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Senior Health

Falls - Threat to Independence Part 1

According to the Center for Disease Control and Prevention (CDC), falls are a significant public health problem. The CDC urges older adults and those working with the elderly to be aware of, understand and address the potential for fractures, injury and functional impairment that threaten one's independence, quality of life and may lead to death. While one in three older adults are likely to fall in any given year, and approximately 16,000 people die each year due to a fall or fall-related injury 5

Putting Falls into Perspective

A plane crash is a rare catastrophe that becomes headline news for the days and weeks to follow. In addition, the coordinated response of federal agencies regularly leads to mandated safety rules and regulations in an attempt to prevent future accidents. Events such as a plane crash often serve as a "wake up call" to bring attention to unrecognized threats and vulnerability. Did you know the occurrence of deaths due to falls is equivalent to a Boeing 767 going down weekly killing all 300 people on board.6

Aging brings challenges to our independence through natural changes that compromise safe mobility and increase fall risk. While not headline news, a fall can be catastrophic to the person affected. And, for many older adults, falls can be avoided if risks are understood and addressed.

Eliminating all fall risks is not possible, however; raising awareness and understanding about risks to safe mobility is key to helping older adults maintain and extend their independence. Since independence is highly valued, researchers note that a health promotion and independence approach is effective 7 in counseling older adults versus more traditional fall prevention focus (e.g., facts and problem oriented approach).

Addressing Fall Risks

We understand that fall risks are multi-factorial and include physical, psychological, financial, environmental and social risk factors. With the focus of this month's Gero Gems on encouraging health care and social service professionals to assess and address mobility safety, we emphasize the importance of conducting targeted screening. A variety of screening tools are available to assess functional mobility status including the Timed Up and Go Test 8 that is effective when used to identify community dwelling older adults at risk of falling and the Morse Fall Scale 9 is validated as useful in long-term care facilities. Each of these screening tools can be administered in less than one minute and provides a basic overview of functional mobility and risk for falls. It is understood, however, that the use of any screening tool is only a first step toward identifying the need for a comprehensive, follow-up assessment required to uncover additional fall risk factors.

As the aging population continues to grow at record rates, it is more important than ever for health care and social service professionals to help increase awareness and understanding of the catastrophic consequences of falls. In addition, as with many health challenges, there is a "ripple effect" associated with falls. Falls not only impact the individual faller (death, dependence), they also affect their family (care, finances), and their community (health care system, volunteer lost). As professionals serving older adults, we need to lead the charge, setting in motion a "risk reduction mind-set" for all of us to help ward off this significant threat to life and independence.

Did you know falls are a significant threat to the independence of older adults:

Direct cost of falls:

Recommended Resources- Evelyn's Picks Center for Disease Control and Prevention. Falls in Older Adults. Information on preventing injuries at home and at leisure. 

Gillespie, L. & Handoll, G (2009). Prevention of falls and fall-related injury in older people. Cochrane Corner. Injury Prevention, 15: 354-355. 

GERO GEMS is a monthly publication of the Center for Aging with Dignity. Compiled by Evelyn Fitzwater, this publication is designed to raise awareness of aging and related issues impacting health care professionals and our society as a whole.

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Last Reviewed: Jul 22, 2010

Evelyn L Fitzwater, DSN, RN Evelyn L Fitzwater, DSN, RN
Associate Professor Emerita
Associate Director of the
College of Nursing
University of Cincinnati