Photo: Balance movement class at Friendship Centers

Deadly Falls Are on the Rise for Older Adults, and Prevention Is Key

Posted on June 12, 2019 by Michael Moore Jr., Herald-Tribune Media Group

Every second of every day in the United States an older adult falls. Every 11 seconds an older adult is treated in an emergency room for a fall. Every 19 minutes an older adult dies from a fall.

“How many times have you fallen in the past 12 months?”

That’s the first thing physical therapist Laura Wazen asks patients when they walk through the doors of her practice to undergo a balance assessment. And if statistics are any indication, it’s a question of growing importance. Deadly falls are on the rise.

Not every person who ends up at Equinox Physical Therapy thinks they have a balance problem — many are there because of pressure from either their family or doctor. She once had a patient deny they had a balance issue because they “only fell once or twice a day.”

But Wazen, who specializes in inner ear and balance disorders, said this isn’t quite right.

“People shouldn’t fall. Falling is not normal,” Wazen said. “A lot of people think that’s what getting older is about, but no, it’s not. If you have trouble getting out of a chair, if it takes you two or three times to get up or somebody has to help you, there’s probably a few things going on. You’re probably a little bit weak, maybe you have a balance disorder — these are things we could work on and improve.”

While falling may not be a normal part of aging, it is becoming an increasingly dangerous proposition for a growing elder population. A recent study published in the medical journal JAMA found that the mortality rate from falls has more than doubled from 2000 to 2016 for those 75 and older.

Every second of every day in the United States an older adult falls. Every 11 seconds an older adult is treated in an emergency room for a fall. Every 19 minutes an older adult dies from a fall.

More than 3 million older adults are treated in emergency departments for falls each year, with one out of five of those falls resulting in serious injuries such as broken bones or head trauma, according to the Centers for Disease Control and Prevention. Falls are the leading cause of traumatic brain injuries and cause more than 95% of hip fractures, both of which can be deadly.

They are also the No. 1 cause of injuries and deaths from injury among older Americans, according to the CDC. With more than 10,000 residents turning 65 each day, the number of fall-related injuries and deaths is expected to climb.

Early assessment

But most falls are preventable, according to Wazen, once you identify what’s causing them. That’s why she and other health professionals recommend making balance tests a regular part of your health screenings.

“Doing a balance assessment really helps people narrow down what’s causing the issues,” said Amanda Harrison, vice president of Pines of Sarasota, a rehabilitation and senior care community. “You get your eyes checked every year, you get your physical, your hearing checked — but we also want them to go ahead and make getting a balance assessment a part of their normal annual routine.”

Both Harrison and Taryn Flagg, an occupational therapist at Pines of Sarasota, said that getting started with these assessments as early as possible is beneficial, as it gives doctors baseline results for patients which can then be monitored and compared with future results to see if there’s been any change or decline. It also gives doctors and physical therapists a head start in identifying a patient’s potential risk factors for falling, of which there can be many.

Muscle weakness, vision loss, and balance disorders are all common causes for falls, according to Wazen. But it’s also factors that are often overlooked, such as the side effects of certain medications, which can induce drowsiness, or even environmental factors, such as steep steps or a poorly placed throw rug that can be the impetus for a fall. A 2012 analysis by Johns Hopkins University on data showed that those with some level of hearing impairment are up to three times more likely to suffer a fall.

“Saying that people are having bad balance just because they’re older is my absolute last option,” Wazen said.

Pines of Sarasota’s Ready and Steady program, which offers free balance assessment, is one community resource people can tap if they feel they are in danger of a fall. Each evaluation involves a questionnaire that asks about medical history, a mobility test designed by the CDC called “Timed Up and Go” and the use of a Biodex Balance System, which tests for muscular imbalances and stability. Once someone is determined to be at risk of falling, their test results are faxed to their primary care doctor, where they can then come up with a rehabilitation plan that focuses on addressing that patient’s risk factors.

Mobility skills

Movement is one of the biggest keys of fall prevention, Wazen says.

“When most people retire they start spending more time doing things they enjoy doing. If your hobbies are sedentary things, like reading, playing cards, watching television or knitting, then you are spending more time being inactive and not keeping up with your mobility skills, which could set yourself up for an increased risk of a fall,” she said. “However, some people enjoy playing tennis, golf, walking the Ringling Bridge or gardening, and they are very active with their body, and those individuals tend to stay in better condition and health as they get older.”

One place to get active is at balance movement classes at the Senior Friendship Centers in Venice and Sarasota, where exercise physiologist Jeannie Burke gets people moving through proper walking techniques, balance exercises, weight shifting, core strengthening and stretching at a cost of a $4 suggested donation per class.

Bob and Chris Bucher are both in their 70s and have been attending Burke’s class twice a week for the last several months. Bob, a retired endocrinologist who has a rare type of neuropathy that causes him to fall, was looking for an activity he and his wife could do together after he completed physical therapy. During his days practicing medicine, Bob constantly advised his patients to keep moving. Now, he finds himself trying to stick to his own advice.

“I’ve seen a dramatic difference since he started attending this class. When Bob went to his last visit with the neurologist, he couldn’t believe how well he was walking and that he was able to go in without a walker,” Chris said.

In addition to building up strength and balance, Burke spends a lot of time teaching proper technique when executing common but difficult movements, such as sitting up and standing from a seated position.

“It’s all about knowing your limitations, but it’s also really important to be able to challenge yourself safely to keep those muscles engaged,” Burke said.

Kathleen Cameron, senior director of the National Falls Prevention Resource Center for the National Council on Aging, calls falling the ”$50 billion problem.” That’s roughly the direct medical cost of falls in the U.S. each year, with that figure expected to increase to nearly $70 billion by 2020, according to the CDC, with Medicare and Medicaid shouldering roughly 75% of these costs.

The organization has tried to increase awareness by implementing things like an annual Falls Prevention Awareness day, which will celebrate its 11th year, and by endorsing evidence-based falls prevention programs, such as Tai Chi, but many seniors still see falling as a regular part of everyday life.

But it doesn’t have to be that way, Wazen says.

“Many people are able to improve their balance, safety, and independence if they just seek out treatments from a physical therapist who is a balance specialist. People come to Sarasota to retire and have a good life, and you can’t have a good life if you’re falling all the time. My goal is to get my patients to a place where they can enjoy their retirement and have a happy, active lifestyle,” she said.

This story comes from Aspirations Journalism, an initiative of The Patterson Foundation and Sarasota Herald-Tribune to inform, inspire, and engage the community to take action on issues related to Age-Friendly Sarasota, Suncoast Campaign for Grade-Level Reading, National Council on Aging and the Suncoast Nursing Action Coalition.

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