In the wake of former Senator Joseph I. Lieberman’s death March 27 at age 82 due to complications from a fall, we wanted to share these resources to help clinicians identify patients at risk of falls solutions to help them mitigate their risk.
Prevalence of Falls
Unfortunately, the probability of a fall increases with age, with literally millions of people 65 and older falling each year. According to the CDC:
- 20% of falls cause a serious injury, like a broken bone or head injury.
- Each year, 3 million older people visit the emergency department for fall injuries, and more than 800,000 patients are hospitalized because of a fall injury.
- More than 95% of hip fractures are caused by a fall, usually falling sideways.
- Falls are the most common cause of traumatic brain injury.
- Falling once doubles your chances of having a subsequent fall.
- In 2015, medical costs for falls totaled more than $50 billion, with Medicare and Medicaid shouldering 75% of the cost.
Risk Factors
Research has helped us identify many conditions that can increase an individual’s risk of a fall:
- Age 65 or older
- A vitamin D deficiency
- Osteoporosis/osteopenia
- Cognitive impairment
- General arthritis, particularly in the foot, knee, or hip
- Difficulties with walking or balance
- Vision problems
- Household hazards (throw rugs, stairs, clutter, pets)
- Use of medications: psychotropics (e.g., antidepressants, antipsychotics, anti-anxiety), antihistamines, muscle relaxants, and blood pressure medications (creating hypotension).
Reducing Your Risk
Fortunately, there are ways you can reduce your risk of a fall for yourself or a family member:
- Ask your doctor for a Fall Risk Assessment
- Strengthen your muscles, particularly your quadriceps—Physical Therapy can help with this
- Improve your balance—Tai Chi is an excellent exercise for balance
- Have your eyes checked annually and be sure to update your glasses as needed
- Eliminate home hazards
- Remove items you can trip over, like rugs or clutter
- Add grab bars by your bathtub and next to the toilet
- Add and/or use stair railings both inside and outside the house
- Make sure your home is well-lit, and make use of nightlights
Resources for Clinicians
The CDC has created STEADI (Stopping Elderly Accidents, Deaths & Injuries), a program to help clinicians reduce fall risk for elderly patients. Resources include:
- An algorithm for fall risk screening, assessment, and intervention
- A pocket guide for preventing falls in older patients
- Several functional assessments, including muscle strength and balance
- Guidelines for managing medications linked to falls
- Resources on fall prevention to share with your patients and their family members
Click here to learn more. STEADI – Older Adult Fall Prevention | CDC
Other resources include:
- Your facility’s rehab department and pharmacy consultant
- The AMDA/PALTC website – the only national medical society that represents and supports clinical leaders and related professionals who work in post-acute settings
- The Falls Dashboard compiled by the Agency for Healthcare Research and Quality (AHRQ)
- Preventing Falls in Hospitalized Patients: State of the Science
- Optimizing Post-acute Care Patient Safety: A scoping review of multifactorial fall prevention interventions for older adults
Summary
As our population continues to age, it’s critical for clinicians as well as at-risk individuals and their families to recognize and mitigate the risk factors of falls. Fortunately, research demonstrates the risk of falling can be reduced through educating both clinicians and patients, conducting fall risk assessments, and taking appropriate action steps to minimize risk.