The health of the elderly population in any society is very important, and the goal of healthcare is to prevent diseases and promote quality health. Also, preventing falls among the elderly population is to promote good health because the impacts of falls leave them hospitalized, while some are eventually institutionalized in Long Term Care facilities due to their inability to care for themselves. The National Conference of State Legislatures (2018) states that falls causes financial stress on the elderly population, and these expenditures might increase if nothing is done to prevent them from falling. The National Council on Aging (NCOA) states that in 2015, fall-related expenditures cost approximately $50 billion, and Medicare and Medicaid paid approximately 75% of these expenditures. This number shows that it is necessary to evaluate measures to reduce this cost, and this could be done by implementing interventions to prevent the elderly population from falling.
The United States of America is governed by laws, which makes up the Constitution. The United States Constitution did not state clearly the right to healthcare by the general population (Swendiman, 2010). The financial burden of healthcare is most times lessened through health insurance, and this is why Medicare is important for the geriatric population. According to the National Academy of Social Insurance, in 1965, Medicare was created because people who are 65 years and older could not get health insurance coverage. Through Medicare, older adults are able to receive treatments for their health-related problems. Although Medicare is available for the geriatric population, they still find it difficult to enjoy full health coverage due to the roles of institutions and actors in healthcare. Healthcare providers, political parties, and health insurance companies are part of the institutions that guide healthcare and they are also considered stakeholders (Santilli, & Vogenberg, 2015). It is necessary to consider the health of the public when making health-related decisions because the goal is to improve health outcomes.
Relevant Statutory and Regulatory Mechanisms related to Elderly Falls
- The National Council on Aging (NCOA) supports awareness and fall-related education. This organization also promotes fall prevention programs and supports the implementation of interventions to prevent elderly falls.
- The National Falls Free Initiative is in collaboration with other partners, and together they create awareness on falls, its related injuries, and death. Also, healthcare providers receive education and training through this program, and they learn community-based interventions on how to prevent the elderly population from falling.
- State Coalitions on Fall Prevention Workgroup is an important initiative to the National Falls Free Initiative program that has 42 states working together to create awareness and provide integrated community interventions that are effective and beneficial to the Elderly population.
- Developed by the U.S Surgeon General, National Prevention, Health Promotion, and Public Health Council, is the Nation’s first Health Promotion and National Prevention Strategy, which is a part of the Affordable Care Act enacted in 2010. Their goal is disease prevention and quality health promotion.
There are different fall prevention programs available to improve falls among the elderly population. One of them is the Arizona Falls Prevention Coalition, which was created by the Arizona Department of Health Services and their goal is to prevent falls and injuries sustained by the elderly, and a mission to reduce the risk of falls in Arizona by utilizing the means of education, outreach, evaluation, and advocacy. Chronic diseases are among the contributing factors of elderly falls, therefore, interventions to manage these chronic conditions are important. This will promote good health and would prevent the elderly population from falling. Falls prevention will reduce the cost of expenditures by Medicare and Medicaid services, and prevent unwanted injuries and death.
References
Arizona Department of Health Services(n.d.). Arizona Falls Prevention Coalition. Retrieved from https://www.azdhs.gov/prevention/tobacco-chronic-disease/healthy-aging/falls-prevention/index.php
National Academy of Social Insurance. (n.d.). What is the history of Medicare? Retrieved from https://www.nasi.org/learn/medicare/history
National Conference of State Legislatures. (2018). Elderly falls prevention legislature and statues. Retrieved from https://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx
National Council on Aging (n.d.). Falls prevention facts. Retrieved from https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/
National Council on Aging (n.d.). State policy toolkit for advancing fall prevention select resources. Retrieved from https://www.ncoa.org/wp-content/uploads/State-Policy-Toolkit-for-Advancing-Fall-Prevention-Select-Resources.pdf
Santilli, J., & Vogenberg, F. R. (2015). Key Strategic Trends that Impact Healthcare Decision-Making and Stakeholder Roles in the New Marketplace. American health & drug benefits, 8(1), 15–20.
Swendiman, K.S. (2010). Health care: Constitutional rights and legislative power. Congressional Research Services, 1-16. Retrieved from https://www.ncsl.org/documents/health/LegPowers.pdf
The Impacts of Falls on Geriatric Population with Dementia 
Interesting insights into the role of institutions, actors, relevant statutory and regulatory processes on elderly falls. Falls among older adults are an escalating public health issue, which requires a multidisciplinary and multilevel approach to affect systems change to effectively address this problem. The National Council on Aging established the Falls Free Initiative, enfolding and facilitating statewide Fall Prevention Coalitions (Schneider et al., 2016). Each year in the United States, one in four adults over 65 years of age falls. Long-term physical injuries, such as hip fractures and traumatic brain injuries, are merely the tip of the iceberg in terms of impacts and costs of older adult falls. It appears falls represent a substantial financial burden and with the aging of the U.S. population, the resulting expenditures are expected to increase substantially if more is not done to prevent falls. According to National Conference of State Legislatures (NCSL, 2018), in 2015 the total medical costs to treat older adult falls exceeded $50 billion, of this total amount, medical costs for fatal falls accounted for $750 million.
Falls are not an inevitable part of aging and are largely preventable. In various efforts to prevent and reduce falls, states have adopted legislation that includes supporting older adults in their homes, communities and clinical settings. Many elders prefer to remain in their homes and communities instead of moving to institutional care, and falls can diminish the capacity of seniors to continue to live on their own. As noted by Schneider et al., (2016), leading to the launching of the National Falls Prevention Awareness Day, Congress had adopted a similar resolution annually since 2008 to increase awareness and to prevent falls among older adults. In 2008, Congress passed the Safety of Seniors Act, which directs the secretary of health and human services to provide funding and support for various older adult fall prevention efforts. Moreover, the Centers for Disease Control and Prevention (CDC, 2016), developed tool kit, Stopping Elderly Accidents, Deaths and Injuries (STEADI) resource for patients and health care providers is meant to be incorporated into providers’ practices to help them identify elderly patients who are at risk of falling and offer prevention strategies or recommendations. STEADI also is available as online training that health care providers can take and receive continuing education credit.
Generally, future costs associated with falls are likely to increase substantially and part of the challenge may be a perception among policy makers and health care providers that falls are an inevitable part of aging. It is imperative that policy makers should continue to give the CDC adequate resources to continue advancing effective strategies for falls prevention.
References
Centers for Disease Control and Prevention (CDC, 2016). Older adult falls. Accessed from https://www.cdc.gov/homeandrecreationalsafety/falls/index.html.
National Conference of State Legislatures (NCSL, 2018). Elderly falls prevention legislation and statutes. Accessed from https://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx.
Schneider, E., Smith, M., Ory, M., Altpeter, M., Beattie, L., Scheirer, M., & Shubert, T. (2016). State fall prevention coalitions as systems change agents: An emphasis on policy. Health Promotion Practice, 17(2), 244-253. doi: 10.1177/1524839915610317.
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Hello Kate360ng!
Falls are increasing in number and continue to bring bad outcomes for the elderly population. Not only are falls costly to the patient, they are costly to the healthcare system. Many older adults that fall and sustain a traumatic injury never return to their previous state of function. Many remain debilitated and require intense amounts of physical therapy and recurrent hospitalizations. According to the Centers for Disease Control and Prevention (2017), one out of every five falls causes a serious injury such as broken bones or a head injury. Millions of people annually are treated in the emergency department from falls.
As you have discussed, there are many agencies, groups and coalitions that support falls and educate the public on fall prevention. The Arizona Department of Health and Human Services (2019) has created the Arizona Falls Prevention Coalition. The host education events and provide support to spread their knowledge on falls. On their website they have videos, fact sheets, contact information for elderly muscle strengthening classes etc. However, even with all of these supportive groups, falls in the elderly population is still a major crisis. I think it is our duty as healthcare providers, that all elderly patients we treat we educate about falls. To our younger patients, we need to provide preventative care to younger patients to prevent falls, loss of bone density and promote exercise/healthy eating.
References
Arizona Department of Health Services (2019). Arizona falls prevention coalition. Retrieved from https://www.azdhs.gov/prevention/tobacco-chronic-disease/healthy-aging/falls-prevention/index.php
The Centers of Disease Control and Prevention. (2017). Home and recreational safety: Important facts about falls. Retrieved from https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
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