Many older adults experience falls every year. In fact, falls are the leading cause of injury-related emergency department visits in this population; totaling an approximate 3 million ER visits, 30,000+ deaths annually, and costing the US healthcare system close to $50 billion each year [1][3]. In fact, as we talk about in this course, falls are one of the biggest predictors of mortality (other words -death!) in elderly people.
Research also shows that older adults who have a fall experience decreased functional ability, increased chances of falling again, and even higher mortality rates [1]. Simply put: falls are no good when you’re young. They even pose greater danger as you age.
As we age, increased fear of falling impacts quality of life, community involvement, and reduced activity [2]. This fear of falling actually acts as a significant predictor of activity restriction and reduction in functional independence which can lead to depression [2]. Being scare or fearful of movement causes us to limit our activity. And, since movement, mobility, and strength falls under the “use it or lose it” category, limiting our activity means we become weaker, less stable, and more at risk for falls.
It’s safe to say that addressing fall risks and fear of falling can greatly increase a person’s quality of life, functional independence, and safety.
What the Research Shows
Regardless of how healthy someone’s heart may be, how clear their mind, or how clean their lungs, research shows that falling poses one of the greatest risks to long-term health as we age. In fact, check out what one article says about falls in older adults:
“Falls are the leading cause of injury-relatedemergency visits in older adults, translating into an estimated 3 million ED visits and 32,000 deaths from fall-related injuries annually in the United States. ” [1]
When I was going to school at The Medical College of Georgia, almost every course we took about working with adults highlighted the importance of preventing falls. They spent so much time on the topic because it poses one of the greatest risks as we age. Even a healthy person, after experiencing a fall, can find themselves in a situation where the things they were once able to do, they can not. A fall, even a minor fall, can cause injuries and weakness that impact everyday activities like walking, cooking, bathing, and dressing.
With that being said, the research also shows that physical & occupational therapy can effectively reduce falls and risk of calls. Below are a couple of findings from recent research.
What are effective methods for addressing falls & risk of falls for patients reporting to an emergency department or urgent care?
Research suggests that early assessment, care coordination and follow-up play a critical role in successful treatment for adults experiencing a fall. Falls result in overall decreased functional ability and higher risk for future falls and increased mortality [1]. Said a different way: people who experience one fall are more likely to experience another fall in the future.
Ideally, screening and consultation by pharmacy and physical therapy in the emergency department can help identify patients who would benefit from further outpatient follow-up, decrease length of stay, and even help prevent future hospitalizations [1]. Because medications may increase the risk of falls, it’s important to talk with your pharmacist to see whether any medications could cause a decrease in balance or weakness which could lead to a fall. Also, physical and occupational therapy evaluate and assess for muscle strength and balance, to decrease the risk of falls.
In the event that someone does fall and injure themselves, the research suggests referring that person to physical therapy and pharmacy. The treatment provided by physical & occupational therapy can prevent future falls.
How can Physical & Occupational Therapy help address fall risk & injury?
Physical & Occupational Therapy treatment focuses on the underlying factors that result in falls such as weakness, decreased mobility, balance impairments, etc. Therapeutic exercise programs, for example, reduce the risk of medical falls [4]. As we explain in our exercise course, weakness is the single largest predictor of falls. So, any strengthening and balance work that you do can help prevent the risk of future falls.
Research also shows that improving physical function and strength also leads to decreased fear of falling, which can improve quality of life [2]. Physical and occupational therapy treatment not only helps build up strength, endurance, and balance, but it also helps build confidence in that movement.
Summary
Falls lead to many hospitalizations and death each year. In fact, falls are one of the greatest risks we face ace we age. Luckily, the research is pretty clear that strengthening and exercise is an effective strategy for preventing falls and decreasing the risk of falls. Even if you’ve experienced a fall in the past, working with a physical and/or occupational therapist to improve mobility and strength can help prevent future falls.
References
[1] Selman, Katherine; Binkley, Christine; Davenport, Katherine; Lliu, Shan W.; and Kennedy, Maura (2021) “Management of Fall Patients – What Should be Done for Emergency Department Fall Patients?,” Journal of Geriatric Emergency Medicine: Vol. 2 : Iss. 10 , Article 1. Available at: https://institutionalrepository.aah.org/jgem/vol2/iss10/1
[2] Schoene, D., Heller, C., Aung, Y. N., Sieber, C. C., Kemmler, W., & Freiberger, E. (2019). A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls?. Clinical interventions in aging, 14, 701–719. https://doi.org/10.2147/CIA.S197857
[3] Vincenzo, J. L., Hergott, C., Schrodt, L., Perera, S., Tripken, J., Shubert, T. E., & Brach, J. S. (2021). Physical Therapists as Partners for Community Fall Risk Screenings and Referrals to Community Programs. Frontiers in public health, 9, 672366. https://doi.org/10.3389/fpubh.2021.672366
[4] Greenwood-Hickman MA, Rosenberg DE, Phelan EA, Fitzpatrick AL. Participation in Older Adult Physical Activity Programs and Risk for Falls Requiring Medical Care, Washington State, 2005-2011. Prev Chronic Dis. 2015 Jun 11;12:E90. doi: 10.5888/pcd12.140574. PMID: 26068411; PMCID: PMC4467255.
