Preventing falls to protect seniors

Three times a week at the East Central Community Center, older adults gather to practice simple skills that could help keep them out of the hospital.

They walk a straight line, heel-to-toe. They start to walk, then stop quickly. They step over imagined obstacles. Combined with strength training and aerobics, these balance exercises are proven to help prevent people from falling down. The exercises are modified for people who use walkers, and those who can’t stand can do them in chairs.

“It straightens my legs, my arms. I stand up with the walker and do the exercises,” said Pat Coley, who is 69 and has multiple sclerosis. “It really, really helps all of us. It helps me with my balance.”

Falling is perhaps one of the country’s most under-recognized medical emergencies. In 2006, more than 12,500 Washington residents age 65 and older were hospitalized after falling. By comparison, hospitalizations from car accidents – for all ages – topped out at 2,540. The same year, 537 older adults died in Washington due to falls. In Spokane County, falling far and away outpaced every other cause of accidental death from 2001 to 2007.

“People are really recognizing the importance of the issue and the research literature is saying, ‘Yes, there is something we can do about this.’ Not only do we have a problem, but we have a problem that we can do something about,” said Ilene Silver, a senior fall prevention specialist with Washington’s Department of Health. “Falls are not an inevitable part of aging. You can do something to prevent falls.”

The Centers for Disease Control and Prevention has made preventing falls one of its top national priorities within its National Center for Injury Prevention and Control, Silver said. The CDC reported that every year in this country, one-third of people 65 and older experience a fall and 10 percent of them result in a serious injury.

Washington has made preventing falls a higher priority as well. The state has budgeted $400,000 to develop programs that will keep people standing on their own two feet. Spokane County, which launched a fall-prevention coalition in March, plans to apply for a grant that would fund a part-time position to coordinate anti-fall efforts. The coalition is led by an injury prevention coordinator with the Spokane Regional Health District and an AmeriCorps VISTA volunteer working with the Retired and Senior Volunteer Program, and brings together representatives from the Eastern Region EMS and Trauma Council, Spokane Fire Department, senior centers and other partners.

In Idaho, the state Department of Health and Welfare began a push to prevent falls about four years ago, said Cynthia Taggart, public information officer for the Panhandle Health District. Idaho residents were falling at twice the national rate and the state developed a free fitness program to help address the problem. Fit and Fall Proof has since swept through the state, organized by Idaho’s health districts. The fitness program has helped older adults improve strength, balance and mobility, as well as emotional well-being and social connections, Taggart said. Preliminary research has shown a decline in injuries. “It’s so incredibly popular,” Taggart said.

A.J. Hutsell, an injury prevention coordinator with Spokane’s health district, said if the county receives state funding, it will be able to analyze different fall prevention programs to determine which are the most effective and work to expand them. Also likely would be a marketing campaign to get the word out about how to prevent falls.

“You can’t say you can prevent them completely; accidents happen,” said Brenda Jurich, wellness director for Rockwood Retirement Communities, who has 25 years of experience working with older adults. But a review of five years of incident reports at Rockwood showed a decrease in falls following stepped-up education about prevention and fitness training specific to that goal, she said.

“I think it’s great that dollars are going to prevention. It should’ve happened 10 years ago,” Jurich said.

Tom Ulvin, the VISTA volunteer working with RSVP, said the new fall prevention coalition is working with 11th Hour Films to put together a five- to seven-minute film about preventing falling. Ulvin has been visiting senior centers and aging-related conferences to distribute information. The coalition also is forming a speakers bureau.

“The No. 1 issue for falls prevention is getting into balance and exercise classes,” Ulvin said. “Everybody I know has stories. Everybody I know knows someone who’s gone down.”

That includes Ulvin, 57, who slipped on the snow in January just as he was starting his new job. He hurt his back and was laid up for several weeks, using a wheelchair and cane temporarily. It also includes his mother-in-law, who fell on Mother’s Day holding a glass and required stitches in her hands.

The statewide push focuses on people 65 and older, Silver said, as that population appears to be particularly vulnerable. About 80 percent of the deaths from falls in 2006 were within that age group. In addition, the aging of the baby boom generation is increasing that population quickly. People age 65 or older make up 11 percent of Washington’s population; by 2020, they’ll make up 19 percent.

Ulvin said one of his greatest concerns is older adults who don’t visit senior centers or take exercise classes. People who are home and have fallen or are afraid they’ll fall can become increasingly sedentary. He wants to find ways to locate those people and help decrease their vulnerability.

Assessing and treating risk factors is the most effective intervention for preventing falls, followed by participation in exercise programs that emphasize strength and balance, Silver said. Risk factors can include medication that causes dizziness or drowsiness, neglecting to have eye exams or update eyeglasses, drinking too much alcohol or having had a previous fall.

Home safety also plays a major role, Ulvin said. Increasing home safety seems common-sense, but many falls are caused by slippery throw rugs, tripping over a pet or not having a pathway lit to the bathroom at night, he said. Other tips include moving furniture to create clear walkways in all rooms; moving cabinet items to keep frequently used supplies on lower shelves; and not using chairs as step stools.