Thoughts about a possible need for nursing home care are intimidating to many older adults. Nursing homes become the last resort when all options to remain at home have been exhausted. They are equated with a loss of independence and significant financial impact.
Admission to a nursing home usually occurs following a hospitalization. A reasonable conclusion is that staying out of the hospital will reduce the risk of nursing home placement.
If one of the leading causes of hospital admissions (800,000 annually) and emergency department visits (over 2 million annually) for older adults is preventable, would you take action to reduce your risk?
The cause of these catastrophic incidents is falls. While attention is often directed toward preventing cancer, heart disease, stroke, and other acute and chronic illnesses; falls remain one of the most commonly experienced and debilitating events for older adults.
The National Council on Aging suggests a number of myths which surround older adults and falls.
- It won’t happen to me – Actually, 1 in 4 Americans over the age of 65 falls every year
- Falling is a normal part of aging – Although muscle strength, coordination, balance, and flexibility may decrease with aging, these changes do not guarantee that falls will occur
- Limiting activity will prevent falls – In reality, limiting activity actually increases the risk of falling because of physical changes which result from a sedentary lifestyle
- Staying at home can help me avoid falls – Over 50% of falls occur in the home
- Muscle strength and flexibility can’t be regained – If this were true, then why do people pursue rehabilitation?
- Using a walker or cane will cause greater dependency – Use of an assistive device provides security and confidence to continue usual routines and improves quality of life
Belief in any these myths is a risk factor for falls, and although it may be challenging, changing one’s beliefs is possible. Additional risk factors which may or may not be easy to modify include the following:
- Vision changes – Normal aging processes make it harder to see tripping hazards such as small objects or changes in floor surfaces
- Medications – side effects of medications or medication interactions can produce symptoms such as dizziness or dehydration which result in unsteadiness
- Chronic health conditions – can contribute to changes in physical functioning and pain which reduce mobility (arthritis is a prime example), increase the likelihood of medication use (see above), and can create situations which impair safety (such as having to rush to the bathroom)
- Environmental hazards – poor lighting, absence of grab bars, throw rugs, stairs, clutter, poor footwear choices, etc.
The prevention of falls is in the interest of older adults, families, and health care providers as falls can impact quality of life in significant ways. Physical injuries from falls cause pain, disability, temporary or permanent loss of independence, potential changes in living situations, and even death. Even without visible injury, the fear of falling can result in changes to daily routines which result in depression, isolation, and reduced mobility, all of which further increase the risk of falling. For more information visit https://www.ncoa.org/healthy-aging/falls-prevention/ .
Society in general also should be motivated to help older adults reduce falls since the financial burden to taxpayers who foot Medicare/Medicaid bills was over $37 billion in 2015 and continues to rise.
Hospitalization for any reason may threaten an older adult’s independence: https://keystoneelderlaw.com/health-information/ . If you desire to remain in your home, maintain your daily routines, and avoid hospitalization and potential nursing home admission; fall prevention should be on your radar. Evaluate your risk factors and take action by honestly admitting your vulnerabilities, talking to your doctor and your loved ones, participating in an exercise program suitable for your ability (this is often more enjoyable when done with friends), and assessing your home/daily routines. In the long run, it will be easier to remain upright than to get off the floor.
Karen Kaslow, RN, BSN