One in every four American seniors will experience a fall this year. Every 11 seconds a senior receives emergency room treatment for a fall-related injury, and every 19 minutes a senior dies from a fall-related injury. Falls are the leading cause of injuries in people over the age of 65, including both fatal and non-fatal outcomes.
According to the National Council on Aging, one of the greatest burdens to the senior health care industry is the cost of caring for seniors after a fall. Advances in medical care allow seniors to live longer, but this has also resulted in an increase in the fall rate. In 2017, Medicare costs associated with falls were over $31 billion, and the CDC estimates that the cost in 2020 will increase to more than $52 billion.
Bone injuries are the most common injuries resulting from falls, with fractures and breaks accounting for approximately 61% of the cost of non-fatal falls. In fact, one in four seniors with hip fractures will incur nursing home stays of at least one year. In fatal falls, traumatic brain injuries account for 46% of all fatalities, putting an added burden on hospitals, caregivers, and the overall cost of health care.
When an older adult falls, their bones are not able to absorb and cushion the fall. This leads to fractures, breaks, soft tissue injuries and head injuries. However, the Council suggests that falls are preventable. To reduce the risk of fall, adults over age 50 must take action today to reduce their chance of falls as they age. One way to reduce the risk of falls is to participate in evidence-based fall prevention programs that offer interventions to reduce or eliminate the risk factors associated with falls.
Fall Prevention Exercise Program
One such program, Moving for Better Balance, is a training regimen to help people at risk for falls, including those with balance disorders. The program uses aspects of activity historically used in martial arts. Several studies have shown that this type of activity is also helpful for people diagnosed with Parkinson’s disease or other neurodegenerative movement disorders. In 2016, the American Journal of Public Health released a study regarding the implementation of fall prevention intervention in community senior centers. The results showed a 49% reduction in the number of falls, as well as improved physical performance in participants. This is also a cost effective way to reduce falls, since many senior centers offer similar classes at no or low cost to seniors. Additional programs include Stepping On and Tai Chi. To find out what programs are available in your area, contact the Agency on Aging in your area.
Older Americans can also reduce the risk of falls by making simple changes to their environment. Rebecca Hohsfield, a pre-med graduate of the University of New Mexico suggests that seniors and their caregivers refer to the National Council on Aging Fall Prevention Checklist to review potential risks that may be present in the home.
Several common household items that pose a large risk factor for falls include throw rugs, electrical cords, and animal items, such as toys and bowls. Some fall risks may require a handyman to make repairs, such as in the case of torn carpet or flooring. Railings should also be tested to ensure they are secure to the wall and floor.
Adequate lighting in every room of the house is also important. Replace bulbs as needed and make sure there is a small bedside lamp in the bedroom that can be turned off without overextension after the overhead light has been turned off.
Hohsfield recommends that items be placed within easy reach to avoid loss of balance when reaching or bending. She also recommends that seniors avoid step stools or ladders. Kitchen cooking items and food should be placed so seniors do not have to overextend themselves. Seniors should also avoid carrying heavy pots, and caution should be used when loading or unloading the dishwasher or the washer and dryer.
One of the most overlooked areas of the house are the bathrooms. Restrooms typically pose a threat, not only due to slippery surfaces, but because there is not adequate support for people to sit, stand, or move into or from the tub or shower. Hohsfield urges caregivers to install a grab bar inside the shower, as well as near the toilet, “Seniors should use shower seats with handles while bathing,” she said, “and hand-held showers are now easy to install and more affordable than ever.”
Hohsfield said that while environmental changes are an absolute necessity to reduce the risk of falling, it is also important to review the checklist with your physician and pharmacist, “Your medical team should be notified if you feel dizzy or if you have trouble with balance in order to review your medications. This is especially true if you are on new medication or if your dosage changes,” she said.
Annual Vision Check
Annual physicals are a must, and that includes vision checks, since poor vision can significantly increase the risk of falling.
Hohsfield points out that people need to be aware that their clothing could pose serious fall risk. Seniors should wear shoes with non-slip soles. Women should use caution when wearing long or flowing clothing, as they can get caught on furniture, door handles, or in walkers. Long clothing can also pose a trip hazard.
Alarm devices make many seniors feel more secure, especially if they live alone. The alarms are typically worn as a necklace and can be pushed for help in the event of a fall.
If possible, seniors with balance problems should have sleeping quarters on the same level as the living quarters. Hohsfield encourages seniors to be creative, “Even if your home doesn’t have a bedroom on the main level, many seniors have chosen a dining or living room as their designated bedroom.”
Inactivity caused by recent illness or chronic conditions can contribute to falls. More than 80% of seniors have at least one chronic illness, such as diabetes, arthritis, or stroke. People suffering from one or more condition have been shown to have an increased risk of falling. If you are a caregiver, ask if the person you care for feels afraid of falling. If so, talk with their medical provider about how to help. If you are a senior afraid of falls, ask a loved one or trusted friend to be your advocate when you visit your doctor to help you develop a plan for reducing the risk of falls.
In addition to the above, people who have trouble with balance should avoid rising abruptly and should not carry items while walking. Caregivers should encourage seniors with balance problems to use sturdy walkers to help with walking and to help prevent falls. Many walkers come with small baskets to allow for the transport of small items.
The risk of falling is not something to be taken lightly. If you are a caregiver, don’t be afraid to bring up the subject with your senior. And if you are a senior, make sure you discuss your concerns with people you trust. Together, we can all reduce the risk of falls and help seniors live healthy and secure lives.