Falls are among the top health risks for adults 65 or older, causing more than 3 million emergency room visits and 36,000 deaths annually nationwide, according to the Centers for Disease Control and Prevention.
One out of five falls cause a serious injury, such as broken bones or head injuries. More than 95% of hip fractures are caused by slips, and tumbles are among the top causes of traumatic brain injury and death among older adults.
Additionally, medical costs caused by accidents average $50 billion annually, three-fourths of which are paid by Medicare and Medicaid.
Who’s most at risk for falling and why?
Falling becomes a greater risk around age 65 and older. Within that age group, more than 1 in 3 people fall each year, according to the National Institute on Aging. Physical or mental impairments further increase one’s risk of falling.
“Several physiological changes that occur with age make older individuals more susceptible to falls. This includes loss of muscle mass, cognitive decline, visual impairment, memory lapses, dehydration, and urinary incontinence,” said Lori Newcomb, board-certified geriatric pharmacist and clinical consultant pharmacist at long-term care pharmacy Guardian Pharmacy of Atlanta.
“Certain neurodegenerative conditions like dementia and Parkinson’s disease further elevate the risk of falls in this demographic.” Medications increase risk also, she added. “It’s crucial to recognize that medications stand as a leading cause of falls among older adults. Polypharmacy, defined as the concurrent use of five or more medications, is closely linked to a heightened fall risk.”
Consult with the care team
Consulting with health care professionals is an important initial step to preventing falls and managing risks for yourself or a loved one, according to experts.
“This should include consultations with a pharmacist, physical therapist and physician.” Newcomb said. “A pharmacist can evaluate the medication regimen to identify any drugs that might increase the risk of falling and suggest modifications like discontinuing medications that cause drowsiness or recommending adjusted doses to prevent harmful interactions.”
“Concurrently, physicians can assess and offer guidance on manageable health conditions to diminish fall risk. Engaging in physical therapy, which provides specialized exercises tailored to an individual’s needs, is pivotal in enhancing coordination, gait, balance, and overall physical conditioning to mitigate the risk of falls,” Newcomb added.
Additionally, “talking with your loved ones’ health care provider is a great way to determine what fall prevention methods are best for them, depending upon their specific situation,” Kuswita said.
Physical inactivity is a significant risk of increased falls, according to Anna Helmrath, vice president of Medicare strategy and execution at UnitedHealthcare. “In Georgia, roughly 35% of older adults were classified as physically inactive and 32% were classified as obese, according to the America’s Health Rankings 2023 Senior Report,” she said.
Therefore, exercise and strength training are vital to preventing falls and decreasing risk. SilverSneakers is one of many free programs available to older adults to help improve and maintain physical fitness, strength, flexibility and mobility. The Medicare program is free for adults ages 65 and older, offering free online exercise classes and free admission to local gyms.
“Taking regular walks is a great way to help the body stay healthy. However, walking doesn’t help with fall prevention as much as lower body strength and balance training does,” Helmrath said.
Key safety precautions at home
Environmental hazards can also contribute to one’s risk of falling. Therefore, it’s important to secure living spaces of older adults and take general precautions to help prevent falls, according to Christian Kuswita, owner of ComForCare home care of Cobb County. He suggests the following:
- Install additional lighting to improve visibility and help avoid trip hazards
- Declutter: Secure or remove rugs and other tripping hazards from walkways
- Move daily items into easily accessible areas/places
- Add handrails in bathroom and around the house
- Install nonslip pads, especially in the bathroom
- Use a bath seat while showering
Paying attention to other key details — wearing proper footwear, eyewear, and hearing aids that enable older adults to be more aware of their surroundings — can help prevent falls.
Devastating long-term impact
A single fall can be an inflection point, setting off a chain reaction of progressively severe issues. In addition to the physical injuries caused by the impact of the tumble itself, falling can exacerbate existing risk factors such as immobility or social isolation, which can lead to a person’s general decline in health. Once someone has experienced a fall, their odds of having another accident double.
“Falling can reduce an adult’s ability to remain independent, and may increase hospital visits, cause serious injuries such as hematoma, joint dislocation, severe laceration, sprains, internal bleeding, fractures, broken bones or even death,” said Kuswita.
Therefore, it’s important to empower older adults to maintain their independence safely, when possible. In addition to health consults and safety precautions, wearable devices can help prevent falls or monitor loved ones to render aid more quickly.
A variety of devices and wearable technologies are available today, including the growing market of remote patient monitoring devices. Kuswita’s company offers a technology called Connected Care, an RPM system that “observes the mental and physical state of a client daily including change in activity in the home,” while also monitoring vital signs, medications, and detecting falls.
Other available technologies to help prevent falls and monitor remotely include smartwatches, fall pendants/wearables (like LifeAlert or LifeCall), video/audio monitors and bed sensors.
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