By Jonathan Springston, Editor, Relias Media
The week of Sept. 21-25, 2020, is Falls Prevention Awareness Week, an annual observance that allows for the spread of education about this important public health issue.
Every year, one-fourth of Americans age 65 years and older fall. Falls account for more than 3 million injuries treated in EDs every year, including 29,000 deaths. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults. This year, the financial cost of treating these injuries is estimated to exceed $67 billion.
Falls may occur at home or in medical facilities. Older adults may fall because their mobility has become limited, they cannot see as well, a medication produces side effects, or some combination of all these. This makes prevention tricky, but possible. Prevention includes everything from making safety improvements in the home, enrolling in exercise programs, or avoiding medicines that increase fall risk. Organizations such as the National Council on Aging and the Fall Prevention Center of Excellence offer extensive guidance.
An article in the October issue of ED Legal Letter details the legal risks associated with falls in medical facilities. More than one-third of falls in hospitals result in injury, such as serious fractures, head trauma, lacerations, or internal bleeding. In the ED, 84% of 102 ED providers surveyed believe all geriatric patients should be screened for fall risk. Seventy-six percent also believe if a geriatric patient was identified as at risk for falls, that patient should go through an intervention in the ED. However, ED providers were unwilling to spend lots of time on it; 46% were only willing to spend less than two minutes.
“We’re looking at the whole person, everything from the shoes they wear and their activities, trying to sign them up for things like tai chi if they are cognitively intact,” says Daniel Devine, MD, board certified in internal and geriatric medicine, practicing with Devine Concierge Medicine in Wayne, PA. “Part of the way we look at falls is seeing the actual incident as just the tip of the iceberg. We have to look underneath to see what actually caused the fall. It can be easy to think of all patients at risk of falls as one category of patients and then apply the same fall prevention strategies to them across the board. It is much more effective to look at each patient, determine what makes that particular person at risk for falling, and address those issues.”