Elder falls prevention

Are elder falls preventable? Long-term care has made positive strides in the identification of fall risk factors, the evidence-based assessments of fall probability and in addressing and reducing risk factors. Some studies indicate elder falls and injuries are reaching epidemic proportions, so how do we keep this epidemic from growing?

Falls, especially frequent falls, should not be ignored. Studies have shown a person who has fallen once is two to three times more likely to fall again within a year. It is not unusual that an underlying heath-related issue or medication may be increasing a person’s risk of falling. Mitigate intrinsic risk factors through proper nutrition,

strengthening/balance exercises, pain management, vision care and proper footwear. Take action to reduce extrinsic risk factors, too: Remove or tack down throw rugs, repair loose banisters, remove clutter and secure trip hazards.

Fall-related deaths among U.S. seniors have risen steadily in the past 13 years. Death rates among those age 65+ were 41 per 100,000 in 2004, but have increased to 58 per 100,000 by 2013, according to the Centers for Disease Control and Prevention.

Advancements for elder fall injury protection

Hip protectors: Various products, soft or hard shell, worn under or over clothing covering hips. Compliance of application is key. Some studies conclude hip protectors offer little to no protection from a hip fracture while others support use.

"Smart" clothing:  A flexible, energy-absorbent material called Armourgel has been adapted to help mitigate the impact of falls that often leave elderly people with broken bones. Armourgel's British designer says the material can be incorporated into conventional clothes, providing protection for fragile bodies falling on to hard surfaces.

Wearable airbag:  A wearable airbag that incorporates a fall-detection system that uses both acceleration and angular velocity signals to trigger inflation of the airbag. The fall-detection algorithm was devised using a thresholding technique with an accelerometer and gyro sensor.

Helmet for elders:  A head covering with a hard or soft shell and various shock-absorbing materials. Proper fit and compliance are required for the protection to be effective. The bulkiness and social stigma of head gear are major complaints.

Floor mats:  Bedside floor mats range in thickness from 1-3 inches and are designed to absorb impact and reduce risk of injury from a fall. Floor mats have a durable vinyl cover, a slip-resistant bottom, and some are outfitted with pressure sensors. However, some studies show that floor mats can have risk factors of their own. The mat itself can be a stumbling risk, especially if a person has poor balance or poor vision, uses a walker or uses a portable IV pole.

Partner for prevention

Partnerships and care coordination are strategies to help elders reduce their fall risks. According to the American College of Surgeons Committee on Trauma’s Committee on Injury Prevention and Control suggests these four strategies in its 2014 Statement on Older Adult Falls and Fall Prevention:

1. Older adult care providers to implement comprehensive fall prevention programming including:

• Developing community partnerships with community-based centers, such as YMCAs, churches, senior centers, and older adult living centers.
• Incorporating an evidence-based exercise/physical therapy fall prevention program.
• Partnering with home-based visiting programs to complete multi-factorial risk assessments, including: medication review, including the use of opioids; assessment of vision, home safety, and balance and gait; and consideration of vitamin D supplementation.

2. Assessment of the risk/benefit of anticoagulation and anti-platelet therapies in older adult patients.

3. Risk assessment of falls in regular practice. Examples are included in the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) tool kit.

4. Collaboration with regional and statewide fall prevention coalitions for local networking/resources.

In summary, identifying and addressing specific intrinsic and extrinsic factors can reduce the risk of elder falls. Advancements in injury-protection devices can reduce fall-related injuries when used properly. Is it then possible to theorize with a greater emphasis on advancements in Elder falls injury protection would also impact the rising death rate in seniors caused by unintentional falls? Root cause analysis and advancements in technology will play a major role.

Tom DiCarlo is Director of Rehab with Renewal Rehab and a member of the Illinois Falls Coalition. He can be reached at 847-962-9701.

Author does not endorse nor promote any products mentioned.

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