Fall Prevention Coalition

1. Fall Prevention Coalition Preventing falls in older adults

2. Why do we want to prevent falls? • Some startling statistics from the CDC: • More than one third of adults 65 and older fall each year. • Among older adults, falls are the leading cause of injury deaths. • Falls are the most common cause of non-fatal injuries and hospital admissions for trauma. • Every 18 seconds, an older adult is treated in an emergency room for a fall. • Over 95% of hip fractures are caused by falls. • The average hospitalization for a fall costs $17,500. • The direct medical costs for falls in 2010 was $30 billion.

3. Falls as they relate to the Elderly ‘One of my biggest fears is, if I tell my children that I fell or my doctor that I fell, they will think that I’m incompetent and can’t take care of myself and therefore I will go to a nursing home’ An older adult will fall numerous times in his or her home, but no one will take action until the fall results in an emergency room visit or hospital stay. Injuries from a fall will account for almost half of new nursing home admissions and many will die from complications. The fastest way to go from Independent Living to Nursing Home Care is through the results of a FALL

4. What Might Happen After You Fall • If this is one of multiple visits to the hospital, or if the fall resulted in a serious injury or health consequence, the doctor and discharge planner may determine that the older adult is unsafe to return home without assistance or will need a higher level of care than can be obtained by in-home help. • Families and patients are given a very small window in which to find help or placement. Choices become narrower and will be based primarily on availablility. • Care in the home, placement in an appropriate assisted living community or long term care home will be necessary, with costs ranging from a few hundred to many thousands of dollars per month. • After a fall, physiological and psychological changes happen. Sometimes these changes can be stabilized but rarely can they be reversed. Care needs tend to be higher and therefore, more expensive. Ancillary services such as physical therapy add to the costs. Permanent disability or ongoing medical conditions require supportive services and equipment that add to the over all costs. • Quality of life diminishes. Isolation, decreased participation, diminished communication skills, loss of functionality and the need for others to take care of private and personal activities. • Family members will sometimes take on the role of caregiver. They are well meaning but will primarily be unqualified, unskilled, overworked and underappreciated. Adjusted for other factors, strained elderly spouse caregivers were at 63% higher risk of death than non-caregivers. Abuse, neglect and exploitation can result when family members are pressed into the role of caregiver.

5. What Causes a Fall? There is only one cause of falling Loss of Balance ! There are three reasons why we lose our balance Medications Lack of Physical Activity Home Hazards

6. Medications • Cardiac Medications/Diuretics can cause: • Orthostatic hypotension • Dose-related hypotension • Water and electrolyte imbalance • Weakness • Arrythmias • Diabetic Medications can cause: • Hypoglycemia leading to dizziness • Syncope (fainting) • CNS (Central Nervous System) Medications can cause: • Drowsiness • Sedation • Eye Medications can cause: • Changes in vision

7. Tips and Precautions • Polypharmacyis taking three or more medications. • Can cause adverse drug effects, drug interactions, electrolyte imbalance, and decreased drug clearance rates with aging. • Be alert to high-risk adverse effects like hypotension, dizziness, sedation, hypoglycemia, visual disturbances due to polypharmacy. • Call for assistance before getting out of bed by yourself while experiencing these side effects. • Ask your doctor or pharmacist for a medication review • Discard Outdated or Unused Medications • Have your eyes checked regularly and update your glasses!

8. Home Hazards Falls account for 75% of all accidents at home. The elderly person was at home alone 79% of the time. • The bathroom – 29% • Living or sitting room – 18% • Kitchen – 14% • Bedroom – 11% • Dining room – 10% • Injury by sharp object – 8% • Ingestion of foreign object – 6% • Crush injury – 4% • Burns/scalds – 3% • Hit by/onto fallen objects – 3% • Electric shock – 1%

9. Tips and Precautions • Home Modification– Easy & Inexpensive • Remove throw rugs or secure them to the floor • Add lighting to hallways and dark areas of the home • Remove excess furniture from rooms • Add grab bars to bath enclosures • Have the floors coated with a non-skid surface • Avoid placing anything on the floor • Rearrange cabinets to avoid using stepstools in kitchen or bathroom • Put nightlights along the path from bed to bathroom • Put a bell on the cat • Secure loose cords from appliances and avoid stretching them across pathways • Wear shoes with non-skid soles • Change to bright light bulbs in lamps • Clean up spills immediately • Home Modification – Moderately Expensive • Have the tub cut into a walk in enclosure • Replace frayed or worn carpeting • Repair loose handrails and loose steps • Install handrails on stairs • Install additional light switches at top and bottom of stairs and at all entrances of rooms • Contract with a service that offers an emergency personal alarm system • Installing ramps to entrances instead of steps • Home Modification – Expensive • Replacing the tub with a wheel-in shower • Installing sensors to lights for automatic turn on/off • Lowering cabinets and shelving • Installing a chair lift between floors

10. Physical Activity • Physical Activity is one of the key components of fall prevention. It’s never too late to get moving and physical fitness has many obvious health benefits for older adults! Remember, physical activity for the elderly should never hurt, and you don’t have to work up a sweat for physical exercise to be effective. Activities such as cleaning the house, dancing, or even climbing a few stairs are all levels of physical exercise. • Any physical activity that safely moves your body and uses energy is good for you. Whether you’ve been sedentary for years or currently lead an active lifestyle, there’s sure to be a physical activity program in your area that will suit your needs and your budget.

11. Tips and Precautions • Exercise can come in many forms. Tai-Chi, Yoga,Walking and Gardening are all ways to get exercise. Join the Silver Sneakers Walking Club. Find a Matter Of Balance Class. Play with the dog or the grandchildren. • Use your assistive devices! • Canes • Walkers • Reachers • Always consult with your doctor before beginning any exercise class or regime.

12. Additional Resources • www.azstopfalls.org • Arizona Fall Prevention Coalition • www.cdc.gov/Features/OlderAmericans/ • Center for Disease Control • www.nsc.org/safety_home/Resources/Pages/Falls.aspx • National Safety Council • www.safeaging.org • Safe Aging • www.aarp.org • AARP

13. Brought To You By: Area Agency On Aging Fall Prevention Coalition 1366 E. Thomas Road Phoenix, AZ 85014 602-264-2255 www.aaaphx.org Bivens & Associates, PLLC 5020 E. Shea Blvd, Suite 100 Scottsdale, AZ 85254 480-922-1010 www.bivenslaw.com