Clinical Interventions in Aging
Verma et al. (2016) highlight falls as a major cause of fatal and non-fatal injuries in the US. In the year 2010, falls accounted for 37% of all medical-consulted injuries with more than 90% accounting for hip fractures and traumatic brain injuries. The most recent data reveals that annually, healthcare providers manage up to 2.8million people aged 65 or older in emergency departments for falls with more than 800,000 hospitalizations and $31 billion direct costs every year (Dellinger, 2017).Clinical Interventions in Aging
According to Burton et al., (2018), since elderly people live longer in community neighborhoods, they are more likely to experience falls outside their homes. Nicklett, Lohman & Smith (2017) reveals that most falls in the community take place on curbs, sidewalks, and streets (73%) when walking (47.3%). It is for this reason that elderly people are less likely to walk in areas that they consider unsafe. However, they are more likely to walk if they perceive that help will be available in areas such as pedestrian crossings. The factors that increase the risk of falls among older adults in community settings are a history of a previous fall, female gender, problems with mobility, balance, gait, and environmental hazards.Clinical Interventions in Aging
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High-Level Detail Regarding the Problem
Falls are a common occurrence among elderly people in community settings and hospitals. Luk, Chan & Chan (2015) describe a fall as an event, which causes an individual or part of a person’s body to come to rest to the ground. Dellinger (2017) highlights that annually, more than 28.7% of elderly people sustain a fall. Nationally, this translates to 29 million falls leading to 7 million fall-related injuries that require activity restriction or medical treatment. In the year 2014, there were approximately 49 million falls, which transforms to 12 million fall-related injuries with significant costs by the year 2030 (Dellinger, 2017).
Currently, the direct Medicare fall-related costs for elderly people are at par with that of treatment for cancer at $10,000. In the year 2013, fall-injuries among elderly people ranked fifth in personal health expenditures and the rate of fall-related deaths has continued to double. To date, more than 27,000 people aged 65 or older die every year from falls with one death occurring every twenty minutes (Dellinger, 2017). The issue of fall-related injuries and incidences is also associated with a high population risk due to the rapid growth of an aging population that has a great fear to fall losing independence. The risk is even and real since same-level falls can lead to very severe injuries with poor health outcomes.
Effect of the Problem
According to Ott (2018), falls increase physical injury, impair mobility, restrict physical functioning and activity, placement in a nursing home, hospitalization, mortality, and morbidity. In 2014, among the more than 2.8 million elderly Americans who visited ERs with fall-related injuries, more than 27,000 die due to fall-sustained injuries. From an economic perspective, falls have a significant economic impact on individuals, families, and society. According to the estimates provided by WHO, the economic global expenditure for falls and fall-related injuries will be $240 billion. While the annual direct-related healthcare costs due to falls in 2014 were $31 billion, indirect health-related costs due to depreciated QoL costs was $ 162 billion (Ott, 2018).
Significance and Implications for Nursing Practice
Implementing fall prevention strategies in the community to address individual needs helps to prevent falls and associated injuries. Community-based fall prevention programs also allow older community-dwelling adults to participate actively in fall prevention strategies, address potential barriers, and provide essential resources that can influence a person to change individual health beliefs. Nurses can play an integral role in influencing the implementation of fall prevention programs in community settings. The greatest role is conducting community assessments to gain an understanding of integral components to include in a fall prevention program.Clinical Interventions in Aging
The Department of health, through state departments of health, has influenced the implementation of programs to prevent falls in community-based sites including senior housing facilities, healthcare organizations, senior centers, and faith-based organizations. According to Kulinski et al. (2017), the primary purpose of these programs is to increase the number of elderly patients at risk of falling, with disabilities, and those who take part in evidence-based fall prevention programs in the community. These programs focus on different aspects such as promoting balance to overcome the fear to fall, weekly group sessions of moderate to intensity exercise, recognizing fall risks in the environments and behaviors, interventions to assist elderly people to improve balance, strength, stamina, and flexibility as effective fall prevention strategies (Kulinski et al., 2017).
Burton, E., Lewin, G., O’Connell, H., & Hill, K. D. (2018). Fall prevention in community care: 10 years on. Clinical interventions in aging, 13, 261–269. https://doi.org/10.2147/CIA.S153687
Dellinger A. (2017). Older Adult Falls: Effective Approaches to Prevention. Current trauma reports, 3(2), 118–123. https://doi.org/10.1007/s40719-017-0087-x
Kulinski, K., DiCocco, C., Skowronski, S., & Sprowls, P. (2017). Advancing Community-Based Falls Prevention Programs for Older Adults-The Work of the Administration for Community Living/Administration on Aging. Frontiers in public health, 5, 4. https://doi.org/10.3389/fpubh.2017.00004
Li, F., Harmer, P., & Fitzgerald, K. (2016). Implementing an evidence-based fall prevention intervention in community senior centers. American journal of public health, 106(11), 2026-2031.
Luk, J. K., Chan, T. Y., & Chan, D. K. (2015). Fall prevention in the elderly: translating evidence into practice. Hong Kong Med J, 21(2), 165-71.Clinical Interventions in Aging
Nicklett, E. J., Lohman, M. C., & Smith, M. L. (2017). Neighborhood environment and falls among community-dwelling older adults. International journal of environmental research and public health, 14(2), 175.
Ott, L. D. (2018). The impact of implementing a fall prevention educational session for community‐dwelling physical therapy patients. Nursing Open, 5(4), 567-574.
Verma, S. K., Willetts, J. L., Corns, H. L., Marucci-Wellman, H. R., Lombardi, D. A., & Courtney, T. K. (2016). Falls and fall-related injuries among community-dwelling adults in the United States. PLoS One, 11(3), e0150939.
Clinical Interventions in Aging