Falls Among Older Adults

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Facts Regarding Older Adults and Falls

Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma. More than one third of adults 65 and older fall each year in the United States. In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized. The rates of fall-related deaths among older adults rose significantly over the past decade.

According to the data compiled from the 1997 and 1998 National Health Interview Survey, the majority (55%) of fall injuries among older people occurred inside the house, whereas an additional 23% occurred outside but near the house and 22% occurred away from the home. Falls have devastating consequences for older adults in terms of morbidity and mortality. Fall-related hip fractures account for approximately 25 percent of injury deaths among those over age 65, and 34 percent of injury deaths among those aged 85 or older.

Various types of intervention strategies have been implemented with different target populations and in a variety of settings. In general, these intervention strategies include, but are not limited to: (1) fall risk assessment and management (including medication management), (2) physical activity-based interventions, (3) environmental modifications, (4) education, (5) assistive devices, (6) visual interventions, and (7) footwear interventions.

Fast Facts:

   * 3 in 10 fall each year
   * 2 in 10 who need home health care after being in the hospital will fall during the first month after coming home
   * 1 in 10 suffer a serious fall injury such as a broken bone or head injury
   * 5 in 10 have problems getting up without help after they have fallen
   * Falls cause over 90% of broken hips; only half of those who break their hip will get around like they did before their broken hip
   * In the United States, 16 percent of all Emergency Department visits and almost 7 percent of all hospitalizations are for fall-related injuries


Resources:

http://www.stopfalls.org http://www.cdc.gov http://fallprevention.org


A Matter of Balance

What is A Matter of Balance?

A Matter of Balance: Managing Concerns About Falls is a program designed to reduce the fear of falling and increase the activity levels of older adults who have this concern. It is based upon research conducted by the Roybal Center for Enhancement of Late-Life Function at Boston University.

What are the components of A Matter of Balance?

A Matter of Balance is a structured group intervention, which utilizes a variety of activities to address physical, social, and cognitive factors affecting fear of falling and to learn fall prevention strategies. The activities include group discussion, problem-solving, skill building, assertiveness training, videotapes, sharing practical solutions and exercise training. During the class, participants learn to:

   * view falls and fear of falling as controllable
   * set realistic goals for increasing activity 
   * change their environment to reduce fall risk factors 
   * promote exercise to increase strength and balance

Each of the eight sessions is two hours in length including a break for light refreshments. Early sessions focus on changing attitudes and self-efficacy before attempting changes in actual behavior. The exercise component, which begins in the third session, takes about 30 minutes of the session to complete.

Who should attend A Matter of Balance?

The program was designed to benefit community-dwelling older adults who:

   * are concerned about falls
   * have sustained a fall in the past
   * restrict activities because of concerns about falling
   * are interested in improving flexibility, balance and strength
   * are age 60 or older, ambulatory and able to problem-solve

What are the class outcomes for A Matter of Balance Volunteer Lay Leader Model?

After completing A Matter of Balance:

   * 97% of participants are more comfortable talking about fear of falling
   * 97% feel comfortable increasing activity
   * 99% plan to continue exercising
   * 98% would recommend MOB 


Preliminary findings of the participant outcome evaluation indicate that there were significant improvements for participants regarding their level of falls management, that is the degree of confidence participants perceive concerning their ability to manage the risk of falls and of actual falls; falls control, that is the degree to which participants perceive their ability to prevent falls; level of exercise; and social limitations with regard to concern about falling. These measures indicate that the program has been successful to date in reducing the fear of falling by increasing participants’ confidence that they can manage falls risk better and actual falls if they occur and that they can take action to help reduce the risk of falling. In addition, participants indicated that their concerns about falling are interfering less with their social activity and they report that they have increased their exercise levels. (Healy, McMahon, Haynes, ASA/NCOA presentation, Sustainability through Collaboration: An AoA Evidence-Based Prevention Program for the Elderly, March, 2006.)


Reference:

http://www.aaacap.org