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Falls among older adults are both costly and preventable. Each year over one third of people over 65 fall and the numbers rise with age. Comparisons of national average with the CDC posted in 2018 put Colorado in the 20% percentage compared to 28.8% in other states. The reported result total was about 36 million falls of which 37% reported injury that required medical treatment. That total was 8 million fall injuries nationwide that year.

While not all falls result in an injury, about 37% of those who fall reported an injury that required medical treatment or restricted their activity for at least one day, resulting in an estimated 8 million fall injuries(1).

CDC data confirms that ”Falls among adults age 65 and older are very costly. Each year about $50 billion is spent on medical costs related to non-fatal fall injuries and $754 million is spent related to fatal falls. Non-fatal falls with $29 billion is paid by Medicare-$12 billion is paid by private or out-of-pocket payers-$9 billion is paid by Medicaid.
As the number of Americans age 65 and older grows, we can expect the number of fall injuries and the cost to treat these injuries to soar.”

Osteoporosis is a Major Falls Factor

Since we now know the soaring costs of falls, we need to understand how to prevent them because they can seriously impact independence, resulting in disability, changes in lifestyle, reduced activity and as a result social isolation and death. That underscores the importance of prevention that can be tied in with a number of risk factors.
In a discussion of falls prevention, the Osteoporosis Foundation health professionals talked about the huge impact with those suffering from osteoporosis and injuries incurred when a hip fracture becomes a serious complication. “Among people who survive surgical intervention for an osteoporotic hip fracture, only one-third are restored to their former physical status(2)”

Facts point to reducing the risk of falls if possible and that it is one of the many lifestyle measures that can make a big positive difference in improving and maintaining bone health. Preventing falls by exercising and home safety interventions has been shown to reduce the risk of falls (3).

Existing Medical Hazards

• Impaired balance, mobility and gait
• Muscle weakness
• Impaired vision (decreased visual acuity)
• Decreased sensory perception of the lower extremities
• Blackouts and impaired cognition
• Chronic diseases such as neurological disorders, heart diseases and stroke
• Kyphosis (also known Dowager’s Hump)
• Slow walking speed
• Use of medications that can cause dizziness and drowsiness (antidepressants or sedatives)
• Multiple drug therapies.

Prevention is the Key

A Fall Prevention guide is readily available at the CDC website. This “how-to” guide is designed for community-based organizations interested in implementing evidence-based fall prevention programs. The guide is a practical and useful tool, and provides guidelines on program planning, development, implementation, and evaluation.

The Osteoporosis Foundation published the six steps to prevent falls on their website, see below.

SIX STEPS TO PREVENT FALLS
1. Fall-proof homes by removing hazards, installing grab bars and using extra lighting.
2. Doing regular, suitable weight-bearing and muscle strengthening exercises, alongside exercises to improve balance. Read more about exercise.
3. Keeping glasses clean and in good repair, being careful on stairs if wearing bifocals, and wearing sunglasses on bright days to reduce glare.
4. Wearing comfortable shoes with good support, a broad heel and non-slip soles.
5. Maintaining a healthy diet that includes fresh fruit, vegetables and calcium-rich foods. Read more about nutrition.
6. Asking the patient about previous falls, if any, if they have any dizziness and monitor medications and their potential side effects. Prescription medications can contribute to falling, particularly if taking three or more.

THE FALL-PROOFED HOME
Floors
• Removing objects that can cause a person to trip, such as throw rugs, electrical cords and clutter
• Ensuring mats are firmly affixed and repairing loose carpet or raised areas in the floor
• Moving furniture out of walking paths and being aware of raised doorways
Bathrooms
• Installing handrails
• Installing non-skid mats in the toilet, bath or shower
Lighting
• Keeping an apartment or house well lit, especially in hallways, stairways, porches and outside walkways
• Adding extra light switches or using remote switches such as motion sensors
Kitchen
• Using non-skid floor wax and wiping up spills immediately
• Keeping regularly used kitchen items at an easy-to-reach level
Stairs
• Checking handrails are sturdy and secure

Goldleaf Home Health provides a complimentary in home assessment, acknowledging warning signs from loved ones, that there is a need for additional care and support. Our Elder Care Services ensures that all of our clients are able to live safely at home and participate in their communities with comfort and independence.

1.Moreland B, Kakara R, Henry A. Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:875–881 DOI: http://dx.doi.org/10.15585/mmwr.mm6927a5external icon                                                                                                                                                                                                                                                             
2-Greendale, G.A., et al., Late physical and functional effects of osteoporotic fracture in women: the Rancho Bernardo Study. J Am Geriatr Soc, 1995. 43(9): p. 955-61
                                                                           
3-Compston, J., et al., UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos, 2017. 12(1): p. 43.

*Image by Gerd Altmann from Pixabay