One of the top fears of older adults is falling. For Wisconsinites age 65 and older, falls are the leading cause of accidental death. A new process for patients who visit Marshfield Clinic aims to help prevent these accidents.
When patients are taken to the exam rooms, Clinic staff, using the electronic health record, ask older adults some key questions about whether they have fallen. If they have or are at risk, further assessment may be needed by the provider. Evidence shows that these intervening steps can play a role in reducing fall risk.
"Asking about falls and offering interventions lead to fewer falls in this population," said Ellen Vanderboom, R.N., clinical nurse specialist in Marshfield Clinic’s Institute for Quality, Innovation & Patient Safety. "A fall prevention program can help reduce serious fall-related injuries, ER visits, hospitalizations, nursing home placements and functional decline among our elderly."
The screening for fall risk is one of several factors reported as part of the Clinic’s participation in a Centers for Medicare and Medicaid (CMS) project to demonstrate that health care costs can be reduced while overall quality is improved. Individuals at risk can be identified through screening so that interventions can be recommended.
“The number of elderly men and women who die from accidental falls is comparable to the national yearly mortality of some fairly common cancers,” said Family Medicine Physician Paul Thompson, M.D., Marshfield Clinic Merrill Center. Because this is a complex problem with many potential causes, it’s crucial to have efficient and effective diagnosis and intervention. “Reducing falls in the elderly requires action by the entire health care team, as well as collaboration with community resources,” he said.
A variety of strategies has helped reduce fall risk, according to Vanderboom. Tai Chi and other exercise programs that target balance, gait and strength training have been shown to be effective. Having nightlights in the bedroom and grab bars in the bathroom and removing throw rugs can make homes safer. Minimizing certain medications has also reduced fall risk.
"These interventions can reduce the risk of falls for our elderly patients and give them and their families more peace of mind," Vanderboom said.
Prevent Falls with these Tips
Some simple ways can help lessen the chance of older adults falling, and help them maintain their independent lifestyle. The Centers for Disease Control and Prevention recommend the following tips:
- Exercise regularly. Exercise should focus on increasing leg strength and improving balance. Tai Chi programs are especially good.
- Ask your doctor or pharmacist to review your medications -- both prescription and over-the-counter -- to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
- Have your vision checked by an eye doctor at least once a year and update eyeglasses for optimum vision. Consider getting a pair with single-vision distance lenses for some activities such as walking outside.
- Make homes safer by reducing tripping hazards, removing throw rugs. Add grab bars inside and outside the tub or shower and next to the toilet. Install stair railings and improve the lighting in homes.
To lower hip fracture risk, older adults should:
- Get adequate calcium and vitamin D from food or supplements
- Do weight-bearing exercise
- Get screened and treated for osteoporosis
