▪ Massachusetts residents have over 900 emergency department visits for fall injuries every week
▪ Researcher said the fall risk assessment is easy to conduct and effective
Carol Crownfield, 78, fell and broke her wrist six years ago. She was thinking where she was going while walking and was being stumbled by a plastic thing.
I had a surgery and the doctor put something like a pin in my wrist, said Crownfield.
Although recovered well, ever since the fall, she became particularly aware of things on the ground, like little nuts and drinking bottles.
“Falls are always a problem for senior citizens,” she said.
Every week among Massachusetts residents ages 65 and older, there are approximately 900 emergency department visits, 400 hospital stays, and 10 deaths due to fall injuries, according to the most recent data on the serious issue of older adult falls.
To deal with this issue, older adults themselves, their primary care physicians and the government all need to make some efforts.
“Be careful and walking like penguins,” said John Hampton, 72, who fell on the day before Thanksgiving three years ago. He was just out of a pharmacy with two bags in hands. A car suddenly came by, he stepped back and lost his balance.
Hampton was sent to a hospital but nothing serious happened. He said for falls prevention older adults should take some exercise and always be prepared when walking around.
Taking exercise is “probably the best way to keep older adults from falls,” said Elizabeth Howard, an associate professor of Connell School of Nursing who engaged research about strategies to reduce the risk of falling in 2016.
“They can do things as simple as walking, hiking and yoga which help with balance. But they should be exercising with supervision to make sure they don’t get hurt,” she added.
Howard said there are many strategies can help older adults minimize chances of falls, like putting railings in the bathroom, sitting in the armchairs for they can use the arms to get up and putting taps on stairs for the tapes can highlight each step.
Besides taking regular exercise and using smart strategies, older adults also need to overcome the fear of falls.
In recent years, there are programs, like “Matter of Balance,” an 8-session, 16-hour group workshop, designed to reduce the fear of falls and increase activity levels in older adults.
“The fear of falls can be just as dangerous as falling itself,” said Dave Fink, a coordinator of “Matter of Balance.”
According to Fink, when older adults are afraid of falls they tend to stay at home and stay inactive. They believe this will reduce the risk of falls, which is true, but then also have the consequence of making them weaker and increase their risk of falls.
Fink also mentioned sometimes older adults need to ask their family, friends or even stranger for help to walk steadily and did not feel asking such a small help was a bother.
“If they don’t ask for help and they fall, then they have to ask for a lot of help,” said Fink. “Ask for a small amount of help to avoid having to ask for a lot of help.”
As for the state government, it has been a leader in older adult falls prevention in several respects.
In 2010, the state legislature passed laws to the Massachusetts Falls Prevention Commission; and in 2012, a survey conducted by the Boston Medical Center showed investigator identified 107 fall prevention programs in a statewide.
But recently some researchers are asking further effort for the government by improving the primary care practice for falls prevention.
Currently, primary care physicians were focusing on treating their patients after they suffering from falls but were not doing enough to assess and help them prevent falls, said Jonathan Howland, The Director of the Injury Prevention Center at Boston Medical Center.
In the survey conducted by Boston Medical Center in collaboration with the Massachusetts Falls Prevention Commission, Howland and other researchers proposed to integrate two things into primary care: assessment algorithms and community programs for fall prevention.
The assessment algorithms refer to a standardized approach for healthcare providers to assess fall risk in older adults, like asking them “how many times did they fall in the past year” and “do they feel unsteady when standing or walking” and testing their gait, strength and balance.
Giving older patients fall risk assessment was like giving them blood pressure assessment, which was easy to do but could be very helpful, said Howland.
The assessment could show the risk of falls like the blood pressure assessment can show the risk of having heart disease, so both doctors and patients could take preventive measures to avoid something serious, he explained.
Another thing Howland and other researcher are proposing to integrate into the primary care practice is community programs for fall prevention, like “Matter of Balance” and “Tai Chi: Moving for Better Balance.”
Those community programs can be very cost-effective. According to their survey, which involved in 136 primary care providers in Massachusetts, “94% of the responders thought community falls prevention programs can reduce the risk for falls among older adult patients identified as high risk.”
However, the problem was since those programs were not in the primary care practice many physicians did not know about them, so they did not refer their patients to those programs, according to Howland.
The proposal made by Howland was worth looking at, said Windel Stracener, a member of the board of directors of the American Academy of Family Physicians.
But physicians have to be adequately paid when bringing a proposal that may involve more people and work, so they can afford to give these services, he said.
According to Howland, the Massachusetts Falls Prevention Commission would write a report to the state legislature about their proposal. He hopes the legislature can pass the law so more senior citizens can benefit from that.
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