Falls are the Leading Cause of Adult's Injuries

What's Unfortunate is that No One's Talking About Falls and Their Risk to Older Adults

After admission to the hospital, patients are discharged (if they make it out) without information or methods to reduce the potential of future risk.

After landing on the ground or piece of furniture: many seniors develop a fear of falling become less active, further increasing their risk quality of life then decreases as activities of daily living (ADL) are reduced

Older People Aren't Aware of Their Risk for a Fall

Despite the high prevalence and adverse effect of falls among older adults, fall prevention receives little attention in clinical practice.

Physicians don't question or test for risk of falling so neither the older person nor the physician attempt to reduce risks. It’s only after a fall occurs that awareness increases.

Unfortunately, physicians don’t have the training to assess the risks of falling and even if they did, they are unaware of the guidelines to prevent falls.

Current Guidelines Recommend Routine Doctor Assessment of Fall Risk

The purpose of the Fall-Prevention-Institute.org is to assist physicians, nursing homes, and community-dwelling seniors by providing fall risk assessment through an evidence-based screening program.

The definition of a fall is “unintentionally coming to the ground or some lower level as a result of a fall and not because of a violent blow, loss of consciousness, or sudden-onset paralysis as in stroke or an epileptic seizure.”

One-third of older Caucasians living in the community will fall at least once a year with many suffering multiple falls.

Costs involved in falling include:

• doctor visits
• acute hospital and nursing home care
• outpatient clinics
• rehabilitation stays
• diagnostic tests
• medications
• home care
• home modifications and equipment
• residential care

Projected costs per fall are US $7,399.00.

By 2020, total US estimated costs of falling is US $32.4 billion.

Forty-Two Percent of Fallers Reduce Activity After a Fall

Although there’s much evidence and emphasis on osteoporosis, it (osteoporosis) per se does not cause broken bones, a fall does. 15% of all older adults will have a hip fracture in their life time.

Risk Factors for Falls

There are many causes of falls. Many older adults will not tell anyone about a fall they encountered because of the fear of losing their independence. In one survey, 80% of the respondents said they would rather be dead than be confined to a nursing home.

The following table identifies the major risks for falling in adults:

Risk Factor
Muscle Weakness
History of Falling
Gait Deficit
Balance Deficit
Use of Assistive Device
Visual Deficit
Arthritis
Impaired Activities of Daily Living (ADL)
Depression
Cognitive Impairment
Age > 80 Years

One of the Most Important Predictors of a Fall is Postural Sway

Dr. Gregory Ellis’s Fall-Prevention-Institute.org uses the dynamic posturography system by Vestibular Technologies' CAPS EQ system to evaluate postural sway.

Control of postural sway when standing involves continual muscle activity (primarily the calf muscles), and requires an integrated reflex response to visual, vestibular, and somatosensory inputs.

Factors found to be highly correlated with increased postural sway include: Reduced lower extremity muscle strength Reduced peripheral sensation Poor near visual acuity Slowed reaction time

Strategies for Prevention of a Fall

Physical Training Programs

Many of the risks for falls are modifiable by appropriate exercise programs.

Dr. Gregory Ellis’s Fall-Prevention-Institute.org provides an evidence-based training program focused on all the research to date completed on fall prevention.

Functional training is defined as conditioning that applies to the Activities of Daily Living (ADL) such as rising from a chair or climbing steps.

An exercise program must be designed according to the tenants of research defining progressive exercise.

This includes: specificity of training overload principle   There are three main strategies in an exercise prescription: intensity duration frequency

The Fall-Prevention-Institute.org completes a thorough screening battery to evaluate the fall risk for older adults.

The results are provided to the primary care physician for review/further evaluation. We have a Physician Guidelines for Falls Prevention by the American Geriatric Society.

Ankle Balance Stabilization Reduces the Risk of a Fall by 30-60%

Dr. Gregory Ellis’s Fall-Prevention-Institute.org provides a custom made ankle foot orthotic to provide immediate fall reduction risk.

The AFO is a long-term solution to falls and can be used in conjunction with the training program, environmental changes, and medication review to provide a comprehensive fall prevention program.

The orthotic is a prescription device covered by Medicare. The screening program provides the physician with the information required to determine medical necessity.

The goal of the Fall-Prevention-Institute.org is to provide doctors and other health care providers, such as nursing homes, with the knowledge and assessments recommended by international health organizations and governmental agencies to provide fall reduction strategies for older adults to reduce their risk of falls.