In the Journals

Older patients do not participate in fall prevention activities

Patients aged 65 and older who go to the ED for a fall-related injury are not likely to take part in a fall prevention program after being discharged even after receiving a flyer advertising such a program, according to findings recently published in Injury Epidemiology.

“To better understand older adults’ experience of engaging in fall prevention behaviors after a fall-related ED visit, we investigated postfall behaviors by community-dwelling older adults during the 60 days following an ED visit for a fall or fall-related injury,” Kalpana Narayan Shankar, MD, MPH, of the department of emergency medicine at Boston University Medical Center and colleagues wrote.

Researchers recruited 87 participants aged 65 years and older that presented to an ED with a fall, or fall-related injury, and were sent home with a flyer advertising the Matter of Balance course.

Narayan Shankar and colleagues then conducted follow-up interviews over the phone 60 days after the patient’s ED visit, gathering information on postfall behaviors, attempts to include family and the primary care providers in care, participants registering in a falls prevention program, participants’ attitudes towards falling and any subsequent falls.

Researchers found that:

•71% spoke to a health care provider about the fall that led to their enrollment in the study;

•46% talked to a family member about things the patient can do to avoid falls;

•37% spoke to their health care provider about reducing risk for falls — the same amount indicated talking to friends about ways to prevent falls;

•22% spoke to their health care provider about how medications can affect risk for falls;

•2% tried to reach out to a falls prevention program; and

•0% attended a falls prevention program, such as tai chi or Matter of Balance.

In addition, 14% of the participants reported another fall, and 8% said they returned to the ED after the incident.

Narayan Shankar suggested ways that doctors can implement the study’s findings into their practice.

“A falls history should be a regularly asked thing at all primary care physician visits for older adults given its morbidity and mortality,” she told Healio Family Medicine in an interview. “Fall prevention is not a one-off conversation and the more providers talk about it, the more patients will view it as an important health topic.”

A different study suggested that an exercise regimen that involves activities of daily living such as walking sideways or bending the knees reduced the risk of falls by 31% in elderly participants.

A third of those aged 65 and older experience a fall, and falls are the leading cause of fatal and nonfatal injuries in this age group, according to a press release, which also stated that in 2015, direct medical costs for such incidents were calculated at between $31.3 billion and $36.8 billion. – by Janel Miller

Further reading :

American Geriatrics Society Guideline for the Prevention of Falls in Older People

http://www.americangeriatrics.org/files/documents/health_care_pros/JAGS.Falls.Guidelines.pdf Accessed August 21, 2017.

National Council on Aging’s Program Summary: A Matter of Balance https://www.ncoa.org/resources/program-summary-a-matter-of-balance/ Accessed Aug. 21, 2017.

Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs https://www.cdc.gov/homeandrecreationalsafety/falls/community_preventfalls.html Accessed August 21, 2017.

Disclosure: The researchers report no relevant financial disclosures.

Patients aged 65 and older who go to the ED for a fall-related injury are not likely to take part in a fall prevention program after being discharged even after receiving a flyer advertising such a program, according to findings recently published in Injury Epidemiology.

“To better understand older adults’ experience of engaging in fall prevention behaviors after a fall-related ED visit, we investigated postfall behaviors by community-dwelling older adults during the 60 days following an ED visit for a fall or fall-related injury,” Kalpana Narayan Shankar, MD, MPH, of the department of emergency medicine at Boston University Medical Center and colleagues wrote.

Researchers recruited 87 participants aged 65 years and older that presented to an ED with a fall, or fall-related injury, and were sent home with a flyer advertising the Matter of Balance course.

Narayan Shankar and colleagues then conducted follow-up interviews over the phone 60 days after the patient’s ED visit, gathering information on postfall behaviors, attempts to include family and the primary care providers in care, participants registering in a falls prevention program, participants’ attitudes towards falling and any subsequent falls.

Researchers found that:

•71% spoke to a health care provider about the fall that led to their enrollment in the study;

•46% talked to a family member about things the patient can do to avoid falls;

•37% spoke to their health care provider about reducing risk for falls — the same amount indicated talking to friends about ways to prevent falls;

•22% spoke to their health care provider about how medications can affect risk for falls;

•2% tried to reach out to a falls prevention program; and

•0% attended a falls prevention program, such as tai chi or Matter of Balance.

In addition, 14% of the participants reported another fall, and 8% said they returned to the ED after the incident.

Narayan Shankar suggested ways that doctors can implement the study’s findings into their practice.

“A falls history should be a regularly asked thing at all primary care physician visits for older adults given its morbidity and mortality,” she told Healio Family Medicine in an interview. “Fall prevention is not a one-off conversation and the more providers talk about it, the more patients will view it as an important health topic.”

A different study suggested that an exercise regimen that involves activities of daily living such as walking sideways or bending the knees reduced the risk of falls by 31% in elderly participants.

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A third of those aged 65 and older experience a fall, and falls are the leading cause of fatal and nonfatal injuries in this age group, according to a press release, which also stated that in 2015, direct medical costs for such incidents were calculated at between $31.3 billion and $36.8 billion. – by Janel Miller

Further reading :

American Geriatrics Society Guideline for the Prevention of Falls in Older People

http://www.americangeriatrics.org/files/documents/health_care_pros/JAGS.Falls.Guidelines.pdf Accessed August 21, 2017.

National Council on Aging’s Program Summary: A Matter of Balance https://www.ncoa.org/resources/program-summary-a-matter-of-balance/ Accessed Aug. 21, 2017.

Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs https://www.cdc.gov/homeandrecreationalsafety/falls/community_preventfalls.html Accessed August 21, 2017.

Disclosure: The researchers report no relevant financial disclosures.