Preventing Falls

“Jack and Jill went up the hill, To fetch a pail of water.

Jack fell down and broke his crown, And Jill came tumbling after.”

The Centers for Disease Prevention and Control, in reporting results from various studies, indicate that adjusted for inflation, direct medical costs for fall injuries in 2013 were $34 billion. Direct medical costs are what patients and insurance companies pay. Of this amount, hospital costs account for approximately 2/3 of the total. The price tag will undoubtedly increase with the rise in numbers of older adults. Falls are among the twenty most expensive medical conditions in which the average hospital cost is $35,000 for a fall injury. Statistics from CDC show Medicare probably pays for about 78% of the costs of falls. “Each year, millions of older people—those 65 and older—fall. In fact, one out of three older people falls each year, but less than half tell their doctor.” Falling once doubles the chances of falling again.

Some statistics about falls:

• One out of five falls causes a serious injury such as broken bones or a head injury.
• Each year, 2.5 million older people are treated in emergency departments for fall injuries.
• Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
• Each year at least 250,000 older people are hospitalized for hip fractures.
• More than 95% of hip fractures are caused by falling, usually by falling sideways.
• Falls are the most common cause of traumatic brain injuries (TBI).
• Risk factors/conditions that contribute to falling include: lower body weakness, Vitamin D deficiency, difficulties with walking and balance, use of medicines such as tranquilizers, sedatives, or antidepressants and over-the-counter medicines, vision problems, eyeglass lens prescriptions, foot pain or poor footwear, home hazards such as broken or uneven steps, throw rugs or clutter that can be tripped over, and absence of handrails along stairs or in the bathroom. A combination of factors is most likely the reason. The more the risk factors, the greater the chances of falling.

Diseases causing Infections and their relationship to falling

An October media release from the Infectious Diseases Week annual meeting of specialists in infectious diseases reported, that although falls brought patients to emergency centers, the underlying factors were infections in many cases. Some studies suggest between 20 percent and 45 percent of falls are caused by infections. “Infections can lower blood pressure and lead to dizziness and lightheadedness, increasing the risk for a tumble. Illness can also increase confusion in older people with dementia.” Urinary, bloodstream and respiratory infections were the most common culprits.

Take actions to prevent falls! Do a visual check of your home surroundings and remove the clutter!

1. Do Strength and Balance Exercises. Do exercises that make legs stronger and improve balance. Consider using a walking or hiking stick to aid in walking.
2. Include weight lifting in exercise routines. Tai Chi is a good example of an exercise that helps improve balance. Various places in Whatcom County offer Tai Chi classes. For example, the YMCA offers Introduction to Tai Chi (Monday and Thursday at noon) with a new class beginning in January, 2016).
3. Have Eyes Checked. Update lens if needed. If bifocal or progressive lenses are worn, consider using a pair of glasses with only distance prescription for outdoor activities, such as walking. Take care in walking down stairs if wearing progressive lens.
4. Make Home Safer. Get rid of things that can be tripped over. Add grab bars inside and outside bathtub or shower and next to the toilet. Put railings on both sides of stairs. Make sure home has lots of light by adding more or brighter light bulbs.
5. Talk to Your Doctor or health care provider to evaluate risk. Review medications (both prescription and OTC’s) that might cause drowsiness. Check labels to see if lightheadedness or drowsiness are side effects. Have vitamin D level checked to see if supplementation is needed.

Resources:

• http://www.cdc.gov/homeandrecreationalsafety/falls/compendium.html
• http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
• http://www.cdc.gov/homeandrecreationalsafety/falls/fallcost.html
• http://www.cdc.gov/homeandrecreationalsafety/index.html

Ten Leading causes of death in United States:

• http://www.cdc.gov/injury/wisqars/leadingcauses.html

Infectious Diseases Week, news release, Oct. 9, 2015   

• http://www.idsociety.org/News_Releases/