally since the late 1990s. The local hospital, Stony Brook Southampton, has been doing it for the last five years. But it didn’t offer the class in Spanish until 2023.

In East Hampton, a quarter of the local population is Latino. Some of those people are now over 65 and don’t speak English well. The health care system is still catching up with their needs — offering classes like these and language translation services at doctors’ offices. 

Sarah Cohen is with the Center for Parkinson’s Disease at Stony Brook Southampton Hospital. She teaches “A Matter of Balance” in English. She said that last year, she and her colleagues got some extra funding to expand the program to Spanish speakers. That turned out to be a bit more challenging than they expected.

“We’ve learned a lot. It’s not just translating your flyers into Spanish,” she said. “I wish it were that easy, but it’s not.”

The hospital partnered with a local advocacy group, OLA of Eastern Long Island, which was already familiar to many Latinos in the area. OLA staff spent days going into local churches and senior centers, Cohen said, “to explain the importance of these evidence-based, fall-prevention programs, to get buy-in and trust from the Latino community, as well.”

Cohen and a colleague trained two of OLA’s employees — Wally Ramirez and Alma Tovar — so they could teach the program themselves, in Spanish.

Ramirez said that since so many in the area are Latino, she appreciates it when any services are offered in Spanish, including by non-native speakers.

“But I think it makes it extra special when it’s a fellow Latina or Latino because you can connect in a different way,” she said. “You relate to the way they grew up, to the foods that they eat — and you know, the Latino community, we’re all about the food — so, it just makes the connection a little bit more intimate.”

You can feel that intimacy during the class, where there were plenty of jokes and laughter during the exercises and — speaking of food — a break for a special celebratory lunch. On her way to class, Ramirez had stopped off and bought beef empanadas and sancocho, a brothy soup with beef, corn, yuca and potatoes, for everyone to share.

Several participants gushed about how grateful they were for their teachers’ patience, for helping them increase their confidence and decrease their fear of falling. 

The class covered everything from basic tips like wearing weather-appropriate shoes, and not having rugs that are easy to trip over, to ways to maintain balance. Everyone does exercises each time to help increase their physical stamina and build flexibility so that they’re less likely to fall. They also learn how to manage their concerns about falling.

But these classes haven’t just been about imparting information. The weekly sessions have provided an opportunity for the instructors and students to bond. They all share a language, and nearly everyone here is a first-generation immigrant from South or Central America. 

During the recent class, several participants shared their gratitude for the experience.

Student Zara Chuya began to cry as she said her two teachers would always be in her heart.

“May God bless you,” she said in Spanish. “You just never know who will come into your life … I’ll have wonderful memories of this time.”

Chuya added that she feels three years younger than she did before the class began, and said that she plans to teach what she’s learned to her own 86-year-old mother back in Ecuador. 

This fall-prevention class is what the medical world describes as culturally competent care. 

Fernando Torres-Gil is a professor emeritus at UCLA who has advised various administrations on aging policy. He said that this type of care, where language and culture are shared and understood, is vital to immigrants “because that way, they’ll age healthier and be less of an economic health burden on the community.”

But he’s concerned that it may be difficult to fund these programs in the next few years, given the incoming administration’s attitude toward immigrants and migrants.

“That’s going to make it very hard to provide culturally competent care,” he said, “because in many communities, the nativist, anti-immigrant sentiments are going to translate to, ‘Why doesn’t everybody speak English?’”

Some in this class in East Hampton do speak English. Salvador Ceron has lived in the US since the 1970s. But he said that if he had taken this class in English, he’d have missed a lot of the details. 

His job was in construction, and he has suffered from vertigo over the years. He said that until recently, “In the morning, I’d often feel a little dizzy … not much, but still, I was worried.”

But after regularly doing the balance exercises he’s learned during this class, that feeling has gone away, and he’s delighted. 

Ramirez said that one of the best things about teaching the class has been seeing how it provides an opportunity for these older adults to make friends. Some of them don’t have access to a car and need to be picked up and brought to class each week. 

“They may go for a walk but that’s not socializing,” she said. “And that’s another big aspect of these workshops is bringing people together. … It makes them feel good. That’s super important, to be with other people and not isolated.”

As the final class wrapped up, Ramirez and Tovar presented the students with certificates of completion, and everyone posed for photographs. There were hugs and farewells and promises to meet up. Then, the students headed up the stairs, out of the church basement and into the sunshine of an early winter day.

This story was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The John A. Hartford Foundation.