Falls Are a Rising Problem for Older Adults, Especially in Healthcare

Fatal falls among the elderly are on the rise in the United States, according to a new report from the Centers for Disease Control and Prevention. The CDC shares that “in 2016, a total of 29,668 Americans ages 65 and older died as a result of a fall. This means that falls ended the lives of 61.6 out of every 100,000 senior citizens in that year alone. Back in 2007, there were 47 fall-related deaths for every 100,000 senior citizens. That means the mortality rate due to falls increased by 31% over the course of a decade” (CDC, 2018).

However, falls are a serious risk across all ages of the population, not just the elderly. Again, according to the CDC, “Accidents and unintentional injuries are the fourth-leading cause of death for Americans of all ages (behind heart disease, cancer and chronic lower respiratory infection). Falls are the most common type of accident or accidental injury” (CDC, 2018).

Falls Have Serious Impact on Senior Health

That being said, falls have an outsize importance for senior health. A recent LATimes article states that “About one in four senior citizens has a serious fall each year, experts estimate, and these falls prompt nearly 3 million visits to hospital emergency departments. Twenty percent of falls result in broken bones, traumatic brain injury or other significant problems. Once every 19 minutes, a senior citizen in America dies as a result of injuries sustained during a fall. Fatal falls have become more common for older Americans almost everywhere, according to the new study, which is based on data from death certificates from across the country” (Kaplan, 2018).

Aging and the increase in falls go hand in hand. As people age, “the greater their risk of dying from a fall. In 2016, there were 15.6 fatal falls for every 100,000 Americans between the ages of 65 and 74. Among adults ages 75 to 84, there were 61.4 such deaths per 100,000 people. And for those ages 85 and up, there were 247.9 fatal falls per 100,000 people. Since Americans are getting older, they should brace themselves for more fatal falls, the report authors warned” (Kaplan, 2018).

Falls in the Hospital

Falls are especially problematic in a healthcare setting. The Agency for Healthcare Research and Quality (AHRQ) offers that “Each year, somewhere between 700,000 and 1,000,000 people in the United States fall in the hospital. A fall may result in fractures, lacerations, or internal bleeding, leading to increased health care utilization. Research shows that close to one-third of falls can be prevented. Fall prevention involves managing a patient's underlying fall risk factors and optimizing the hospital's physical design and environment” (AHRQ, 2018).

Identifying Fall Risks

Just because falls are common, they don’t happen to everyone, and there are preventive measures that are very helpful. The CDC reminds us that “Falls are not an inevitable part of aging. There are specific things that you, as their health care provider, can do to reduce their chances of falling.” The CDC has created a program aimed at fall prevention, named STEADI, which stands for Stopping Elderly Accidents, Deaths & Injuries. It involves an array of tools and educational materials whose goal are to help healthcare providers:

• Identify patients likely to fall and rank them low, moderate, and high risk
• Identify risk factors and lessen them
• Intervene in other effective way (CDC/STEADI, 2018)

3 Questions to Ask Your Older Adult Patients

A good place to start addressing fall risk in older adults is for clinicians to use the following CDC-recommended questions as a routine part of any exam:

1. Have you fallen in the past year?
2. Do you feel unsteady when standing or walking?
3. Do you worry about falling? (CDC/STEADI, 2018)

The CDC suggests that if patients answer “yes” to any of these key screening questions, they are considered at increased risk of falling. Further assessment of the patient’s likelihood of falling is recommended.

References

AHRQ, “Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care,” 2018, Retrieved at https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html

CDC, “Deaths from Falls Among Persons Aged ≥65 Years — United States, 2007–2016,” 2018, Retrieved at https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.htm?s_cid=mm6718a1_w.

CDC, “STEADI-Older Adult Fall Prevention,” 2018, Retrieved at https://www.cdc.gov/steadi/index.html.

Kaplan, Karen, “Fatal falls are on the rise for America’s senior citizens,” LATimes, May 10, 2018, Retrieved at http://www.latimes.com/science/sciencenow/la-sci-sn-fatal-falls-rising-20180510-story.html?utm_source=&utm_medium=&utm_campaign=.

Training for preventing falls is an important component of HealthStream’s Post-Acute Care Library. Learn more here.