One in three older adults fall every year in the United States, according to the National Council of Aging (NCOA), and a common misconception is that this is a normal part of aging. But in fact, falls often are predictable and preventable.
“Falls are the leading cause of injury-related deaths, hospitalizations, and emergency department visits among adults 65 and older,” says Marvin Berg, injury prevention coordinator at NuHealth, in East Meadow, N.Y. “They can result in lasting, serious consequences, but they occur in patterns with recognizable risk factors.”
Recognizing the opportunity for improvement in geriatrics care and fall prevention, NuHealth and Zuckerberg San Francisco General Hospital (ZSFG), two members of America’s Essential Hospitals, have made this a priority in their communities.
A Balancing Act
Heel to toe, heel to toe. This is Diana O’Connell’s new mantra as she walks down the hallways of Atria Senior Living, in New York City. Like a handful of other seniors at the facility, O’Connell recently participated in a tai chi program run by NuHealth.
The program is an outcome of the New York State Department of Health’s initiative to reduce falls and fall injuries among older New Yorkers. In collaboration with the state, NuHealth launched Tai Chi for Arthritis, a community-based fall prevention program, in April.
Tai chi is a form of martial arts that helps with balance, stress, and pain. Methods such as “heel to toe” can help seniors make lifestyle adjustments to reduce falls by up to 55 percent, according to NCOA.
NuHealth held the first set of classes twice a week for eight weeks at senior facilities throughout the city, such as Atria Senior Living. A survey conducted at the end of the program revealed patients feel more confident about their balance.
“The majority of the participants said that they have less fear of falling and that their balance is better,” Berg says. “Only one or two of the participants have fallen since the class began.”
More than 2.8 million fall-related injuries are treated in U.S. emergency departments annually, 800,000 of which result in hospitalizations, according to the Centers for Disease Control and Prevention. Bed rest, glaring lights, untimely visits by nurses, and inadequate nutrition are just some of the reasons hospital stays are less than ideal for elderly patients. One study shows that about a third of patients leave the hospital weaker and more disabled than when they arrived.
But things are different for seniors admitted to ZSFG’s Acute Care for Elders (ACE) ward. With anti-glare flooring, an outdoor garden, and a common space for community gathering, the innovative ward strives to prevent further health decline of elderly patients.
“ACE units prevent falls by promoting independence and function from the first day,” says Edgar Pierluissi, medical director of ACE. “By preventing loss of strength and delirium, patients have a lower risk of falling.”
Staff focus on mobilizing patients and maintaining functional independence. Opened in 2007, the ward has resulted in better functional state, fewer falls, and less cost compared with patients in usual care units.
“The older you are, the worse the hospital is for you,” Ken Covinsky, a University of California geriatrics researcher, said in an NPR interview. “A lot of the stuff we do in medicine does more harm than good. And sometimes with the care of older people, less is more.”