Fall Injuries
Falls are the second leading cause of unintentional injury deaths and the most common cause of injuries and of hospital admissions for trauma.1 In 2001, 15,764 persons died as the result of falls (10% of all injury deaths). Falls are the leading cause of nonfatal injury in the United States, accounting for 783,357 hospitalizations and an estimated 11.5 million minor injury cases that are not hospitalized.
One of every three adults aged 65 years old or older suffers a fall each year. Of those who fall each year, two thirds fall again within six months. The majority of falls occur in the home with the highest proportions among young children and the elderly.
Facts about Older Adults who Fall:
- The risk of falling increases with age
- For people age 65 and older, more than half of all falls happen at home
- Often, people don’t know how or why they fell. Many do not recall a fall that happened 2-3 months earlier
- Older Adults who fall once are 2-3 times as likely to fall again within a year.
- At least 95% of hip fractures are caused by falls. Only about 2% of hip fractures are spontaneous.
- Fall-related death rates and hip fracture hospitalization rates are increasing
Falls in Nursing Homes:
- Of the 1.5 million nursing home residents, approximately 50% fall at least once each year
- About 1800 fatal falls occur each year in US nursing homes
- Among people 85 years+, 20% of fall-related deaths occur in nursing homes
- Causes = weakness/gait problems and environmental hazards
The Cost of Fall Injuries Among Older Adults:
- One of every 3 people age 65 and older falls each year
- Older adults are hospitalized for fall-related injuries 5x more often than they are for injuries from other causes
- Of those who fall, 20-30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death
- In 1994 , the average direct cost for a fall injury was $1400 for a person over age 65
- The total direct cost of all fall injuries for people age 65 and older in 1994 was $20.2 billion
- By 2020, the cost of fall injuries is expected to reach $32.4 billion
Falls result in: (regarding people over 65 years old)
- 9500 deaths/year
- 87% of fractures
Most falls occur at home – due to environmental hazards:
- slippery surfaces
- uneven floors
- poor lighting
- loose rugs
- unstable furniture
- tripping hazards
Prevention: Install grab bars, remove tripping hazards
Environmental Modifications in the Home
Because seniors spend most of their time at home, one-half to two-thirds of all falls occur in or around the home. Most fall injuries are caused by falls on the same level (not from falling down stairs) and from a standing height (for example, by tripping while walking). Therefore, it makes sense to make the home environment safer to enter and exit and to move around safely within. Installing stair railings, ramps, and grab bars (such as in the bathroom) are simple but effective modifications. However, these are most successful when combined with other fall-related interventions.
Conduct Home Assessments
Falls in the home may be prevented by conducting home assessments. Home assessments can be performed by individuals on behalf of a family member, or working collaboratively with community groups to canvas high risk households. The Centers for Disease Control and Prevention has provided a checklist to help locate and remove such hazards, and can be found at http://www.cdc.gov/ncipc/pub-res/toolkit/brochures.htm. The checklist suggests removing things that can be tripped over (such as papers, books, clothes, and shoes) from stairs and paths where people walk, removing small throw rugs or using double-sided tape to keep the rugs from slipping, keeping items often used in cabinets that are easily reached and accessible without a step stool, installing grab bars next to the toilet and in the tub or shower, using non-slip mats in the bathtub and on shower floors, improving lighting in the home, installing handrails and lights on all staircases, wearing shoes that give good support and have thin non-slip soles, and avoiding wearing slippers and athletic shoes with deep treads.
Promote Exercise Programs Among Seniors
Exercise programs can be administered on-site by trained health care professionals at hospitals, nursing homes and other senior care facilities under the supervision of a physician. Walking programs to increase physical capacity could also complement the strength and balance programs.
