Falls Among Community-Dwelling Older Adults
Every 18 seconds, an older adult is in the emergency room because of a fall, according to the Center for Disease Control and Prevention (CDC). That translates into a person 65 or older dying, due to a fall, every 35 minutes, according to the CDC. Falling in adults 65 and older is a complex problem confronting public health, the health care system and families. Statistics alone do not begin to measure the pain, suffering and loss of independence that are experienced by older adults who fall, but according to the CDC, a number of trends highlight the magnitude of the problem: Falling accounts for 80-95% of hip fractures in older adults, The rate of fatal falls increase dramatically with age,
Falls are the leading cause of injury deaths for older adults, and Among adults 75 and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer. Based on the CDC 2012 data, each year one in three older American’s 65 and older fall and about 30% of those falls require medical treatment. Falls are not only the leading cause of fatal and nonfatal injuries but also the most common cause of hospital admission for trauma. More than $19 billion annually is spent on treating the elderly for the adverse effects of falls: $12 billion for hospitalization, $4 billion for emergency department visits, and $3 billion of outpatient care. Most of these expenses are paid for by the Center for Medicare and Medicaid Services through Medicare. According to the CDC, It is projected that direct treatment costs for elder falls will escalate to $43.8 billion annually by 2020.
There are several reasons why people fall. Fall risk is multifactorial in nature, with risk factors being intrinsic (i.e., age-related physiologic changes, diseases and medications) or extrinsic (i.e, environmental hazards) (Graafmans et al., 1996). It is important to remember that a single fall may have multiple causes, and repeated falls may each have a different etiology (Graafmans et al., 1996).
It's not just in their own homes that elderly persons are at risk for dangerous falls. Seniors fall in public places and in nursing facilities, too. Many elderly people don't see as well as younger adults, and may not move as quickly as they once did or with the same agility. Complications of old age are often compounded by stroke, disease, or some other physical ailment (Fuller, 2000). Sometimes persons advanced in age get confused as to where they are; as a result of anxiety, many seniors are not as careful moving about the surrounding area – even familiar places. According to NIH Senior heath, there are a number of personal risk factors to falling. Muscle weakness, especially in the legs, is one of the most important risk factors. Your balance and your gait -- how you walk -- are other key factors. Blood pressure that drops too much when you get up from lying down or sitting can increase your chance of falling. Some people with postural hypotension feel dizzy when their blood pressure drops. Your reflexes may also be slower than when you were younger. Foot problems that cause painful feet, and wearing unsafe footwear can increase your chance of falling. Sensory problems can cause falls, too. If your senses don't work well, you might be less aware of your environment. Not seeing well can also result in falls.
Other vision problems contributing to falls include poor depth perception, cataracts, and glaucoma. Wearing multi-focal glasses while walking or having poor lighting around your home can also lead to falls. Confusion, even for a short while, can sometimes lead to falls. Some medications can increase a person's risk of falling because they cause side effects like dizziness or confusion. The more medications you take the more likely you are to fall.
Educating seniors to the causes of falling before a falling incident occurs is the best prevention...
References: Centers for Disease Control and Prevention (2013). Costs of Falls Among Older Adults. Retrieved 11/15/13 from www.cdc.gov/homeandrecreationalsafety/falls/fallcost.html
Centers for Disease Control and Prevention (2013). Falls Among Older Adults: An Overview. Retrieved from www.cdc.gov/HomeandRecreationalsafety/falls/adultfalls.html
Centers for Disease Control and Prevention (2013). Hip fractures Among Older Adults. Retrieved 11/15/13 from www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html
Fuller, G.F. (2000). Falls in the Elderly. American Family Physician 61(7), 2159-2168. Retrieved 11/15/2103 from www.aafp.org/2000/0401/p2159.html
Graafmans, W.C., OOms, M.E., Hofstee, H.M., Bezemer, P.D., Bouter, L.M., & Lips, P. (1996). Falls in the elderly: a prospective study of risk factors and risk profiles. American Journal of Epidemiology, 143(11), 1129-1136.
NIH Senior Health (2013). Falls & Older Adults: Causes and Risk Factors. Retrieved 11/15/2013 from http://nihseniorhealth.gov/falls/causesandriskfactors/01.html
Rao, S.S. (2005). Prevention of Falls in Older Patients. American Family Physician, 72(01), 81-88. Retrieved 11/24/13 from www.aafp.org/afp/2005/0701/p81.html
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