Strategies have been identified to assist adults 65 and better BEFORE they experience an injurious or disabling fall.
- Identify an individual’s risk for a fall. Research shows four primary risk factors should be considered including
- physical function, medication, vision and hearing and environmental factors
- Mitigating an individuals’ risk
- Regular exercise is the one intervention clearly demonstrating reduction of falls and fall risk. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Exercise programs are that focus on balance are especially good, such as Tai Chi.
- Medication reviews are important for any patient taking four or more medications. The medication review should include both prescription and over-the counter—to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
- Vision screening. Encourage older adults to have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision. Consider getting a pair with single vision distance lenses for some activities such as walking outside.
- Hearing screening. Hearing loss increases an older adults risk for falling. Hearing increases fall risks because people with hearing difficulties have less awareness of their environment, making tripping and falling more likely.
- Home safety. Make their homes safer by encouraging patients to take the following measures or having an agency or family member make these modifications: reduce tripping hazards (e.g., throw rugs, lamp cords across walking paths, peeling linoleum), add grab bars inside and outside the tub or shower and next to the toilet, add railings on both sides of stairways, and improve the lighting in their homes.
- Vitamin D – Studies show that taking 700- 1000 IU of supplemental or active vitamin D reduces the risk of falling.
U.S. Centers for Disease Control and Prevention (CDC) developed the Stopping Elderly Accidents, Deaths and Injuries (STEADI) toolkit to help health care providers determine which older adult patients are at increased risk for falls. The kit’s resources and tools help make fall prevention a simple addition and integral part of clinical practice. The toolkit is based on a simple algorithm adapted from the American and British Geriatric Societies’ Clinical Practice guidelines. (link broken)
STEADI tools can be easily integrated into the Welcome to Medicare and Annual Medicare visits; or at other appropriately-identified visits. SRHD staff provide assistance to assess current fall prevention clinical practices with adults aged 65 and better and make recommendations for change as identified. For more information call (509) 324-1530 or email firstname.lastname@example.org.
The U.S. Preventive Services Task Force (USPSTF) recommends exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls.
The USPSTF does not recommend automatically performing an in-depth multifactorial risk assessment in conjunction with comprehensive management of identified risks to prevent falls in community-dwelling adults aged 65 years or older because the likelihood of benefit is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of the circumstances of prior falls, comorbid medical conditions, and patient values.
Accessing resources to reduce the identified risks