Every second of every day in the United States an older adult falls.
This makes falls the number one cause of injuries and deaths from injury among older Americans. In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs.
Eighty-seven percent of all fractures in the elderly are due to falls. Two-thirds of those who fall will do so again within six months.
When an older person falls, his or her hospital stays are almost twice as long as those of older patients who are admitted for any other reason. Among people aged 65 to 69, one out of every 200 falls results in a hip fracture.
That number increases to one out of every 10 for those aged 85 and older. One-fourth of seniors who fracture a hip from a fall will die within six months of the injury.
Many falls do not result in injuries, yet 47 percent of non-injured seniors who fall cannot get up without assistance.
Falls, with or without injury, also carry a heavy quality of life impact.
A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in a further physical decline, depression, social isolation, and feelings of helplessness. The most profound effect of falling is the loss of independent living.
Many older patients are resistant to using a cane, let alone a walker. Trying to get them to agree to a home assessment is next to impossible.
To get them to consider wearing an ankle brace is even harder. Patients will take a myriad of medications prescribed by their internist without question but will be so resistant to doing something that will clearly reduce their risk of falling.
The analogy can be made that the prescription for your high blood pressure is a pill, and your prescription for your risk of falling is…”
There are so many things that can be done for patients that are at risk of fall, most of which are covered by insurance/Medicare, why not take advantage? The following are some things that can be done to reduce risk of fall.
Home fall-risk assessment: many healthcare agencies will come in and assess ones home to make suggestions to reduce risk of fall in the home.
Here are some great tips for reducing risk of fall in the home:
Remove obstacles inside and outside of the house that could cause tripping.
Install handrails and lights on staircases, with light switches at the top and bottom of the stairs. Add nonslip treads for bare wooden steps.
Install shower and tub grab bars in the bathroom, around the toilet and the tub.
Place no-slip mats on the shower floor and bathtub.
Secure loose rugs with double-faced tape, tacks, or slip-resistant backing.
Store clothing, dishes, food and other necessities within easy reach.
Make home lighting brighter.
Have vision checked often and regularly.
Have the senior wear sensible shoes. They should be properly fitting, sturdy shoes with nonskid soles.
Consider a PERS (Personal Emergency Response System) unit that will alert others when help is needed.
Physical Therapy: PT is a great tool for patients that are at risk of falling.
Most therapy facilities will now come to the patient’s home which is a great convenience. There are many therapeutic modalities that can reduce one’s risk of fall, and a good therapist that has experience with balance therapy can be a great resource.
Assistive Devices: canes, walkers, orthopedic shoes, braces; these words are often stigmatized in the older population.
Using a cane or walker can make an older patient feel inferior. It is seen as a sign of age and loss of function and independence.
Many of my patients shun the use of an assistive device because they don’t want to give in to father time.
In conclusion, an elderly patient’s risk of fall is the leading cause of mortality in this population. There are so many things that can be done to limit such risk.
Information provided by David J. Sands, DPM, www.sandspodiatry.com.
