When a Fall Changes Everything

“I’m sorry ma’am – your father is unresponsive. You will have to meet us at the hospital.” These are words no family member wants to hear. Yet, similar circumstances are all too common when falls take place. According to the Centers for Disease Control and Prevention (CDC), one in four falls occur in older adults, and injury and death as a result are on the rise (Division of Unintentional Injury Protection, 2017)

This statistic is just as shocking as the experience itself. Even as a healthcare professional, knowing what I know, I was taken aback when my father, at age 72, fell victim to a fall. We had no idea why it happened and no knowledge of ways in which we could have potentially prevented it. His unintended fall led to a fractured femur, a surgical procedure and rehab. Within two months of that procedure, he experienced a blood clot that resulted in a brain aneurysm that ultimately led to his death. What most people don’t realize is the high percentage (in some instances as high as 50%) of adults who will pass away within six months of their surgical procedure due to an unintended fall (Liem et al., 2013). That is what happened to my dad and countless other older adults, leading me to wonder—how did this happen so quickly?

There’s Hope

Believe it or not, falls are not a normal part of aging, yet so many accept this as an inevitable  stage. As the strategic manager for a national in-home care agency, ComForCare Home Care, I contributed to the recent development of Gaitway—our approach to helping older adults understand more about why falls occur and what they can do about it. Our goal is to help reduce the risk of falls and injury, and we believe that starts with education and, most importantly, understanding what can be done regarding fall risk. Most of the older adults we support nationally who experience a fall cannot tell us why it occurred when asked. This level of uncertainty tells us a lot about awareness and resources that aren’t getting into the hands of the population most vulnerable to related risks. Unless we know why falls are happening, they’ll continue to occur, and older adults and their families will continue to experience fear and anxiety about the possibility of an eventual fall.

We need to look at ways to truly empower our older adults by starting difficult conversations, routinely screening for fall risk, and intervening to address risk factors that are specific to each individual we support. When we do this as a collective whole, we truly believe we will see a reduction in falls in older adults.

Why Do Falls Occur?

So why do they happen? All older adults are at risk, but the data tells the story that falls do not impact all older adults in the same way. Those who are younger or living independently in the community (defined as community dwelling older adults) are at a far lower risk of injury or death from a fall than those who are older, more frail or institutionalized—requiring assistance or support (Bergen et al., 2019).

Those adults who are more frail are the most likely to experience a serious injury, fracture, traumatic brain injury or death from a fall than any other age group. There are numerous reasons why older adult falls are complex. Falls are considered a “geriatric syndrome” or a multifactorial health condition common in the elderly that is associated with morbidity and poor outcomes. Examples of common geriatric syndromes include falls, delirium, incontinence, functional decline, and pressure ulcers. Geriatric syndromes are often seen in adults who are older and have cognitive impairment, functional impairment, or impaired mobility in combination with the additional risk factors unique to older adult falls.

To put it simply, falls are often consequences of multiple medical conditions (also known as risk factors) and/or inactivity during the aging process. With the appropriate preventative action, it is possible to lessen the likelihood of a fall.

Fall Risk Factors

When an older adult falls, it is common for them or their family to not really understand what could have led to the fall in the first place. The person who fell may feel they are clumsy, but when it comes to falls in older adults, there are further considerations that typically come into play. Knowing what risk factors lead to falls, and how to manage them properly, can help decrease the risk of falling. Some of the most common risk factors in (primarily community dwelling) older adults include: