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Elder Falls Prevention Initiative

Elder Falls Prevention Initiative. Safe Communities Madison/Dane County (WI). Falls in Perspective Falls are Dane County’s #1 cause of injury hospitalization

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Elder Falls Prevention Initiative

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  1. Elder Falls Prevention Initiative Safe Communities Madison/Dane County (WI)

  2. Falls in Perspective • Falls are Dane County’s #1 cause of injury hospitalization • Wisconsin has 2nd highest death rate from falls in U.S.  Data is inconclusive:  other cold weather states have lower falls death rates; could be due to higher alcohol consumption. • Older adults bear brunt of fall-related death and injury • Older adults are 10x more likely to be injured in a fall than from any other injury cause

  3. Age-adjusted Rate of Unintentional Injury Hospitalizations by Underlying Cause Dane County and Wisconsin – 2008 (ages 65+) Source: Wisconsin Interactive Statistics on Health (WISH) www.dhs.wi.gov

  4. Fatal and Non-Fatal Fall Injuries Among People Ages 65+Dane County 2008

  5. Falls That Landed Us in the HospitalDane County Fall-Related Inpatient Hospitalizations, 2008 By Specific Cause (E-code) Ages 65+ 50% of falls happen in or around the home

  6. Causes of Falls in Older AdultsSummary of 12 Large Studies – Rubenstein & Josephson

  7. Falls: An inevitable part of aging and end of independence, or preventable? • 1/3 of people 65+ will be injured in a fall this year • 31.8% of older adults who sustained a fall-related injury required help with activities of daily living as a result, and among them, 58.5% were expected to require help for at least 6 months • 40% of older adults who suffer a serious fall will end life in a nursing home • Community/medical interventions can reduce falls risk by 30%-65% • Falls are not an inevitable part of aging Sources: CDC and BRFSS survey

  8. What works to prevent falls? Studies point to: • Regular, progressive exercise program (at least 6 months in duration) that improves balance and coordination • Home safety assessments and modifications • Regular vision checks • Regular medication review

  9. Appropriate Balance Classes and Therapies by Falls Risk

  10. Vision Screening • Annual vision checkups/screenings for glaucoma, other eye disorders • Prescribing single lens (not bifocals) for walking • Cataract removal on both eyes (if it will improve vision) • Importance of Home Safety Checks • One-half of all falls among seniors happen in or around the home • Home safety checks boost falls risk reduction in targeted programs (NoFalls, Stepping On) by 15% • Home safety improvements need to be paired with other interventions (e.g. balance exercise program) to reduce falls

  11. Medication Review • Use of multiple medications (polypharmacy) increases falls risk 4+ meds = 40% increase 8+ meds = 80% increase • Some medications effect balance – can they be eliminated from use without negative health impacts? • If medication is required, is dosing appropriate given person’s age?

  12. Discharge Locations After Hospitalization for a FallDane County 2008, n=1,205

  13. Opportunities and Falls Prevention Referral Sources • United Way 2-1-1 • Community educational events put on by Task Force and partners • Fire/EMS/Police • Discharge planners: hospital, ED, skilled nursing • Older adults and their families • Paid and unpaid caregivers • Clinicians and community health care providers including doctors, nurses, occupational and physical therapists, pharmacists, eye doctors, nutritionists • Faith communities/parish nurses • Senior Centers/focal points • Independent and assisted living/congregant housing • Home health agencies • Community senior advocates (RSVP, CWAG, others) • Falls prevention class instructors

  14. Factors that Contribute to Senior Falls • Reluctance to use walking aids and other perceived trappings of aging • Not understanding what the doctor told them about their health problem or medical treatment plan • Disregarding or not understanding the serious potential for a fall • Lack of a system or plan for managing medicines • Not having a single primary care physician who looks a the over-all medical plan for treatment • Not seeking medical attention when early warning signs appear • Reluctance to participate in prevention programs • Not asking loved ones for help Source: Institute for Healthcare Advancement

  15. What’s been accomplished:Safe Communities Falls Prevention Task Force • Meeting monthly since January 2007 • Broad and active representation from 47 health care providers, • community organizations, first responders and aging network • Workgroups: • - MD Visit • - Community Exercise • - Community Education and Outreach • - Home Safety Assessment • - Falls Helpline at United Way 2-1-1

  16. Safe Communities Falls Prevention Infrastructure

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