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Falls, leading cause of fatal, non-fatal injuries

posted Sep 26, 2017, 10:42 AM by Wayne Wieseler   [ updated Sep 26, 2017, 11:26 AM ]

Falls are the leading cause of fatal and non-fatal injuries for older Americans, according to the National Council on Aging. Falls threaten seniors' safety and independence and generate enormous economic and personal costs.

However, falling is not an inevitable result of aging. Through practical lifestyle adjustments, evidence-based falls prevention programs, and clinical-community partnerships, the number of falls among seniors can be substantially reduced.

Falls are a challenge

According to the U.S. Centers for Disease Control and Prevention:

  • One-fourth of Americans aged 65+ falls each year.
  • Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.
  • Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.
  • Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.

Because fall prevention is such a critical issue, the Sebastopol Area Senior Center has an ongoing Fall Prevention Advisory Committee to develop a community-wide intervention.

What is fall prevention?

Falls are the number one cause of injury, hospital visits due to trauma, and death from an injury among people age 65 and older. It is estimated that one in four older adults fall each year. Falls among older adults is a serious issue, but research has shown that many fall risks can be reduced.

There are many different factors that can increase the risk of falling. These include:

  • Past falls
  • Hazards in the home and community
  • Problems walking
  • Balance problems
  • Weakness
  • Improper footwear • Chronic diseases
  • Multiple medications
  • Poor vision
  • Depression
  • Memory problems
  • Behaviors like rushing

Because there are many different factors that contribute to falls, there are different recommendations for reducing fall risks. These include

Talking with a health professional 
Identify and treat medical problems that might lead to falls. This includes discussing any previous falls with the doctor, reviewing medications with a doctor or pharmacist, and getting vision checked at least once a year.

Getting Regular Physical Activity
Make a plan to have regular physical activity either in a class or at home. The most effective types of activities to reduce fall risk improve balance, strength, flexibility, and endurance.

Being Aware of Safety Hazards in the Home and Community 
This includes looking at the home to identify fall hazards and making changes for safety, also called home modifications. It is also important not to rush and to be aware of fall risks when outside.

Statistics show that:

  • More than 40% of people hospitalized with hip fractures do not return home and are not capable of living independently again;
  • 25% of those who have fallen pass away each year;
  • On average, two older adults die from fall-related injuries every day in California.
Falls can result in hip fractures, head injuries or even death. In many cases, those who have experienced a fall have a hard time recovering and their overall health deteriorates.

In California alone, 1.3 million older adults experience an injury due to falling. A person is more likely to fall if s/he is age 80 or older or if s/he has previously fallen. Over time people may feel unsteady when walking due to changes in physical abilities such as vision, hearing, sensation, and balance. People who become fearful of falling may reduce their involvement in activities. Also, the environment may be designed or arranged in a way that makes a person feel unsafe.

The good news is that with adequate knowledge, falls can be prevented.

How Can We Prevent Falls?

Researchers have identified that the most effective fall prevention programs have many components. First, a person needs to understand what may put them at risk for falling. Some risks can be reduced. Medical providers can help to identify risks and develop a plan. Specific physical activity can target reduce fall risk by increasing balance and mobility skills. Also, changes to the home and community environment can reduce hazards and help support a person in completing daily activities. While this is not a comprehensive list of fall prevention strategies, it’s a good place to start:

Medical Management (Risk Assessment and Follow-up)

The first step is to talk with a health professional about getting a risk assessment for falling. During routine doctor visits, ask the doctor about your risk of falling. Some of the health factors that can contribute to falls are osteoporosis, being over age 80, changes in balance and walking patterns, changes in vision and sensation, and taking multiple medications. Certain medications cause older adults to experience dizziness. Once you have an idea of some of the risks and how you might be affected, you can work with your doctor, other health professionals, and your family to determine what factors can be modified to reduce your risk.

Balance & Mobility (Physical Activity)

Studies show that balance, flexibility, and strength training not only improve and mobility but also reduce the risk of falling. Statistics show that most older adults do not exercise regularly, and 35% of people over the age of 65 do not participate in any leisure physical activity. This lack of exercise only makes it harder for individuals to recover from a fall. Many people are afraid of falling again and reduce their physical activity even more. There are many creative and low-impact forms of physical activity for fall prevention, such as tai chi.

Environmental Modification

The environment can present many hazards. At home older adults are commonly concerned about falling in the bathtub or on steps. In the community, there can be trip hazards such as uneven or cracked sidewalks. By making changes to the home and community environment a person can feel safer and less at risk of falling. For example, the bathroom can be modified by installing grab bars as in the shower or tub, having a place to sit, and having non-slip surfaces. Steps can have handrails, adequate lighting, and a contrast between steps. Community sidewalks in disrepair can be reported to city officials for repair.