Are falls really a serious health issue?
Falls are a major cause of injury for older adults in Maryland. In fact, studies show that one in three people age 65 and over fall each year. Maryland data for the year 2009 shows that falls were the leading cause of emergency room visits and accounted for almost one quarter of the 513,034 emergency room visits for the year. In 2010, falls caused 509 injury related deaths among Marylanders age 65 and up. Falls among seniors represented 65% of injury related hospitalizations and 20% of injury related emergency room visits.
For some people, falls result in serious injuries like hip fractures, which can mean long-term hospital or nursing home stays, or even death. Seniors who fall are two to three times more likely to fall again. Plus, seniors who fall once are likely to restrict their activity level for fear of falling again, which can reduce their quality of life.
But aren't falls just accidents?
Falls are not an inevitable part of aging. While many people think of falls as accidents, the truth is that many falls can be prevented. Studies show that most falls have one or more causes related to the following:
- Physical mobility problems (poor strength or balance, foot and ankle problems, arthritis, diabetes, and depression)
- Vision loss or low vision
- Medication issues
- Home and environmental hazards
How can falls be prevented?
Fall prevention programs focus on promoting healthy behaviors and creating safe environments. Older adults can reduce their risk of falling by beginning a regular exercise program, making the home safer; having a health care provider review medications; and having their vision checked and corrected. Effective falls reduction programs address these multiple risk factors.
What is DHMH doing to prevent falls in Maryland?
Safe Steps for Seniors: A Fall Prevention Program for Older Adults is a mini-grant program provided by the Department of Health and Mental Hygiene (DHMH) to provide county-level fall prevention programs aimed at adults aged 65 and older. In FY2012, five Maryland counties are implementing fall prevention programs: Baltimore City, Allegany County, Caroline County, Kent County, and Washington County.
With funds from the recently funded CDC's Core Violence and Injury Prevention Program (Core VIPP), Maryland was able to award three additional mini-grants to Cecil County, MAC Inc. Area Agency on Aging, and Washington County to support fall prevention in older adults. All three counties will implement both the Stepping On and the Tai Chi: Moving for Better Balance programs in the community.
Working with the Fall Prevention Advisory Group under the Partnership for a Safer Maryland, DHMH coordinated fall prevention awareness promotion with local health departments during the Fall Prevention Awareness week in 2010 and 2011. In 2011, more than half of Maryland's county health departments conducted activities such as publication distribution, educational presentations, gait and balance workshops, home risk assessments, demonstrations, and health screenings in the community during the week of September 18 - 24.
What are some evidence-based fall prevention programs?
The following are proven, evidence-based fall prevention programs that have worked in communities all over the United States and Canada:
Remembering WhenTM: A Fire and Fall Prevention Program for Older Adults, was developed by the National fire Protection Association (NFPA) and the Centers for Disease Control and Prevention (CDC) to help older adults live safely at home for as long as possible. Remembering When is centered around 16 key safety messages, eight fire prevention and eight fall prevention, developed by experts from national and local safety organizations as well as through focus group testing in high-fire-risk states.
Tai Chi: Moving for Better Balance
Tai Chi: Moving for Better Balance is an 8-form version of Tai Chi that Oregon Research Institute studies have found can substantially decrease the risk of falls in older adults. The program is designed to be offered 2-3 times per week in community settings.
Stepping On is a seven-week falls prevention class incorporating behavior change theory. It was found in research by Dr. Lindy Clemson of Australia to be effective in reducing falls among older adults by about 30 percent. Theprogram isaimed at seniors age 70 plus. Stepping On is a free community-based and interactive evidence-based falls prevention program aimed at educating participants and building confidence in order to reduce and/or eiminate falls. Stepping On focuses on how strength and balancing exercises, medication management, homesafety, footwear, vision and mobility are important in preventing falls.
A Matter of Balance emphasizes practical strategies to reduce fear of falling and increase activity levels. Participants learn to view falls and fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance. This program has been adapted from the original intervention to be more suitable for community-dwelling older adults by allowing small group sessions to be led by a trained facilitator.
Other fall prevention links:
Fall Prevention Checklist
Falls Prevention for older Adults Resource List
Partnership for a Safer Maryland Falls Prevention Factsheet
Maryland Falls Prevention Awareness Week 2013
Jade Leung, M.S.
Environmental Health Bureau/PHPA
Department of Health and Mental Hygiene
201 W. Preston Street
Baltimore, MD 21201