Why understanding falls through numbers is vital to your facility

So, how do falls actually translate in statistics?

Looking at the data surrounding falls and fall-related injuries lends a great deal of insight into why it is crucial to consider strategies and measures to mitigate fall possibilities. Without question, it is one of the most critical challenges that long-term care facilities have to regularly manage.

For example, as a starting point, it is estimated that there are 1.6 falls per bed per year and nearly half of those then repeat falls on multiple occasions Even more, these statistics make for startling reading:

• In 2015, medical costs for falls were $50 billion, with Medicare and Medicaid covering 75% of those costs.²
• Falls are the most common cause of traumatic brain injuries (TBI).
• 800,000+ people each year are hospitalized because of a fall-related injury, mostly head or hip injury.
• Older adults with dementia fall 2-3 times more than cognitively healthy older adults.³
• More than 95% of hip fractures are caused by falls.²
• Each year, 3 million older people are treated in emergency departments for fall injuries.
• From 2007 to 2016, fall rates increased 30%, meaning that if fall rates continue to rise, by 2030, it is anticipated that 7 fall deaths will occur every hour.²

Overall, the resounding statistic that stands out significantly is that 1 in 4 Americans aged 65+ falls each year.

Further, in 2014, nearly 29% of older adults reported falling at least once in the preceding 12 months, resulting in an estimated 29 million falls nationwide.⁴ Of those who fell, 37.5% reported at least one fall that required medical treatment or restricted activity for at least 1 day, resulting in 7 million fall injuries.⁴

Without doubt, older-adult falls can result in death, serious injury, and loss of independence with a great deal of falls resulting from environmental factors, reduced muscle strength and/or loss of cognitive abilities.

What effective interventions and measures can be put in place?

Taking those statistics into account and then assessing the overarching risk factors, such as the external and internal elements surrounding each resident, you begin to address where potential risks could be averted:

External:

• Flooring and surfaces
• Furniture and settings
• Lighting
• Stairways, bathrooms, kitchens
• Inappropriate or broken equipment

Internal:

• Reduced cognitive and physical capacity
• Progressive disease
• Medication-induced lack of ability
• Need for independence/control and denying possibility of fall likelihood
• Refusing to use device assistance
• New injuries/illnesses

Therefore, possible interventions could be:

• Identify and address external, environmental risk factors
• Holistic assessment to identify fall risk factors related to the person
• Assess medications that could exacerbate fall likelihood
• Review daily routine to manage any risks

"When you look at the incredibly high cost of falls to our society, healthcare system, and the people who are hurt by them, it can be overwhelming. But it's equally important to remember that falls are not a foregone conclusion. There are real, evidence based solutions out there. It's our responsibility as healthcare providers to seek those solutions out, so we can do what we are all here to do: improve the lives of those we care for."

- Emilia Bourland, OT, ECHM

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‍References

¹ Mileski, M.; Brooks, M.; Topinka, J.B.; Hamilton, G.; Land, C.; Mitchell, T.; Mosley, B.; McClay, R., “Alarming and/or Alerting Device Effectiveness in Reducing Falls in Long-Term Care (LTC) Facilities? A Systematic Review”, Healthcare, 2019.

² “Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention”, Centers for Disease Control and Prevention, August 2021 (most recent update).

³ Racey, M; Markle-Reid, M; Fitzpatrick-Lewis, D; Ali, M.U.; Gagne, H,; Hunter, S.; Ploeg, J.; Sztramko, R.; Harrison, L.; Lewis, R.; Jovkovic, M.; Sherifali, D., “Fall Prevention in community-dwelling adults with mild to moderate cognitive impairment: a systematic review and meta-analysis”, Biomed Central, 2021.

⁴ Gwen Bergen, PhD; Mark R. Stevens, MA, MSPH; Elizabeth R. Burns, MPH, “Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014”, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, September 2014.

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