AGE | Falls Among Older People, and How We Can Prevent Them
Bernard A. Steinman
Anyone who has ever unexpectedly experienced a fall (which should be about all of us) knows the terror that occurs between the moments of our trip, slip, or stumble, the fall itself, and the jarring moment of impact!
Falling is a serious problem among older adults and carries repercussions that can be both physically painful and expensive to address. Each year, an estimated one out of three older people fall, leading to serious injuries, fear of falling again, and even death.
In fact, falls are the leading cause of injury and accidental deaths among people over the age of 65 and cost individuals and taxpayers in the U.S. about $50 billion per year, according to the Centers for Disease Control.
Fortunately, many falls can be avoided through evidence-based interventions and practices that focus on factors with known associations to falls.
The best interventions include medical assessments to identify and respond to risk factors for health-related falls (such as sensory impairment or low blood pressure); improving environmental conditions by assessing and modifying the home with supportive features; and changing behaviors, through education, mindfulness practices, and exercise programs that exist in communities throughout Wyoming.
Most falls are not caused by any single factor alone. Instead, falls experienced by older people usually occur because of a combination of circumstances.
For example, when homes are not well equipped with good lighting, or when there are many hazards in the home (such as stairs without railings, or unsecured throw rugs), older people—especially those with disabilities related to sensory loss, cognitive impairment, or mobility issues— are at much greater risk of having an accident.
That is why the most effective falls prevention programs take a multifaceted approach to avoiding accidents, which often place us at greater risk of losing our independence and becoming less active in our homes, social circles, and communities.
For example, the CAPABLE program, developed at the Johns Hopkins University, School of Nursing, focuses on the importance of medical and environmental assessment via credentialed professionals (such as registered nurses and certified occupational therapists), along with environmental changes implemented by knowledgeable handypeople who know how to appropriately install home modifications (such as grab bars in bathrooms) in ways that are safe and customized to fit the needs of older people.
In fact, the CAPABLE program has been shown to improve the ability of older adults to live confidently, reduce depression, and safely continue with activities that are necessary for daily living (such as bathing, dressing, and using the toilet).
In Wyoming, the Department of Health and its aging division have prioritized the importance of falls prevention to improve the well-being of people of all ages in the state, and to reduce costs associated with falls.
Evidence-based safety programs such as Bingocize and ThinkFirst, which combine engaging games, exercise, nutrition, and educational activities, have been promoted by the Wyoming Department of Health to improve outcomes that often are associated with growing older.
At the local level, many activity centers that serve older people also offer regular falls prevention classes. For example, Laramie’s Eppson Center provides fall prevention courses three days a week in their scheduled activities!
Many outcomes that are associated with greater longevity, including reduced muscle mass and bone density (which in themselves place older adults at greater risk for falling) are inevitable if you live long enough. But falling and the resulting injuries are not inevitable.
You can begin to take steps today that ensure you…stay on your feet!
Bernard A. Steinman, PhD, CFLE, (bsteinm1@uwyo.edu) is a gerontologist and an associate professor in the Department of Family and Consumer Sciences at the University of Wyoming.
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