The People's Perspective on Medicine

Don’t Fall!

Just slightly late but always topical, in honor of National Falls Prevention Awareness Day,  September 23, 2015, we offer this by our colleague Bernadette Keefe, MD.

Take a Stand to Prevent Falls

“One of every three older adults falls each year, but less than half talk to their healthcare providers about it.” – Lawrence Z. Rubenstein MD, MPH, Chair of Geriatrics at the University of Oklahoma Health Sciences Center

Introduction

On September 23, 2015, the U.S. celebrated the 8th Annual Falls Prevention Awareness Day.The announcement on the National Council for Aging (NCOA) Falls Prevention Day website reads:

“The 8th annual Falls Prevention Awareness Day (FPAD) will be observed on September 23, 2015 – the first day of fall. The event seeks to raise awareness about how to prevent fall – related injuries among older adults. The 2015 theme is Take A Stand to Prevent Falls and the official twitter hashtag for this year’s event is #FPAD15 “

Dr. Robert Glatter wrote an excellent piece in Forbes this year, “Why Falls Should Be Part of The Doctor-Patient And National Conversation for Older Persons.” In the piece he highlighted the shocking falls statistics in the U.S.:

  • one third of older adults over the age of 65 fall each year
  • 2 million older adults present to the emergency department (ED) because of falls each year
  • …over 700,000 of whom are hospitalized ( costing over $30 billion )
  • CDC data for 2013: 2.5 million non- fatal falls treated in ED
  • CDC data for 2013: 25,000 older adults died as direct result of a fall
  • I highly recommend his entire article as an introduction to this topic.

All of the above statistics have sharply worsened over the past 10 years (partly due to increased awareness of reporting and increased longevity). In fact, people under 65 years old are falling with more frequency as well. Alcohol, medication and decreased fitness are key factors here. A recent falls prevention awareness campaign infographic highlighted this by addressing its message to the over age 55 population!
Risk factors for falling at any age include:

  • altered perception/coordination due to alcohol or drugs/medications
  • decreased visual acuity
  • poor fitness
  • hazards in the built environment around us
  • distraction (ie walking while texting etc)

KEY Consequences of Falls to Patients/People

Injury, even death.

Fear of falling again also affects quality of life, mobility, ability to socialize. There is, additionally, a ‘downhill” spiraling effect: If You Think You’ll Fall – You Will!

Resources for Falls Prevention Strategies

There are numerous trusted sources for Falls Prevention Strategies. Please see the reference list below to get informed on some of what is available. Please talk to your physician or geriatrician about any questions or worries.

Technology for Falls Prevention

The aging demographic (over age 65) will comprise 77 million American adults by 2030. (The boomers aren’t babies any more.) Almost for this reason alone, numerous technologies have been released or are in development to make aging in general safer and aging-in-place a reality.

From personal sensors (on the body, in shoes, etc.) to home sensors (to monitor movement) to bed sensors to completely wired /sensored living environments for aging – the innovation is robust. However, most sensors at this point are focused on falls detection. What we are in desperate need of is technology to assist with falls prevention.

Falls prevention technologies are available to the athlete in the form of extensive gait analysis, balance and foot strike assessment. My hope is that this technology will filter over to mainstream applications, in the “ordinary” patient. The consequences of falling are too serious not to offer the best technologies to all people.

Please see the category: Aging in place, Active Aging: Technology, Startups, Hackathons in the reference list below for more information about this vibrant and essential innovation space.

Conclusion

Falls over the age of 55 are common, and over the age of 65 become a serious, deadly problem.

Take steps now to avoid falling yourself! Take steps now to prevent falls in your loved ones. (Use the upcoming holidays to take a walk through ALL of the house, including the garage. Remove the hazards you find, arrange for the installation of banisters or grab bars where they would be helpful, etc.)

‘Have The Conversation’ with a trusted healthcare professional (physician etc) if you or your loved one fears falling or has fallen.

Raise awareness about our national Falls Prevention Day – the first day of fall every year.

Get involved in local governance regarding the built environment and pedestrian safety. This is not just relevant for older people. Strollers, toddlers, multi-generational families, young & older persons with physical limitations, people on walkers, using canes, in wheelchairs all benefit from attention to access. Be aware of access issues for them and hazards.

Peruse the references below & keep handy at home for Falls Prevention!

References:

Falls Prevention Awareness

Falls Prevention 2015 

Get Ready for Falls Prevention Awareness Day with These 5 Resources

Why Falls Should Be Part of the Doctor – Patient And National Conversation For Older Persons 

Falls In The Elderly – Just Not Sexy Enough? 

Bracing for Falls of An Aging Nation

Strategies to Prevent Falls

Falls Free – NCOA : 6 Steps to Protect Your Older Loved One 

CDC Information on Falls Prevention

The STEADI initiative (Stopping Elderly Accidents, Deaths, and Injuries)

American Geriatrics Society – Health in Aging Foundation – Falls 

SGEM: #89 – Preventing Falling to Pieces 

Video Demonstrating the Sit-To-Stand Challenge 

Translating Research Into Action: Go4Life Month Promotes Exercise 

Interventions for preventing falls in older people living in the community 

Aging in America: Insurers Seek Ways to Slow Worrisome Rise in Seniors Who Fall

Falls Reduction and Exercise Training in an Assisted Living Facility 

Aging-In-Place/Active Aging: Technology, Startups, Hackathons:

The 100 Year Lifespan 

Technology, while not a fountain of youth, can make aging safer 

Live-in lab to test aging-in-place technology 

Mobile Safety Products that Can Help Seniors on the Go

Aging in Place Gadgets : Gadgets that Help You Stay Home Longer

Slide-show: 7 technologies working to prevent falls

Is Digital Health Leaving Senior Fitness Behind?

Proto-typing the age-ready city 

Best Technology Assisted Aging in Place Cities 

Walkway System

Aging #30in30in30 World Tour Wants to Find Best Startups for Seniors 

Cautionary Note: Use It OR Lose It

The End of Walking: Step by step Americans are sacrificing their right to walk 

Test shows how old your body really is. 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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The best prevention I have seen for falls is doing Tai Chi.

Then there is judgment (stupidity?) as a cause of falls. Last winter I had a painful fall on the 3 steps leading down from our back deck, when, dressed for work, I tried to help my husband (not by his request) carry a dining table down the stairs to his truck. The wood on the stairs was slippery and giving way at the step edges, and my feet went out from under me. The table didn’t land on me, because my husband actually was supporting the whole weight of the table. He has since replaced all the wood on the back deck, including the steps. But let TROSA or someone pick up the donation next time!

A couple of years ago I tripped on a root while hiking Occoneechee Mountain trails in Hillsborough. Usually not a problem. But it was muddy and slippery, and my other foot had no traction, so down I went. Now if it’s been raining, I don’t hike Occoneechee trails.

It’s still tempting to get on ladders, to clean gutters or pick cherries from our backyard trees. So far, cherries yes, gutters no. Goodness it’s hard to let go of doing things that are physically possible, but not advisable!

I am 75 and have had dizziness/weak knees for awhile. I finally told my doctor of my symptoms of dizziness/weak knees; dry cough; and dry mouth. He reduced two medications and the symptoms are much better. Please, if you have those symptoms, talk to your doctor about them.

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