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"I've fallen, and I can't get up!"

"I've fallen, and I can't get up!". How big is the problem?. >1/3 of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001). Every 18 seconds, an older adult is treated in an emergency room for a fall

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"I've fallen, and I can't get up!"

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  1. "I've fallen, and I can't get up!"

  2. How big is the problem? • >1/3 of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001). • Every 18 seconds, an older adult is treated in an emergency room for a fall • 2 million ED visits in 2006 for nonfatal injuries • 500,000 hospitalized19 billion each year for injuries • Average hospitalization $17,500 • $54.9 billion (in 2007 dollars) projected for 2020

  3. How big is the problem? 20% to 30% of people who fall suffer moderate to severe injuries (Alexander et al. 1992; Sterling et al. 2001) Mortality 5X higher than young with similar injuries(Trauma)

  4. Epidemiology

  5. Deaths and Mortality (Data are for the U.S.) Number of deaths: 2,426,264 Death rate: 810.4 deaths per 100,000 population Life expectancy: 77.7years Infant Mortality rate: 6.69 deaths per 1,000 live births Number of deaths for leading causes of death: Heart disease: 631,636 Cancer: 559,888 Stroke (cerebrovascular diseases): 137,119 Chronic lower respiratory diseases: 124,583 Accidents (unintentional injuries): 121,599 Diabetes: 72,449 Alzheimer's disease: 72,432 Influenza and Pneumonia: 56,326 Nephritis, nephrotic syndrome, and nephrosis: 45,344 Septicemia: 34,234 CDC Website “FastStats” 2006 data

  6. Scope of the Problem National Vital Statistics Report 2006

  7. Risk Factors - Fear of Falling Can be as life altering as any physical limitation! May start vicious cycle of inactivity May occur when a person has not fallen

  8. Intervention Programs Comprehensive fall history Medication review +/- pharmacist consult Physical exam by physician Physical therapist evaluation Occupational therapist evaluation Home safety assessment Evidence Based Health Promotions

  9. Home Safety Assessment • Furniture that is too high • Electrical cords on floor • Clutter on floor • Lighting • Phone • Low furniture • Throw rugs

  10. Bed and Bath Bedside phone Bedside lamp Night light Non- slip surface Grab bars Shower seat Raised toilet seat

  11. What Works for Prevention? • Cochrane Review 2009 “Interventions for preventing falls in older people living in the community” • Exercise interventions reduce risk and rate of falls. • Research is needed to confirm the contexts in which multifactorial assessment and intervention, home safety interventions, vitamin D supplementation, and other interventions are effective.

  12. Summary Falls are not an inevitable part of aging Intervention before a fall is ideal Prevention is the key Intervention after a fall is essential Request a PT/OT consult after the fall Outpatient Therapy In The Home

  13. Collaborative Partnerships

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