Want to Decrease Falls? Here's how.

A combination of screening, modifying risk factors, and evidence-based interventions can lower older adults' fall risk.

Falls are a significant problem for adults age 65 and older. According to the Centers for Disease Control and Prevention, each year:

• 3 million older adults are treated in the emergency department for injuries related to
  falls
   
• Over 800,000 patients are hospitalized because of a fall injury
   
• More than one out of four older people fall
   

Additionally, falls are costly. In 2015, falls were responsible for about $50 billion in healthcare costs.

And, once an older person falls, they are at risk for future falls. But new research on the impact of the CDC's Stopping Elderly Accidents Deaths and Injuries initiative on medically treated falls (a fall-related treat-and-release emergency department visit or hospitalization), finds older adults with a "fall plan of care," are less likely to experience fall-related hospitalizations.

The STEADI initiative, a multifactorial approach to fall prevention, includes:

• Screening for fall risk
   
• Assessing for modifiable risk factors
   
• Prescribing evidence-based interventions to reduce fall risk
   

"Fall prevention activities such as raising awareness about fall risk, identifying individual risk for fall, discussing fall risk prevention strategies, and providing referrals to fall risk reduction programs in the community for older adults were shown to reduce fall-related hospitalizations," Yvonne Johnston, DrPH, MPH, MSN, RN, FNP, research associate professor at the Binghamton University Decker School of Nursing and corresponding author of the study, says in a news release.
 

Fall Prevention Screening Works
 

"As a result of these interventions, older adults may be more conscious of conditions that contribute to falls, take steps to modify their home environment to reduce fall risk, and participate in falls prevention programs and physical activities that improve strength and balance. These steps, what we called development of a Fall Plan of Care, likely contributed to the observed lower rates of fall-related hospitalizations for older adults who were identified as being at risk for fall," Johnston says.

The researchers classified older adults who were screened for fall risk into three groups:

1. At-risk and no Fall Plan of Care
    
2. At-risk with an FPOC
    
3. Not-at-risk
    

The researchers found that for older adults who were prescribed an FPOC, the odds of a fall-related hospitalization were 40% lower than those who were at risk but did not receive an FPOC.

This project demonstrated that healthcare systems can successfully implement fall prevention screening and referral for older adults in the primary care setting, said Johnston.

"These system-wide changes—screening for fall risk among older adults in primary care and developing a plan of care for those identified as being at risk for fall—were shown to have a positive impact on reducing hospitalizations. These findings suggest benefit for patient health and well-being and potential reduction in health care costs associated with fall-related hospitalizations," she says.