Fall Related Deaths Increasing, Improved Advice for OAs Needed

Angie Szumlinski Studies

A new study suggests that typical fall prevention advice for seniors is mostly ineffective. Almost three times as many adults aged 75 years and older died from falls in 2016 than in 2000 (25,189 people in 2016 compared to 8613 in 2000) (Journal of the American Medical Association). Experts suggest a more personalized approach to fall prevention as well as more involvement by medical practitioners and better ways to motivate seniors to take action.

Elizabeth Burns, co-author of the report and health scientist at the U.S. Centers for Disease Control and Prevention, contributes this increase in falls to rising life expectancies paired with conditions like diabetes and cardiovascular disease. Seniors are also taking more opioids than in the past.

The CDC predicts that by 2030, 49 million older adults will fall each year, causing 12 million injuries and over $100 billion in health-related spending. The CDC has tried to improve these statistics by encouraging doctors to implement more evidence-based fall prevention tactics, but health care professionals still aren’t doing enough according to Burns. Burns also found that physicians and nurse practitioners routinely failed to properly review older adults medications (approx. 40% didn’t), recommend exercise (48% didn’t), or refer people to a vision specialist (approx. 62% didn’t).

Emily Nabers, the program manager of the Fall Prevention Center of Excellence at the University of Southern California, put an emphasis on physician involvement and encouragement because seniors will typically place a lot of value in their doctor’s advice.

A significant issue is holding older adult’s attention when it comes to providing fall prevention advice. Experts from around the country suggest the following as alternatives to laundry lists of suggestions:

Get a fall risk assessment. Doctors should ask patients three questions regarding their falls: Have you fallen in the past year? Do you feel unsteady when you walk or stand? And are you afraid of falling.

Get a personalized plan. An effective fall assessment should identify specific risk factors that are personalized to the individual being treated. The most important intervention is exercise. This step in particular needs to be catered specifically to the person in question. For seniors with sedentary lifestyles, walking is their best option. But for those with more active lifestyles, exercises focused on strength and balance may work better. Careful medication reviews are also important. Taking three or more psychotropic medications put seniors at a higher risk for falls (Dr. Maust, University of Michigan Medical School).

Be careful during transitions. Residents coming back from the hospital or starting new medications should use extra precaution because they may be weak, disoriented, deconditioned, and/or exhausted. Hospital staffers should discuss fall prevention before older adults leave the hospital.

Consider the message. Research groups and studies have found that older adults do not like the negative messages surrounding falls. Saying things like, “you could hurt yourself or die,” are not productive. These types of words can make seniors feel patronized, instead try phrases like “these measures will help ensure your independence.”