September 21st kicks off the start of fall.....and also Falls Prevention Week.
The facts about falls in the United States speak loud and clear. According to the Centers for Disease
Control and Prevention, treating elders for the adverse effects of falls in 2000 cost more than $19 billion
that year in the United States: $12 billion for hospitalizations, $4 billion for emergency room visits and
$3 billion for outpatient care. Medicare pays for most of these expenses. The Centers for Medicare and
Medicaid Services projects that by 2020, direct-treatment costs from elder falls will escalate to $43.8
billion a year.
Loss of life, the onset of disability and the burden of exorbitant medical costs have done little to raise
awareness of the issue. Adding insult to injury, experts estimate that up to 30% of falls are avoidable. An
important sign of progress on fall prevention was the passage by Congress of the Safety of Seniors Act,
signed into law by President Bush in April.
Successful fall prevention involves the three main strategies of: balance training and physical activity; medical management; and, environmental/home modifications. Whether you are a service provider, an interested individual, a caregiver, or an educator/researcher, remember that a combination of all three interventions are necessary to prevent falls in the home and out in the community.
Research has shown that the gold standard for fall prevention is a multifactorial approach requiring
input and analysis from three medical professionals. Although ostensibly expensive, a fall-prevention
evaluation should include a physical examination performed by a doctor; a progressive exercise regimen
implemented by a physical therapist; and an environmental precautions analysis, especially of potential
home hazards, conducted by an occupational therapist. The medical evaluation of at-risk individuals requires a physician to analyze risk factors, such as medications, vision, gait and fall history. Following
this assessment, the doctor recommends appropriate types and levels of exercise.
“Major dangers for falls are the so-called intrinsic risk factors, or those coming from an individual—as
opposed to the extrinsic or environmental risk factors,” said fpce codirector Laurence Rubenstein, who
also codirects the ucla/va Greater Los Angeles Healthcare System, long run by the University of California,
Los Angeles, and theVeteransAffairs hospital system. “The most important intrinsic risk factors
are muscle weakness and gait or balance problems.A person with these factors has a three-to-four-times
greater likelihood of falling as someone without them,” he said.
