“Help! I’ve fallen, and I can’t get up!”
It’s not funny when it happens to you or a loved one.
Especially among the elderly, falls are no laughing matter. Each year, one in three Americans 65 and older falls, and about 30 percent of those falls require medical treatment.
The Centers for Disease Control reports that 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 for outpatient care. Most of these expenses are paid for by the Centers for Medicare and Medicaid Services through Medicare. It is projected that direct treatment costs from elder falls will escalate to $43.8 billion annually by 2020.
That’s why The Falls Free™ Coalition, a group of national organizations and state coalitions working to reduce the growing number of falls and fall-related injuries among older adults, became the driving force to push the adoption of the federal Safety of Seniors Act in 2008.
The American Physical Therapy Association (APTA) was among the coalition of health and consumer groups that undertook to educate members of Congress and their staffs about the importance of falls prevention. In an appearance in Washington, D.C., shortly after the enactment of the Safety of Seniors Act, APTA member and Falls Free Coalition representative Bonita Lynn Beattie, PT, MPT, MHA, told legislators that "falls and falls-related injuries are not normal consequences of growing old. There are evidence-based interventions that can help reduce older adults' risk of falling and can affect the rate of falls and falls-related injuries and death."
Beattie, who also represents the National Council on Aging (NCOA), urged Congress to fund efforts to increase the falls risk assessment and intervention skills of health care providers and promote collaboration with the aging services network.
“Physical therapists are taking an active role in educating consumers about how to safely prevent falls as well as treat those who have fallen and suffered injuries as a result, added then-APTA President R Scott Ward, PT, PhD. “This education will ultimately improve the health and quality of life of our nation's seniors."
The Safety of Seniors Act authorizes the secretary of Health and Human Services to oversee a national education campaign focusing on reducing falls among older adults and preventing repeat falls. It awards grants, contracts, or cooperative agreements to design and carry out local education campaigns.
Meanwhile, a British study indicates that prevention exercises can help the elderly avoid falls, and may also reduce injuries when a fall occurs.
In a 2013 study published in the British Medical Journal, researchers reviewed results of 17 trials involving aged patients who received falls prevention exercises with those who did not, and included data on subsequent falls and the extent of injury sustained. Authors of the analysis then grouped the injuries according to standardized classifications and reviewed seriousness of injuries across the studies.
The research revealed that in addition to lessening the rate of falls, prevention exercises also reduced the severity of injury when falls do occur, with estimated reductions of 37% for all injurious falls, 43% for severe injurious falls, and 61% for falls that produced fractures.
Authors of the study wrote that "it is…thought that exercise prevents injurious falls not only by improving balance and decreasing the risk of falling, but also by improving cognitive functioning, and the speed and effectiveness of protective reflexes (such as quickly extending an arm or grabbing nearby objects) or the energy absorbing capacity of soft tissues (such as muscles), thereby diminishing the force of impact on the body."
The Centers for Disease Control and Prevention's (CDC) new STEADI Tool Kit gives health care providers information and tools to assess and address their older patients' falls risk. The STEADI (Stopping Elderly Accidents, Deaths and Injuries) Tool Kit is based on a simple algorithm adapted from the American and British Geriatric Societies' Clinical Practice Guideline. It includes basic information about falls, case studies, conversation starters, and standardized gait and balance assessment tests (with instructional videos). In addition, there are educational handouts about falls prevention specifically designed for patients and their friends and family.
APTA members who are experts in falls prevention assisted CDC with the development of the toolkit, specifically with the evidence-based community falls prevention programs. A link to the toolkit also is available on APTA's Balance and Falls webpage under "Related Resources."
The American Physical Therapy Association (www.apta.org) is a national organization representing physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can visit www.findapt.us to find a physical therapist in their area, as well as www.apta.org/consumer for physical therapy news and information.