Falls Prevention in Washington State

Karen M. Winston, ADS Planner

What does the data say about falls?

The incidence of falls is troubling. Did you know that 60% of fatal falls occur in the home? Many people do not understand how serious falls can be or how they threaten independence.

According to the Centers for Disease Control and Prevention (CDC), about one in six Americans 65 years of age and older have suffered a fall in the past three months, with about a third of those individuals sustaining injuries such as a broken hip or head injury.ⁱ  In Washington State alone, falls are the leading cause of injury-related hospitalizations, and cause significant disability and mortality.ⁱⁱ

What's happening in Washington?

Many groups have come together to increase awareness about falls throughout the state. Over half of the counties in Washington have community-based senior fall prevention activities underway or starting up.

Pierce County formed a model Fall Prevention Coalition in 2006, as part of a state grant from the CDC. The dedicated coalition members work to educate individuals, families and care providers about reducing fall risks, and increasing access to falls prevention information, services and resources that help older adults to continue to live independent lives.

Earlier this year, the Healthy Aging Partnership (HAP) made falls prevention their number one priority for 2009. HAP is a coalition of 30+ governmental and not-for-profit organizations all located in King County. HAP's goals are to: 1) Increase public and professional awareness about fall prevention; 2) Increase individual assessments for falls prevention; 3) Increase physical activity program visibility and availability in targeted communities; 4) Increase linkages and referrals among HAP partners and others; and 5) Improve communication about supportive public policy. HAP recently hired a VISTA volunteer to help them reach their goals.

Other activities throughout Washington include:

• For the third year in a row, Governor Gregoire has issued a proclamation for Falls Prevention Awareness Day (this year to be held on September 21, 2009). Last year, the second proclamation spurred many community activities statewide.
• The Washington Department of Health is working to establish a State-wide Falls Prevention Coalition.
• The Washington Health Foundation has funded two falls prevention projects in rural communities.
• The Department of Social and Health Services has supported consultation on fall prevention to aging service providers and community organizations by the NorthWest Orthopaedic Institute.
• The Retired Senior & Volunteer Program (RSVP) Directors Association secured funding for eight Americorps VISTA volunteers to work on senior fall prevention in Washington.  
• Over 280 physical therapists and 120 physicians have received specialized training in falls risk assessment and intervention. 
• Linkages between the EMS/Trauma system, public health and the aging network are emerging at the state and community levels.
• Widespread distribution of an educational pamphlet on staying active and avoiding falls (over 23,000 copies distributed in less than a year to Washington seniors).
• Statewide training is available in exercise programs for older adults that have been evaluated for effectiveness in reducing fall risk factors

What are the main components of a falls prevention programs?

The five main building blocks of an effective community-based falls prevention program are:ⁱⁱⁱ

1. Education about falls and fall risk factors.
   
   
2. Exercises that improve mobility, strength, and balance, and that are taught by trained, nationally certified exercise instructors or physical therapists. Exercise programs include:
   
   
   • Tai Chi
   • Individualized exercise sessions
   • Group exercise classes
   • In-home exercise programs with supervision until the older adult can exercise independently, such as the HomeStretch Program  
     
     
3. Medication review to identify side effects or drug interactions that may contribute to falls. The reviews should be conducted by pharmacists or healthcare providers for accuracy. Medication management-adjustments to or changes in medications-should be provided by physicians.
   
   
4. Vision exams by trained healthcare professionals with vision correction by an optometrist or ophthalmologist.
   
   
5. Home safety assessment and home modification by occupational therapists or other healthcare professionals with specialized training, to identify and modify home hazards that can increase older adults' risk of falling.

In summary, falls prevention is a critical part of promoting independence and aging in place. For more information and resource on falls prevention, visit these web sites:

Washington State Falls Prevention 

WA State Department of Health, Stay Active & Independent for Life—an Information Guide for Adults 65+
 
Center for Disease Control and Prevention: Falls Prevention Page