Report on Falls, Injuries Released

PUblished in Woonsocket Call on October 20, 2019

Last Wednesday morning in Dirksen Senate Office Building 562, the U.S. Special Committee on Aging held a hearing to put a spotlight on the economic consequences on falls and to explore ways to prevent and reduce falls and related injuries. At the one hour and 55-minute hearing, titled “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors,” its annual report, Falls Prevention: Solutions to Better Support Seniors, was released.

According to the Senate Aging Committee, falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.

“Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences. In addition to the physical and emotional trauma of falls, the financial toll is staggering,” said Sen. Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Now is the time, and now is our opportunity, to take action to prevent falls. Our bipartisan report includes key recommendations to take steps to reduce the risk of falls,” the Maine Senator noted in an Oct. 16 statement.

Pushing for Positive Change in Releasing Fall Report

“We must dispel our loved ones of the stigma associated with falling so that they can get the help they need to age in place – where they want to be – in their homes and communities,” said Sen. Robert P. Casey, Jr. (D-Pa.). “I am hopeful that our work over the past year will propel the research community to do more, get more dollars invested into supporting home modifications and encourage more older adults to be active,” said the Special Committee’s Ranking Member.

At the hearing, the Committee unveiled a comprehensive report that provides evidence-based recommendations on ways to reduce the risk of falling. The Committee received input from multiple federal agencies, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Food and Drug Administration. In addition, approximately 200 respondents representing falls prevention advocates, hospitals, community organizations, home health agencies, and others shared their expertise on this issue.

The 34-page Aging Committee’s report made recommendations as how to raise awareness about falls-related risks, prevention and recovery at the national, state and local levels. It suggested ways of improving screening and referrals for those at risk of falling so that individuals receive the preventive care necessary to avoid a fall or recover after one. It noted ways of targeting modifiable risk factors, including increasing the availability of resources for home safety evaluations and modifications, so that older adults can remain in their homes and communities. Finally, it called for reducing polypharmacy so that health care providers and patients are aware of any potential side effects that could contribute to a fall.

Increasing Medicare Funding for Bone Density Testing

In an opening statement, Collins noted that falls are often times attributed to uneven sidewalks or icy stairs, medications, medical reasons or muscle strength. But one key cause of falling is osteoporosis, which can be especially dangerous for people who are completely unaware that they suffer from low bone density, she says.

According to Collins, although Medicare covers bone density testing, reimbursement rates have been slashed by 70 percent since 2006, resulting in 2.3 million fewer women being tested. “As a result, it is estimated that more than 40,000 additional hip fractures occur each year, which results in nearly 10,000 additional deaths,” she said, noting legislation, Increasing Access to Osteoporosis Testing Beneficiaries Act that she has introduced with Sen. Ben Cardin,” to reverse these harmful reimbursement cuts.

Casey stated, “I am particularly interested in sharing this report with the relevant agencies and learning how the recommendations will be implemented. Not just put in a report. Implemented,” adds Casey.

Peggy Haynes, MPA, Senior Director, of Portland-based Healthy Aging, MaineHealth that offers A Matter of Balance, an evidence-based falls prevention program, came to the Senate hearing to share details about its impact. “The health care community has a critical role to play in fall prevention – beginning with screening for falls, assessing fall risk factors, reviewing medications and referring to both medical and community-based fall prevention interventions. Our health system is focused on preventing falls in every care setting,” says Haynes.

“The need for a range of community-based options led MaineHealth to be a founding member of the Evidence Based Leadership Collaborative, promoting the increased delivery of multiple evidence-based programs that improve the health and well-being of diverse populations,” adds Haynes.

Haynes noted that older participants attend eight two-hour sessions to help them reduce their fear of falling, assisting them to set realistic goals for increasing their activity and changing their home environment to reduce fall risk factors. A Matter of Balance is offered in 46 states reaching nearly 100,000 seniors.

Virginia Demby, an 84-year-old visually-impaired retired nurse who is an advocate for Community and Older Adults, in Chester, Pennsylvania, came to the Senate hearing to support the importance of fall prevention programs. Despite living with low vision, Demby remains physically active by participating in exercises classes for older adults at the Center for the Blind and Visually Impaired in Chester. She is an advocate for older adults and now helps the local senior center wellness manager recruit more seniors to take falls prevention classes and find new places to offer the classes.

Kathleen A. Cameron, MPH, Senior Director, Center for Healthy Aging, of the Arlington, Virginia-based National Council on Aging, discussed the work of the National Falls Prevention Resource Center, which helps to support evidence-based falls prevention programs across the nation and highlighted policy solutions to reduce falls risk.

Finally, Elizabeth Thompson, chief executive officer, Arlington, Virginia-based National Osteoporosis Foundation, testified that bone loss and osteoporosis are fundamental underlying contributors to the worst consequences of falls among older Americans: broken and fractured bones. Osteoporotic fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, she noted.

For details of the Senate Aging Committee report, go to http://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf.

Advertisements

The Best of…Don’t Fall Flat on Your Face: Simple Tips to Keeping Standing

     Published Julyl 11f, All Pawtucket All The Time

      I  know how easy it is to fall.  On March 14th, leaving the War in Iraq Art Exhibit this writer, an aging baby boomer, fell down several steep steps, tripping after he walked through the huge wooden front door, falling down several slippery steps in front of the historic Pawtucket Armory onto the front sidewalk.   Thank God…No serious injury, only a bruised ego and shins, and scuffed up palms. .

        Three months later, within weeks of each other, two of my older friends, in their seventies, unexpectedly fell.  One tripped on a rug in his kitchen breaking several ribs.  The other one fell down a flight of stairs outside his bedroom injuring his spine. Luckily, both are on the mend, slowly recuperating in their homes.

       But for others who were not so lucky as my elderly friends, traumatic brain injuries due to falls caused nearly 8,000 deaths and 56,000 hospitalizations in 2005 among Americans age 65 and older, according to a new report released last month by the U.S. Centers for Disease Control and Prevention.  .

      The national report notes that traumatic brain injuries, (called TBIs), are caused by a bump or blow to the head; however, they maybe missed or misdiagnosed among older adults. TBI often results in long-term cognitive, emotional, and/or functional impairments. In 2005, TBIs accounted for 50 percent of unintentional fall deaths and 8 percent of nonfatal fall-related hospitalizations among older adults.

      According to the CDC report, each year, one in three older Americans (65 and older) falls, and 30 percent of falls cause injuries requiring medical treatment. In 2005, nearly 16,000 older adults died from falls, 1.8 million older adults were treated in emergency departments, and 433,000 of these patients were hospitalized. Falls were the leading cause of injury deaths and nonfatal injuries for those 65 and over. 

      Falls are not an inevitable consequence of aging, the researchers say, but they do occur more often among older adults because risk factors for falls are usually associated with health and aging conditions.  These conditions include mobility problems due to muscle weakness or poor balance, loss of sensation in feet, chronic health conditions, vision changes or loss, medication side effects or drug interactions, and home and environmental hazards such as clutter or poor lighting.

      “Most people think older adults may only break their hip when they fall, but our research shows that traumatic brain injuries can also be a serious consequence,” said Dr. Ileana Arias, director of CDC’s National Center for Injury Prevention and Control, in her statement announcing the release of her agency’s report.  “These injuries can cause long-term problems and affect how someone thinks or functions.  They can also impact a person’s emotional well-being.”

      Reducing falls can be a simple as removing obvious household hazards along with adding or improving simple safety features in the home, notes an AARP spokesperson in response to CDC’s released report.  The Washington, DC-based nonprofit group represents over 39 million members, age 50 plus, in the United States.    

       According to AARP, studies indicate that half of all falls happen at home and research suggests that one-third of home accidents can be prevented by easy home updates and preventative maintenance.

       It’s easy to fall-proof your home, AARP says.  Aging baby boomers or the elderly parents can:  Install handrails on both sides of all steps (both in and outside);  Secure all carpets and area rugs with double-sided tape;  Install easy to grasp shaped handles for all drawers and cabinet doors; Use brighter bulbs in all lighting fixtures;  Install night lights in all areas of night activity;  Add reflective, non-slip tape on all non-carpeted stairs;  Install lever handles for all doors;  Place a bench near entrances for setting down purchases and resting;  Install closet lights, as well as adjustable rods and shelves; Install rocker light switches; and consider illuminated ones in select areas.

       Finally, why not check out your local hardware stores, too, the businesses even carry many of the products to make simple updates to homes. For homeowners making more extensive renovations, AARP recommends that they consider hiring a contractor who is licensed, certified and bonded to do work in that particular location. A Certified Aging in Place Specialist (CAPS) is a professional designation signaling that contractors have had specified additional training, but homeowners should still ask for documentation that the contractor is licensed or certified and bonded.

      Herb Weiss is a Pawtucket-based freelance writer who covers medical, aging and health care issues. The article was published in the July 11, 2008 issue of All Pawtucket All The Time.  He can be reached at hweissri@aol.com.