On Your Own Two On Your Own Two FeetFeet

Exploring Ways to Exploring Ways to Reduce Your Risk of Reduce Your Risk of

FallingFalling

Amanda Distefano – Program Coordinator

Washington County Health Department

Falls Happen! Falls Happen!

Know the Facts… Know the Facts… Emergency Dept. Visits Emergency Dept. Visits

82%

18%

Under 6565 & Older

79%

21%

Maryland Washington County

In the State of Maryland 18%* and In Washington County 21%* of All Fall Related Emergency Department Visits are made by adults

65 years old or older.* DHMH—Injuries in Maryland 2011 Statistical Report * DHMH—Injuries in Maryland 2011 Statistical Report

Know the Facts… Know the Facts… Hospitalization as result of a Hospitalization as result of a fall fall

34%

66%

Under 6565 & Older

28%

72%

Maryland Washington County

In the State of Maryland 66%* and In Washington County 72%* of All Fall Related

Hospitalizations are for adults 65 years old or older.* DHMH—Injuries in Maryland 2011 Statistical Report * DHMH—Injuries in Maryland 2011 Statistical Report

Know the Facts… Know the Facts…

Fall Related Deaths Fall Related Deaths

23%

77%

Under 6565 & Older

13%

87%

Maryland Washington County

In the State of Maryland 77%* and In Washington County 87%* of All Deaths as a

result of a fall are adults 65 years old or older.

* DHMH—Injuries in Maryland 2011 Statistical Report * DHMH—Injuries in Maryland 2011 Statistical Report

What Does This Mean For What Does This Mean For You? You?

What is the Cost of Falling? What is the Cost of Falling? Maryland - Charges for fall Maryland - Charges for fall

related Emergency related Emergency Department visits in 2013 - Department visits in 2013 - $48,768,154$48,768,154

Maryland – Charges for fall Maryland – Charges for fall related hospitalizations in related hospitalizations in 2013 - $239,882,0002013 - $239,882,000

Maryland – Average length of Maryland – Average length of stay for fall related stay for fall related hospitalization in 2013 – 5 hospitalization in 2013 – 5 days days

In 2013, direct medical costs In 2013, direct medical costs of falls totaled a little over of falls totaled a little over $30 billion$30 billion

* www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

Epidemiology of the Epidemiology of the ProblemProblem

Falls are the leading cause of injury-related Emergency Department visits in Maryland and Washington County

Somewhere between one-third and one-half of the community-dwelling older adults acknowledge fear of falling

Fear of falling is associated with depression, decreased mobility and social activity, increased frailty, and increased risk for falls as a result of de-conditioning.

What Do We Know About What Do We Know About Falls?Falls?

One out of three people over 65 fall each yearOne out of three people over 65 fall each year

Most falls do not result in serious injuryMost falls do not result in serious injury

Falls are not a part of the normal aging processFalls are not a part of the normal aging process

A majority of falls occur during routine activitiesA majority of falls occur during routine activities Falls are not caused by just one issue, it is a Falls are not caused by just one issue, it is a

combination of things coming togethercombination of things coming together

Most falls are preventableMost falls are preventable

Why Do Falls Occur?Why Do Falls Occur?

Group Activity—Group Activity—Brainstorm Brainstorm

Why Do Falls Occur?Why Do Falls Occur?

Two Different Categories of RisksTwo Different Categories of Risks

– Physical (within the individual)Physical (within the individual)

– Environmental (outside the individual Environmental (outside the individual

Why Do Falls Occur?Why Do Falls Occur? Physical Physical

Decreased visual acuityDecreased visual acuity

Impaired balance and gaitImpaired balance and gait

Slowed reaction timesSlowed reaction times

Certain classes of drugs such as sedatives and hypnoticsCertain classes of drugs such as sedatives and hypnotics

Failing to use prescribed assistive devices as Failing to use prescribed assistive devices as

recommendedrecommended

Climbing on objects to reach items on high shelvesClimbing on objects to reach items on high shelves

Hurrying to answer the telephone or doorbellHurrying to answer the telephone or doorbell

Why Do Falls Occur?Why Do Falls Occur? Physical Physical—Continued—Continued

Failing to exercise regularlyFailing to exercise regularly Attempting to carry heavy objects or too many Attempting to carry heavy objects or too many

objects at one time objects at one time Hesitating to bring concerns about falls to the Hesitating to bring concerns about falls to the

attention of the health care provider attention of the health care provider Failure to request assistance with activities of Failure to request assistance with activities of

daily livingdaily living

Why Do Falls Occur?Why Do Falls Occur? EnvironmentalEnvironmental

Highly polished floors Highly polished floors

Wet ground surfaceWet ground surface

Poor lightingPoor lighting

Lack of handrails on stairsLack of handrails on stairs

Cluttered spacesCluttered spaces

Loose or thick pile rugsLoose or thick pile rugs

Irregular ground surfacesIrregular ground surfaces

Why Do Falls Occur?Why Do Falls Occur? EnvironmentalEnvironmental—continued —continued

Absence of grab bars near the toilet and in the Absence of grab bars near the toilet and in the

showershower

Poorly planned storage shelvesPoorly planned storage shelves

Exposed phone cordsExposed phone cords

Improper shoesImproper shoes

Unstable rolling chairsUnstable rolling chairs

Low and overly soft beds and chairsLow and overly soft beds and chairs

Transferring in and out of beds and chairsTransferring in and out of beds and chairs

What can you do to reduce What can you do to reduce the risk of falling? the risk of falling?

Ask the doctor or pharmacist to review Ask the doctor or pharmacist to review all medications both over the counter all medications both over the counter and prescribedand prescribed

See a health care provider regularly See a health care provider regularly for chronic conditions such as for chronic conditions such as Parkinson’s Disease, history of stroke, Parkinson’s Disease, history of stroke, arthritis and visual impairmentarthritis and visual impairment

See an eye doctor for a vision check at See an eye doctor for a vision check at least once a year least once a year

Remove tripping hazards such as Remove tripping hazards such as throw rugs and clutter in walkwaysthrow rugs and clutter in walkways

What can you do to reduce What can you do to reduce the risk of falling? the risk of falling?

Use non-slip mats in the bathtub and Use non-slip mats in the bathtub and on shower floorson shower floors

Have grab bars put next to the toilet an Have grab bars put next to the toilet an in the tub or showerin the tub or shower

Have handrails put in on both sides of Have handrails put in on both sides of stairwaysstairways

Improve lighting throughout the homeImprove lighting throughout the home

Increase lower body strength and Increase lower body strength and improve balance through regular improve balance through regular physical activityphysical activity

Staying Active and Staying Active and IndependentIndependent

Benefits of ExerciseBenefits of Exercise– Improve balance skills and flexibilityImprove balance skills and flexibility– Strengthen musclesStrengthen muscles– Improve coordinationImprove coordination– Improve overall conditioningImprove overall conditioning– Increased feeling of emotional wellbeingIncreased feeling of emotional wellbeing– Research shows that everyone can grow Research shows that everyone can grow

stronger through increased activitystronger through increased activity– Improve blood pressure regulationImprove blood pressure regulation

Staying Active and Staying Active and IndependentIndependent

Reasons People Don’t ExerciseReasons People Don’t Exercise– Belief that inactivity is a natural part of Belief that inactivity is a natural part of

agingaging– Belief that we cannot slow the weakening of Belief that we cannot slow the weakening of

bones and muscles through exercisebones and muscles through exercise– Belief that all exercise is harmful for older Belief that all exercise is harmful for older

peoplepeople– Feeling embarrassed to exercise “at my Feeling embarrassed to exercise “at my

age”age”– Time constraintsTime constraints– Overprotective relatives and friendsOverprotective relatives and friends

Exercise Programs for Older Exercise Programs for Older AdultsAdults

Think Safety…….Think Safety…….

Falls CAN be prevented! Falls CAN be prevented!

Who Is Ultimately Responsible Who Is Ultimately Responsible For Reducing Your Risk of For Reducing Your Risk of

Falling?Falling?

You Are!You Are!

Your ideas are the best ideas.Your ideas are the best ideas.