Falls are defined as unexpected events in which the participants come to the rest on the ground, floor or low level and occur at least once annually in 29% of community dwelling adults 65 years or older.
The rate of falls in community dwelling older adults is 0.67 falls per person per year.
Population studies suggest that 10% of older adults fall at least twice annually.
Annually, the cost of falls is predicted to reach $54.9 billion dollars by 2020, according to the Centers for Disease Control (www.cdc.gov/).
Falls are considered a “preventable” event for hospitals and acute care systems, where protocols are initiated based on the patient’s mental status, physical condition, age, gender, and medications being delivered, among other factors, such as abnormal laboratory values.
According to the Centers for Disease Control, one of the most common causes for falls is the loss of muscle in the lower extremities as we age.
This lower extremity weakness can be exacerbated by a hospital admission, where it is estimated that patients may remain in bed for up to 83% of their stay.
Patients should be monitored for gait imbalances, arthritic impairments of the hip or knees, and diabetic neuropathy which make walking more precarious.
Patients may require an assistive device to stabilize their center of gravity, such as a cane or walker.
If vision is an issue, it is important to establish clear pathways from one room to the next, or to consider the addition of hand-grasps for navigating doorways.
Area rugs should be avoided.
Pets and small children present fall hazards.
Adequate lighting and non-skid footwear are pivotal to avoiding unnecessary stumbles,
Hospitalized patients must follow instructions as provided by the nursing staff to prevent falls, such as calling for help prior to exiting the bed for any reason.
All patients are encouraged to exercise, if they can.
Fall prevention exercise studies results in a 23% lower risk of fall in participants and among those who did not exercise.
Multifactorial interventions, administered by nurses did not result in significantly lower rate of serious fall injury than usual care (STRIDE trial investigators).
Exercise lowers the rate of falls resulting in fractures.
Walking alone has not been shown to prevent falls.
For more information related to falls and fall prevention, you may wish to access the following websites:
www.nobi.nim.nih.gov (Pubmed: systematic review on falls literature)
www.ncoa.org/(National Council on Aging)
assets.aarp.org/ AARP Health Statistics on Falls