September 18, 2017
Not Legends Of The Fall: They’re A Big Problem For Seniors
By Michael D. Shaw
The title of this piece may strike a chord for those familiar with Jim Harrison’s novella (1979) or the film version (1994). The work is a compelling epic melodrama, covering 50 years in the life of the Ludlow family. Here the “fall” refers to a scriptural fall from innocence. Perhaps, they are “legends,” in that the family conflicts and tragedies are so big that they seem larger than life.
For our health-related “fall,” though, we must turn to more mundane—and potentially deadly—matters: Every second of every day in the United States an older adult falls, making falls the number one cause of injuries and deaths from injury among older Americans. Fittingly, the National Council on Aging (NCOA) has declared September 22nd—the first day of fall this year—to be Falls Prevention Awareness Day.
How about some nasty statistics from the CDC…
- One-fourth of Americans aged 65 or better falls each year. 27,000 will die as a result.
- Every 11 seconds, an older adult is treated in the emergency room for a fall.
- Every 19 minutes, an older adult dies from a fall.
- Falls result in more than 2.8 million injuries treated in emergency departments annually.
- The cost of these injuries was $34 billion in 2013, projected to increase to $67.7 billion in 2020.
As to those injuries…Falls account for 87% of all fractures among people aged 65 years or older. About 3% of all falls cause fractures—the most common of which occur in the pelvis, hip, femur, vertebrae, humerus, hand, forearm, leg, and ankle. Of these, hip fractures cause the greatest number of deaths, and lead to the most severe health problems.
Hip fractures come with their own set of nasty statistics. One of the most disturbing is that half of all older adults hospitalized for hip fractures cannot return home or live independently after their injuries.
But, why are oldsters more prone to falls? A few years ago, NCOA commissioned a review of current falls prevention research and public health data. Here are some of the findings…
1. Physical mobility risk factors that predispose older adults to falls include lower extremity weakness; generalized deconditioning and poor endurance; musculo-skeletal stiffness and rigidity; slow reaction time to perturbations in balance; and slow walking speed. Exercise and appropriate physical therapy can do wonders.
2. Management of meds is important. Caregivers and loved ones should be on the lookout for changes in cognitive and physical function; dizziness or light-headedness; balance difficulties; or confusion and sedation. A review and modification of medications could be in order.
3. Ensure that the home is safe. National Health Interview Survey data indicates that 55 percent of all injuries among older people occur inside the home. An additional 23 percent of injuries occur outside but near the house. Recommendations include elimination of hazardous conditions such as clutter and poor lighting; and installing grab bars and handrails in stairwells and bathrooms.
4. Hazardous conditions must also be eliminated in the community (both indoors and outdoors): Watch out for poorly maintained buildings; lack of safety features such as handrails, grab bars, curb cuts, and ramps; and inadequate lighting or glare from surfaces. Outdoor hazards include uneven pavement or surfaces; pavement cracks; tree roots; slippery walking surfaces; obstacles in walkways; snow or ice on walkways or steps; uneven steps; floor mats; door sills; unsafe stair design; and poor lighting.
While many of these precepts seems obvious, they are nonetheless often overlooked.
NCOA has an excellent video on fall prevention. Here is a Falls Awareness & Prevention Guide from the American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association.
If you’re a senior, or know someone who is, create your own legend, and prevent falls!