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Falls A Common Concern of Seniors

We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550. Falls A Common Concern of Seniors. Falls: A Common Concern of Seniors. More than 1/3rd of adults 65+ fall each year in US

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Falls A Common Concern of Seniors

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  1. We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550. FallsA Common Concern of Seniors

  2. Falls: A Common Concern of Seniors • More than 1/3rd of adults 65+ fall each year in US • 50% of seniors that fall have fallen before • As the Senior population increases, so will the absolute number of falls

  3. Population Growth

  4. By Age Per Year 65- 69 22.4% 70- 74 27.9% 75- 79 31.4% 80- 84 39.6% Who Falls?

  5. Who Falls? • Women 65+ 30% • Men 65+ 13% • Gender Differences decrease after 75; at 85 Men = Women By Sex

  6. Community: 0.2 - 0.8 per person per year Hospital: 0.6 - 2.9 per person per year Long-term Care: 0.6 - 3.6 Who Falls? By Living Environment (rates)

  7. Fear of falling Falls cause

  8. Falls cause: • Fear of falling • limits activities • leads to decreased mobility/fitness - increases social isolation - increases actual risk of falling

  9. Fear of falling Increased risk of Nursing Home Placement Falls cause

  10. Falls cause • Increased risk of Nursing Home Placement - those 75+ who fall are 4-5x more likely to be admitted to long-term care for 1 + years

  11. Fear of falling Increased risk of Nursing Home Placement Moderate to severe injuries Falls cause

  12. Moderate to severe injuries - bruises, - traumatic brain injuries - accounts for 46% of fatal falls - fractures: 6% of falls, including, spine, hip, leg, pelvis, ankle upper arm and hand Falls cause

  13. Fear of falling Increased risk of Nursing Home Placement Moderate to severe injuries Increased risk of death Falls cause

  14. Falls cause • Increased risk of death - 15,800 annual deaths in seniors d/t fall (2005); 1.8 Million treated in ER • 85% percent of deaths from falls from seniors 75 and older • after 75 years, white men have highest fatality rates > white women > black men > black women - Men are more likely to die than women (49% higher mortality rates)

  15. Hip Fractures in Seniors • 1% of falls result in hip fractures ($10 billion cost) • 350,000 senior hip fractures/year • 60% have restricted mobility • 25% remain functionally more dependent • 25% die within 1 year

  16. Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes FALLS

  17. Normal Aging Changes Neurologic - proprioception reaction time righting reflexes Intrinsic Factors

  18. Normal Aging Changes Neurologic Gait - Slower - Stride length and arm swing - Body flexion & head/torso; knees shoulders forward - Lateral sway Intrinsic Factors

  19. Normal Aging Changes Neurologic Gait Vision Accommodation Dark adaptation Intrinsic Factors

  20. Normal Aging Changes Neurologic Gait Vision Muscle mass Intrinsic Factors

  21. Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease FALLS

  22. Intrinsic Factors Chronic Disease • Cataracts, macular degeneration • Arthritis • Parkinsons, Strokes • The “Dizzy’s”

  23. Chronic Disease The “Dizzy’s” 27% of seniors 65+ report during last month 37% last > 1 minute 50% of those 80 or greater that are dizzy due to Benign Positional Vertigo Usually due to many causes: - Meniere's disease, circulation, blood pressure drops, - anemia, heart rhythms, anxiety/depression Intrinsic Factors

  24. Intrinsic Factors Acute Illness/Confusion • UTI, pneumonia, diarrhea, dehydration, vomiting

  25. Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Trouble walking FALLS

  26. Trouble Walking (Dysmobility) - Trouble walking increases with age - > 65 y/o: 15% - 85 y/o: 25% men; 33% women - 2/3 of seniors in hospital/Nursing Homes can’t walk w/o assistance Intrinsic Factors

  27. Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Medications FALLS

  28. 4+ prescriptions! Extrinsic Factors

  29. Medications The big offenders - Sedative/hypnotics Depression/anxiety/mood-stabilizing medications - Heart, blood pressure, seizure, incontinence, other medications Extrinsic Factors

  30. Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Medications Environment Improper Use of Cane/Walker FALLS

  31. Environment - Home hazards: bathrooms, stairs, clutter, throw rugs, lighting, sidewalks - "risky" behavior Improper use of cane/walker Extrinsic Factors

  32. So What to Do? Falls: A Common Concern of Seniors

  33. Screen for Risk Factors Do your own Home Safety Evaluation Evaluate your activity; Exercise Talk to your doctor So What to Do?

  34. Nintendo Wii Golf So What to Do?

  35. What your doctor will be thinking Join exercise program None Ask all >= 75+ 1 Fall or Balance/ Gait >= 2 Falls or Balance/ Gait Dx & Treat

  36. Specific Risk Factors, Assessment, Management

  37. Specific Risk Factors, Assessment, Management

  38. Specific Risk Factors, Assessment, Management

  39. Evidence shows these interventions work!

  40. Evidence shows these interventions work!

  41. FallsA Common Concern of Seniors We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550.

  42. References Center for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 2007. “Clinical Practice”. New England Journal of Medicine 2 January 2003:41-44. “What Causes Falls in the Elderly.” American Family Physician. 1 Apr. 2000. http://www.aafp.org/online/en/home.html

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