But what about fall prevention in the community? A cost-benefit analysis revealed that community-based fall interventions are feasible and effective and provide a positive return on investment—no small consideration, given our current circumstances: Every 13 seconds, an older adult is treated in the emergency department for a fall, and every 29 minutes, an older adult dies from a fall-related injury.4,5 These estimates will likely rise as the population ages. The financial repercussions of falls and resultant morbidity and mortality may exceed $59 billion by 2020, according to the National Council on Aging.1 However, a 2013 report to Congress by the Centers for Medicare & Medicaid Services indicated that older adults’ participation in a falls prevention program has resulted in reduced health care costs.11
Over the decades, many different approaches have been used to enhance older adults’ participation in such programs. I am proud to report that my university is among the many organizations to address this issue. A.T. Still University of Health Sciences (ATSU) was recently awarded a $95,000 grant by the Baptist Hospitals and Health Systems (BHHS) to support the university’s Fall Prevention Outreach program—the largest university-based fall-prevention initiative in the country.12
Since the program began in 2008, more than 2,000 Arizonans have completed the eight-week curriculum, which gives older adults the tools they need to prevent falls and manage the often-paralyzing fear of falling that comes with growing older. Since injuries sustained from falls are the leading cause of accidental injury deaths in Arizonans ages 65 and older, according to the state’s Department of Health Services, this program gives us an opportunity to have a direct impact on our community.
ATSU uses A Matter of Balance, a nationally recognized fall-prevention curriculum developed by Boston University.13 After receiving special training, teams of ATSU physician assistant, physical therapy, occupational therapy, athletic training, and audiology students offer the curriculum, at no cost, to older citizens at 41 community sites in the Greater Phoenix area. Collaborations with partners ranging from local municipalities to assisted-living communities make the program possible.
Part of the BHHS grant funded the certification of 15 master trainers who teach the two-day A Matter of Balance curriculum to the ATSU students and the community volunteers who will, in turn, lead the sessions. The grant also funded the expansion of the program to an additional 24 sites, for a total of 65.12
For those who wish to identify appropriate evidence-based fall prevention programs in their community, the CDC developed a new guide, Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs.14 This “how-to” outlines how community-based organizations initiate and maintain effective programs. It focuses on implementation of fall prevention programs and offers strategies on program planning, development, implementation, and evaluation. This resource provides a solid starting point for those seeking to address this increasingly prevalent issue.
How do you investigate the risk for falls with your patients? I would be interested in hearing from you what resources are available in your community. You can contact me at PAEditor@frontlinemedcom.com.
REFERENCES
1. Cameron K, Schneider E, Childress D, Gilchrist C. (2015). National Council on Aging Falls Free® National Action Plan (2015). www.ncoa.org/FallsFreeNAP. Accessed November 5, 2015.
2. CDC. Important Facts about Falls. www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Accessed November 5, 2015.
3. CDC National Center for Injury Prevention and Control. Injury Prevention & Control: Data & Statistics (WISQARSTM). www.cdc.gov/injury/wisqars/. Accessed August 15, 2013.
4. Carande-Kulis I, Stevens JA, Florence CS, et al. Special Report from the CDC: a cost-benefit analysis of three older adult fall prevention interventions. J Safety Res. 2015;52:65-70.
5. CDC. WISQARS leading causes of nonfatal injury reports: 2006. Accessed November 13, 2006.
6. CDC. Risk factors for falls. http://www.cdc.gov/steadi/pdf/risk_factors_for_falls-a.pdf. Accessed November 4, 2015.
7. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82(8):1050-1056.
8. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51-61.
9. CDC. Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults. 3rd ed. www.cdc.gov/homeandrecreationalsafety/Falls/compendium.html. Accessed November 4, 2015.
10. Hafner K. Bracing for the falls of an aging nation. New York Times. November 2, 2014. www.nytimes.com/interactive/2014/11/03/health/bracing-for-the-falls-of-an-aging-nation.html?emc=edit_na_20141102&_r=0. Accessed November 4, 2015.
11. Houry D. The White House Conference on Aging and keeping older adults STEADI and free from falls. www.whitehouseconferenceonaging.gov/blog/post/the-white-house-conference-on-aging-and-keeping-older-adults-steadi-and-free-from-falls1.aspx. Accessed November 4, 2015.
12. Scott K. ATSU receives $95,000 grant to expand Fall Prevention Outreach program [news release]. October 1, 2015. http://news.atsu.edu/index.php/archives/category/arizona-campus. Accessed November 4, 2015.
13. MaineHealth Partnership for Healthy Aging. A Matter of Balance: Managing Concerns About Falls. www.mainehealth.org/AMatterofBalanceFrequentlyAskedQuestions#mob. Accessed November 4, 2015.
14. CDC. Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs. www.cdc.gov/HomeandRecreationalSafetyFalls/community_preventfalls.html. Accessed November 4, 2015.