September 23rd was Falls Prevention Awareness Day, a day of events designed to promote a razor sharp focus on falls and increase awareness around the severity of falls. But it’s important to encourage your older patients to consider falls prevention every day, not just on one day a year.
Falls prevention is becoming a national priority, with $5 million allocated in the 2014 budget for related initiatives at the Administration for Community Living. Though less than desired by the agency, the funding will provide a starting point for new educational and outreach programs.
With more seniors entering the at-risk age group every year, states have dedicated extensive resources toward tracking the causes of falls and developing strategies to help seniors avoid them altogether. The National Council on Aging (NCOA) provides guidance to states for crafting falls prevention programs that work.
Here is a look at how five states track and address falls prevention at a local level.
In its 2011 Falls Free fact sheet, Alabama reported falls as the leading cause of death for residents over the age of 79. For seniors age 60 and older, the state noted that almost 74 percent of all deaths were caused by falls between 1990 and 1998. With an aging population, these statistics are likely to claim more lives: between 2000 and 2009, the population of seniors age 65 and older had increased 11 percent.
Alabama’s State Capacity Building Injury Surveillance Program established the Injury Advisory Council to compile research and evaluate fall prevention interventions. The Council comprises members from both state and private agencies who are working to prevent senior injuries. Together with the Injury Prevention Division and the Council, the Injury Surveillance Program will develop a Statewide Injury Prevention Plan.
California has the largest 65+ population of any US state at 4.2 million. The oldest segment of seniors, those over age 85, is growing faster than any other age group in the state. Matching national averages, about one in three seniors experience a fall — which in California totals 1.3 million falls per year. Since each fall-related hospital stay results in an average cost of $30,000, California’s seniors are vulnerable not only to the physical consequences of a fall, but also for serious financial pain and suffering.
Remarkably, though the public is frequently more aware of and more concerned about automobile and pedestrian accidents, California seniors are hospitalized 15 times due to falls for every one hospitalization related to a traffic injury.
Each year, falls cause around 1,700 deaths. But that’s only a small part of the story: According to the California Department of Public Health, 79,000 hospitalizations and 178,000 Emergency Department visits are also noted yearly as due to falls. The result is more than $2 billion in related medical expenses.
California tracked falls resulting in hip fractures and found that greater than 40 percent of seniors suffering this injury were unable to return to independent living, with 25 percent dying from complications within just one year.
Between 2003 and 2011, California moved aggressively to establish falls prevention grants, programs, and training sessions. The state’s 2011 report details more than 50 such initiatives — many of which operate as partnerships with local universities. Here are a few interesting examples from the report:
- The FPCE assembled the statewide StopFalls Network, whose 143 members include AAAs, senior injury programs, adult day health centers, and other community service providers.
- California facilitated the development of “11 fall prevention coalitions and 6 program expansion projects across California that strengthened the fall prevention infrastructure in their communities.”
- The Center of Successful Aging at CSU Fullterton created and publicized such fall risk reduction programs as FallProofTM and InSTEP (Increasing Stability Through Evaluation and Practice).
- A Matter of Balance an AoA-funded group behavior change program was replicated under California’s Department of Aging and the Partners in Care Foundation. This program was designed to increase physical activity and reduce seniors’ fears of falling.
- The pilots of two evidence-based fall prevention programs, Tai Chi: Moving for Better Balance and Stepping On, were implemented with the support of the Centers for Disease Control and Prevention.
- Online certification programs were established for exercise specialists and clinicians (through the Center for Successful Aging), as well as for those interested in home modification (through USC).
According to the 2011 No Get Hurt Hawaii report, 82 Hawaii residents aged 65 and older perish as a result of a fall each year. Almost 1,800 additional seniors are hospitalized due to falls — an incredible number when noting that Hawaii only registers around 470 hospitalizations annually as a consequence of automobile accidents (when including all age groups). Hawaii has seen an almost 19-percent jump in the resident population of seniors, which will further increase the costs of care in the future. From 2006–2010, seniors in Hawaii incurred over $65 million in falls-related expenses. Medicare paid the bill for 92 percent of these charges.
Hawaii’s Injury Prevention and Control Section partnered with other organizations to offer a biennial falls prevention conferences featuring noted speakers and presenters between 2001–2007, with plans to continue the program when the economy improves enough to support it. Additionally, the state implemented a balance and falls risk screening program, while also facilitating a state-wide program through which pharmacists evaluate the falls-related danger of seniors’ medications.
Tai chi is a popular activity for Hawaii’s older residents, and the practice has been shown to reduce falls risk. Hawaii has embraced tai chi for falls prevention as follows:
- Hawaii was able to implement and evaluate a pilot of Dr. Paul Lam’s Tai Chi for Health Institute’s “Tai Chi for Fall Prevention and Arthritis” protocols at the Pohai Nani Residential Care Home and the Leahi State Hospital long-term care facility. The programs’ successes enabled both facilities to conduct Tai Chi for Fall Prevention twice a week with their own certified tai chi instructors.
- Hawaii co-sponsored a series of statewide Take Charge of Your Health workshops, for both AARP members and the public. These nine workshops included fall prevention awareness information for seniors and their caregivers, as well as instruction regarding tai chi for fall prevention.