According to a new study released on November 20 by the UCLA Center for Health Policy Research, half a million Californian seniors (12.6% of the State’s seniors) fall repeatedly. In addition, many healthcare providers do not routinely screen for falls and almost 60% of seniors fail to seek medical attention after sustaining a fall. The UCLA researchers also found that among the seniors who did seek treatment, 40% did not receive counseling from a healthcare provider about how to prevent future incidents.
Study author Steven Wallace, PhD, associate director of the Center for Health Policy Research, notes that falls are the leading injury-related cause of death and need for medical care among Californians age 65 and older. In 2012, more than 1,800 seniors died after falling and these’ fall-related injuries resulted in more than 72,000 hospitalizations. Dr. Wallace explained, “There is a cost in terms of both lives and resources when doctors fail to talk to seniors who have already fallen about how to prevent future falls.”
For the study, Dr. Wallace accessed data from the 2011–12 California Health Interview Survey. He discovered that older seniors are twice as likely as younger seniors to suffer multiple falls. Almost 1 in 5 individuals aged 85 and older reported that they fell more than once a year, compared to 1 in 10 of those aged 65 to 74. Almost 25% of seniors who have suffered a stroke, and almost 20% of those with any disability, had multiple falls. In addition, 26% of seniors with moderate mental impairment had multiple falls, as did 38% with severe mental impairment.
The study also reported that less than one-third of the approximately 325,000 seniors who did not seek care after multiple falls discussed with their doctor during a routine medical exam about how to prevent falls. Dr. Wallace said that the figure is not surprising because the patients probably did not reveal that they had suffered falls. However, he was surprised that the majority of physicians who knew they were treating multiple-fall patients failed to discuss how to avoid future incidents. Sadly, 40% of seniors did not receive any fall prevention recommendations from a physician or other healthcare professional during their care.
Dr. Wallace stressed, “When a patient with a track record of falling comes in for treatment, the healthcare provider should try to find out why and make appropriate suggestions. Did the patient trip on a rug? Is medication making her dizzy? The safety of their patients may depend on them asking these questions.”
The study found that 75% of at-risk seniors made modifications to prevent future falls, many following a physician’s evaluation. Specifically:
- 41.4% started using a cane or walker for stability.
- 32.4% reviewed medications that interfere with motor skills.
- 31.5% changed daily routines, including wearing different footwear and altering walking routes.
- 28.8% started an exercise or physical therapy program to improve their strength.
- 26.9% made modifications in their homes, such as installing grab bars, improving lighting and removing hazards such as area rugs.
The study recommends that public policy should encourage healthcare providers to screen all seniors for risk of falls during wellness exams and make recommendations for preventing falls. Medi-Cal and Medicare providers could be given incentives to screen and make recommendations. The report explains that the American Geriatrics Association has guidelines on screening for falls and providing referrals, and that many state and federal programs have programming in falls prevention; however, it also stresses that these programs need funding to continue.
“This is a preventable event and prevention starts at the doctor’s door,” explained Joseph Prevratil, president and CEO of the Archstone Foundation, which funded the study. He added, “Public policy should support the ability of doctors and other medical professionals to reduce the number of seniors suffering serious injury from falls.” Dr. Wallace recommended that that Californian seniors should be made more aware of the risks of falling and how to reduce those risks. This can be accomplished via physician screening and fall prevention programming from community groups and government agencies.