MOST FALLS ARE PREVENTABLE – Reasons for Falls
Improper Assist Leads to Preventable Falls
Improper Training or Failure to Follow Care Plans. Unfortunately, many falls occur in nursing homes, assisting living, hospitals and other settings when the resident’s care plan is not followed and only one person assists when the person requires two or more persons to make the transfer or other assist. Other deadly falls, occur from mistakes as simple and easy to avoid as ensuring the lift or transfer equipment and slings are set up correctly before use.
-Attempting to get up on own when unable.
Cognitive Changes can Effect Balance and Ability to Walk Leading to Falls
Medication Error? -Reaction to medication? -Blood Sugars out of range? -Illness/fever/flu? -Sepsis? -Dehydration? -Stroke?
Many Falls that Occur to the Elderly are AVOIDABLE if:
-proper assist when needed? -given adequate supervision when needed? -no medication problems? -redirected when necessary for resident safety?
Why is it Important to Avoid FALLS and Fractures?
-Already frail -Osteoporosis -Fractures lead to pneumonia and death.
Bedrest after Falls Causes:
-Weak or ineffective cough -Lungs Compress and fail to expand fully “atelectasis”, making infection more likely -Aspiration of Food or Upper Airway Secreations -Delirium related to post-anesthesia complications, pain , or the side effects of pain medications -Poor Nutrition causing muscle weakness, which affects ability to cough, take breaths and coordinate swallowing muscles Deaths related to falls can occur immediately, (subdural hematomas) But, often can take 6-12 months or more to occur due to cause death?
Additional Risks from Falls:
-UTI from indwelling bladder catheters and because of urinary incontinence related to fracture -Surgical Wound Infections -Blood Clots, Malnutrition, Pressure Ulcers, and Additional Fall Related to Fractures -Further Additional Falls
Falls – A Minnesota and National Public Health Concern
Falls are the number one cause of trauma deaths, non-fatal major trauma and other trauma care in Minnesota. The vast majority of these cases are among older Minnesotans. • Minnesota’s fall death rate is almost twice the national average and it is increasing. Every hour an older adult dies as the result of a fall. • The total costs for non-fatal falls among Minnesotans 65 years of age and older were $162 million for hospital charges and $20.4 million for emergency department charges in 2005. • Hip fractures are among the most serious fall-related injuries. Twenty percent die within the first year post-fracture, half never regain their previous level of functioning, and many are unable to live independently after their injury. • Falls among the elderly are driving health care costs and significantly impacting quality of life for our older adults.
What you can do to Prevent Falls
The Minnesota Falls Prevention Website has several useful categories such as:
The US Center for Disease Control, CDC, also has a great website which addresses Older Adults and Falls, provides very useful information including:
Costs of Falls Among Older Adults
In 2000, falls among older adults cost the U.S. health care system over $19 billion dollars or $28.2 billion in 2010 dollars. With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.
How Big is the Problem?
- One in three adults age 65 and older falls each year.1,2
- Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.3
- Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.3
- In 2009, emergency departments treated 2.2 million nonfatal fall injuries among older adults; more than 582,000 of these patients had to be hospitalized.4
How are Costs Calculated?
The costs of fall-related injuries are often shown in terms of direct costs.
- Direct costs are what patients and insurance companies pay for treating fall-related injuries. These costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, changes made to the home, and insurance processing.5
- Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.
How Costly are Fall Related Injuries Among Older Adults?
- In 2000, the total direct medical costs of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls.6
- By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).5
- Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.7
- In 2002, about 22% of community-dwelling seniors reported falling in the previous year. Medicare costs per fall averaged between $9,113 and $13,507.8
- Among community-dwelling seniors treated for fall injuries, 65% of direct medical costs were for inpatient hospitalizations; 10% each for medical office visits and home health care, 8% for hospital outpatient visits, 7% for emergency room visits, and 1% each for prescription drugs and dental visits. About 78% of these costs were reimbursed by Medicare.7
- In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services.9
How do These Falls Related Costs Break Down – Age and Sex
- The costs of fall injuries increase rapidly with age.6
- In 2000, the costs of both fatal and nonfatal falls were higher for women than for men.10
- In 2000, medical costs for women, who comprised 58% of older adults, were two to three times higher than the costs for men.6
Type of Fall Related Injury and Treatment Setting
- In 2000, the direct medical cost of fatal fall injuries totaled $179 million. About 78% of fall deaths, and 79% of total costs, were due to traumatic brain injuries (TBI) and injuries to the lower extremities.6
- Injuries to internal organs were responsible for 28% of fall deaths and accounted for 29% of costs.6
- Fractures were both the most common and most costly nonfatal injuries. Just over one-third of nonfatal injuries were fractures, but these accounted for 61% of total nonfatal costs—or $12 billion.6
- Hospitalizations accounted for nearly two-thirds of the costs of nonfatal fall injuries and emergency department treatment accounted for 20%.6
- On average, the hospitalization cost for a fall injury is $17,500.10
- Hip fractures are the most frequent type of fall-related fracture. The average hospitalization cost was $18,000; this was 44% of the direct medical costs for hip fractures.11
- Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050–6.
- Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a randomized trial. The Gerontologist 1994:34(1):16–23.
- Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed November 30, 2010.
- Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of Forensic Science 1996;41(5):733–46.trial. The Gerontologist 1994;34(1):16–23.
- Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
- Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. Journal of Managed Care Pharmacy. 2005;11(4):307-16.
- Shumway-Cook A, Ciol MA, Hoffman J, Dudgeon BJ, Yorston K, Chan L. Falls in the Medicare population: incidence, associated factors, and impact on health care. Physical Therapy 2009.89(4):1-9.
- Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME. Health care utilization and costs in a Medicare population by fall status. Medical Care 1998;36(8):1174–88.
- Roudsari BS, Ebel BE, Corso PS, Molinari, NM, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury, Int J Care Injured 2005;36:1316-22.
- Barrett-Connor E. The economic and human costs of osteoporotic fracture. American Journal of Medicine 1995;98(suppl 2A):2A–3S to 2A–8S.
This website is not to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation. In addition to providing related information this blog may also be considered an advertisement for legal services. If you or a loved one has suffered an injury or abuse in a nursing home or other care facility that serves the elderly in Minnesota, please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact attorney Kenneth LaBore, directly please send an email to KLaBore@MNnursinghomeneglect.com, or call Ken at 612-743-9048.