The Impacts of Falls on the Elderly Population

On a beautiful Saturday afternoon in May 2018, a resident of a long-term care facility with chronic medical diagnoses was walking from her room to the dining room for lunch. After taking a few steps, she lost her balance, fell, and started crying. She could not get up on her own and complained of being in pain and having difficulties getting up. Paramedics were called by the nurse who was on duty, and after further assessments, it was noted that this resident had a left hip fracture. Almost 48 hours after the fall a surgical procedure was done on her left hip, she went for a month rehabilitation and eventually went back to the long-term care facility where she resides. Through physical therapy, this resident was able to walk again without using any assistive device. Less than two (2) months after her first fall incident, she had another fall and fractured her right hip. She went through another surgical procedure and rehabilitation process but she was unable to walk again. She became non-ambulatory and started using a wheelchair for mobility. Less than two (2) weeks after the resident returned to the facility, she died.

The geriatric population often experience health-related challenges, and due to their frail nature, it is important to keep them safe. Older adults experience falls, and there are different factors associated with these falls. Gait and balance issues, side effects of medications, vision impairment, medical diagnosis, and functional status are some of the contributing factors of falls among the geriatric population (Fernando et al., 2017). Older adults with dementia experience twice as many falls due to their cognitive impairment, compared to older adults without any cognitive impairment (Bayen et al., 2017). The impact of falls among this population continue to affect them negatively because they lead to injuries that sometimes lead to unexpected death. The National Conference of State Legislatures (2018) stated that 20 to 30 percent of falls by the geriatric population leads to serious injuries, and these injuries limit their mobility, decreases their quality of life, and increases their risk for an untimely death.

The prevalence of falls among older adults who are 65 years and older continues to increase, they lead to hospitalization, thereby increasing fall-related healthcare expenditures (Kistler, 2018). According to Florence et al. (2018), in 2015, the amount spent on fatal and non-fatal falls was $50 billion; for nonfatal falls, $28.9 billion was paid by Medicare, $8.7 billion was paid by Medicaid, then private and other payers paid about $12.754 billion on fatal falls. Other than the physical injuries associated with falls, there are psychological impacts as well that include the fear of falling, and this could have a long-term effect on the person (Schoene et al., 2019). The annual cost of falls among the geriatric population showed that it is important to address falls and its impacts among the geriatric population, especially among those who are cognitively impaired to mitigate unwanted injuries, hospitalization, increased healthcare expenditures, and unexpected death.

References

Bayen, E., Jacquemot, J., Netscher, G., Agrawal, P., Tabb Noyce, L., & Bayen, A. (2017). reduction in fall rate in dementia managed care through video incident review: Pilot Study. Journal of medical Internet research, 19(10), e339. doi:10.2196/jmir.8095

Fernando, E., Fraser, M., Hendriksen, J., Kim, C. H., & Muir-Hunter, S. W. (2017). Risk factors associated with falls in older adults with dementia: A Systematic Review. Physiotherapy Canada. Physiotherapie Canada, 69(2), 161–170. doi:10.3138/ptc.2016-14

Florence, CS., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc. 2018 Apr;66(4):693-698. doi: 10.1111/jgs.15304. Epub 2018 Mar 7. PMID: 29512120; PMCID: PMC6089380.

Kistler, B. M., Khubchandani, J., Jakubowicz, G., Wilund, K., & Sosnoff, J. (2018). Falls and fall-related injuries among US adults aged 65 or older with chronic kidney disease. Preventing chronic disease, 15, E82. doi:10.5888/pcd15.170518

National Conference of State Legislatures. (2018). Elderly fall prevention legislation and statues. Retrieved http://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx

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. doi:10.2147/CIA.S197857