QUALITY IMPROVEMENT
Falls Aren’t Inevitable— and Prevention is Possible
By Sara Wildberger F
all: It’s a simple word with complex causes and far-reaching consequenc- es in the senior care fi eld. One of the
most serious: Deaths related to falls for older adults increased by 31 percent from 2007 to 2016—a 3 percent increase per year over the past decade. That’s a compelling call to act. The
Centers for Disease Control (CDC) and the American Pharmacists Association collabo- rated on ways to change this picture. The result was the STEADI program: Stopping Elderly Accidents, Deaths & Injuries. Yara Haddad of the CDC’s National Center for Injury Prevention and Control shares insights and actions senior leaders can take.
Implementing Intervention “Fall-related injuries can be devastating, resulting in an inability to care for one- self,” Haddad says. Yet health care provid- ers often don’t routinely screen adults for fall risk. “Many older adults think falls are
inevitable, but that is often not the case,” Haddad says. “Falls can be prevented.” Multifactor interventions—which iden-
tify and alleviate many fall risk factors at once—can reduce falls by as much as 24 percent, the CDC research shows.
Why pharmacists? Health care is more and more a team ef- fort, with diverse skills and services, and older adults are more likely to work with a primary care team. “Pharmacists are some of the most accessible members of the health care team, and are well versed in medications and associated side eff ects,” Haddad says. “For older adult falls, this is important, because the physical changes that occur with aging can alter the way the body reacts to medications, causing more side eff ects and increasing fall risk.”
26 SENIOR LIVING EXECUTIVE JANUARY/FEBRUARY 2018 In addition to being accessible, pharma-
cists have the knowledge needed for medi- cation review and management. They can help determine whether to stop or switch a medication, as well as give guidelines on changing dosage or safe tapering.
Medications make the diff erence “Four in fi ve older adults take at least one medication daily and about a third take fi ve or more medications daily,” Haddad says. “In 2013, more than half of all older adults reported using at least one medica- tion linked to falls in the past year.” It’s not only the amount of medications
being taken, but the types of medications that matter for fall risk: “Certain medica- tions, such as opioids, benzodiazepines, sedative hypnotics, antipsychotics, and an- tidepressants can cause side eff ects, such as blurry vision, dizziness, confusion, or a drop in blood pressure that can make someone more likely to fall.”
What senior living leaders can do now “Senior living leaders can help older adults maintain their independence by fol- lowing some key steps,” Haddad says. She recommends community leaders review the STEADI toolkit at
cdc.gov/STEADI.
Thought Leader Profi le
Yara Haddad, PharmD, MPH Pharmacist and Oak Ridge Institute for Science and Education Fellow CDC’s National Center for Injury Prevention and Control
It includes tools, information, and online training to help screen older residents for fall risk, assess modifi able risk factors, and intervene to reduce risk by using eff ective clinical and community strategies. Such strategies are many and varied: physi- cal therapy, for example; a Tai Chi class, new glasses, or a review and change in medication. The toolkit also includes lists of medica-
tions linked to falls and risk factors for falls, an algorithm for fall risk screening and intervention, and materials created for older adults. Employees may be able to earn continuing education credits through online STEADI education, as well.
FIVE STEPS FOR OLDER ADULTS
The STEADI program has a few simple recommendations for older adults in any and every setting:
1. Openly discuss falls with your health care providers.
2. Talk to a pharmacist or doctor about medications that may make them more likely to fall.
3. Stay active. 4. Have your vision checked yearly.
5. Remove fall hazards from the spaces where you live and visit.
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