Fall Prevention New Initiatives and Programs

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Sponsored by The National Council on the Aging
and CareSource
Healthy Aging Briefing Series
Fall Prevention New Initiatives and Programs
WELCOME
This session will begin promptly at 130pm
ESTPlease mute your phonePersonal
introductions are not necessaryThe moderator
will be on the line shortly
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Falls In Older Adults

• 2002 1.6 million falls treated in the ER
• 12,800 died
• 388,000 admitted to the hospital
• Admission rates with age (40 of fall related
  admissions are 85)
• How many non-reported falls?

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A Growing Public Health Concern

• Growing numbers
• Growing problem

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Hip Fractures

• 95 of hip fractures caused by falls
• 20 die within a year after hip fracture1
• Rates higher for women (76 women)
• 25 of community-dwelling older adults who have a
  hip fracture are in a nursing home for at least
  one year2

1.Lu-Yao GL, AJPH, 1994 2. Magaziner, et al,
2000 NCHS, National Hospital Discharge Survey,
2001
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Financial Impact (In Current Dollars)

• In 1994, total cost of fall injuries among people
  65
• 27.3 billion1
• 43.8 billion projected for 20201
• Medicare costs for hip fractures
• 4.7 billion in 19912
• 240 billion projected for 20403

__________ 1. Englander F, J Forensic Science,
1996. 2. CDC, MMWR, 1996
3. Cummings SR, Orthopaedics
Related Res,1990
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Quality of Life Impact

• 20-30 fear falling1
• 35-40 of people 65 fall each year2
• Those who fall are 2-3 times more likely to fall
  again3
• 10-20 of falls cause serious injuries4

1. Vellas BJ, Age Aging, 1997 Friedman SM,
JAGS, 2002 2. Hornbrook, Gerontologist, 1994
Hausdorff, Arch Phys Med Rehab, 2001 3.
Tinetti, New Eng J Med, 1988 Teno, JAGS,1990 4.
Sterling, J Trauma-Inj Infection Critical Care,
2001
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Intervention Strategies That Work

• Comprehensive clinical assessment1
• Exercise for balance strength2
• Medication management3
• Vision correction4
• Reducing home hazards5

• ___________
• 1. American Geriatrics Society, JAGS, 2001
• 2. L 1. American Geriatrics Society, JAGS, 2001
  2. Lord SR, JAGS, 2001
• 3. Cumming RG, Drugs Aging, 1998
• 4. Ray W, Topics in Geriatric R Rehab,1990
• 5. Day L, BMJ 2002 Gill TM, JAGS, 1999 ord SR,
  JAGS, 2001

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What Do We Know Works?

• Multifactorial intervention strategies, with
  exercise as a core component, are particularly
  effective in lowering fall rates in high-risk
  groups.
• Additional risk factors targeted
• Gait training and assistive device use
• Review and modification of medication
• Treatment of postural hypotension
• Modification of environmental hazards
• Treatment of cardiovascular disorders
• Home assessment and modification

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National Environmental Scan

• Objectives
• Identify national orgs/agencies/foundations
  addressing falls
• Identify major falls prevention initiatives
• Identify gaps in programs, resources, and
  services
• Inform Steering Committee and participants
• Identify organizations interested in
  participating
• Available at www.healthyagingprograms.org

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Review Research Papers

• Objectives
• Provide summit participants with the most
  up-to-date research on effective interventions
• Bring participants to a common level of
  understanding
• Publish a review document to supplement the
  National Action Plan
• Available at www.healthyagingprograms.org

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Falls FreeTM Initiative

• 2 day invitational meeting of 58 national
  organizations, professional associations, and
  federal agencies
• Through consensus process developed and published
  National Action Plan
• 36 strategies and action steps to reduce falls in
  older adults
• www.healthyagingprograms.org

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Falls FreeTM Initiatives

• Falls FreeTM Coalition loosely formalized and
  charged with rolling out the National Action Plan
• http//www.healthyagingprograms.org/content.asp?s
  ectionid69ElementID220
• Presentations, media messages, journal articles
• Falls FreeTM E-news
• http//www.healthyagingprograms.org/content.asp?s
  ectionid69ElementID266
• Advocacy Workgroup, Legislative Update S. 1531
  Keeping Seniors Safe from Falls Act of
  2005http//www.healthyagingprograms.org/content.a
  sp?sectionid69ElementID251

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Other initiatives

• State Coalitions forming to address fall
  prevention
• Center of Excellence for Fall Prevention
  initiative to enhance programs and build
  community coalitions
• Professional associations developing tools and
  resources
• AGS revision of clinical guidelines

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Still more initiatives

• CMS New Code  V15.88 History of Fall
• Research
• ASPE LTC study on home modifications
• CDC funded dissemination study, UNC and state
  program in Minnesota
• AoA funded projects Matter of Balance,
  Medication Management Model, Evidence-Based Fall
  Prevention in Senior Centers

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Vision for the ASN

• Check with local/state health department on
  prevalence
• Spread the message that falling is not inevitable
• Identify appropriate partners and activities in
  your community to promote community activities
• Involve your older adult participants in planning
• Provide programs and services appropriate for
  your organization and participants
• Let your health care partners know how your
  programs can be part of the solution

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Resources

• Center for Healthy Aging www.healthyagingprograms.
  org
• Falls FreeTM Electronic News
• write to fallsfree_at_ncoa.org to join listserv
• Center of Excellence for Fall Prevention
  www.stopfalls.org
• National Resource Center on Supportive Housing
  and Home Modification www.homemods.org

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Resources

• National Center for Patient Safety Falls
  Toolkitwww.patientsafety.gov/SafetyTopics/fallsto
  olkit/index.html
• Home Safety Council State of Home Safety
• Facts About Safety in the Home
  http//homesafetycouncil.org/state_of_home_safety/
  sohs_2004_p017.pdf
• National Resource Center for Safe Aging
• www.SaveAging.org

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Program Tools

• National Center on Injury Prevention and
• Control A Tool Kit To Prevent Senior Falls
• www.cdc.gov/ncipc/pub-res/toolkit/toolkit.htm
• Safe Steps Program
• www.homesafetycouncil.org/expert_network/en_safest
  eps_w001.aspx
• American Geriatrics Society Falls in Older
• Adults Management in Primary Practice
• www.americangeriatrics.org/education/falls.shtml

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Programs

• A Matter of Balance,
• Partnership for Healthy Aging
• www.aoa.gov/prof/evidence/SMaine.pdf
• Safe Steps Program
• Home Safety Council
• www.homesafetycouncil.org/expert_network/en_safest
  eps_w001.aspx

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Programs

• HEROES Program, Temple University
• Health, Education, Research and Outreach for
  Seniors
• www.temple.edu/older_adult/
• FallPROOF!
• A Comprehensive Balance and Mobility Training
  Program
• www.exrx.net/Store/HK/Fallproof.html
• National Center for Safe Aging
• www.safeaging.org/model/default.asp