New program for seniors works to prevent falls

Stewart Grant, 86, a former Navy Seal underwater demolition expert, knows firsthand the importance of balance, strength and advance planning to prevent dangerous, debilitating and deadly accidents like a fall.

A resident of the Lake Barrington Woods retirement community, the retired tax consultant and World War II veteran who saw extensive action in the South Pacific, says he was simply moving his lounge chair away from the wall when the chair slipped causing him to fall and strike his head.

“I was trying to reach the emergency pull cord when my daughter-in-law arrived and summoned help,” recalls Grant, the father of three, grandfather of seven and great-grandfather of two.

Grant's experience isn't uncommon, according to Dr. Robert Witkowski, trauma medical director at Advocate Good Shepherd Hospital in Barrington. In fact, Witkowski said statistically falls are the No. 1 cause of injury death for seniors.

“Falls are the leading cause of trauma admissions for seniors,” he says. “Many patients admitted with hip injuries and dangerous bumps to the head already have health issues like high blood pressure, diabetes, osteoporosis and heart or vascular disease, which can complicate treatment and recovery.”

Colleague Dr. Greg Brebach, an orthopedic surgeon affiliated with Lake Cook Orthopedics, says those predisposing health problems can make recovering from a fall-related hip injury difficult for seniors.

“Hospitalization, surgery and a lengthy rehabilitation can challenge strength, poise and determination,” he says. “Prevention is vital. Preventing falls and making seniors aware of the need for strength and safety are key.”

A new emphasis on prevention has spurred some county health departments to initiate community outreach programs in conjunction with area hospitals, senior centers and retirement communities.

Such programs seek to raise awareness, address fears and provide seniors with tools to prevent falls.

Brebach says curbs, icy or slippery pavement, rugs that slide, lack of a night light, and not using canes and walkers are causes frequently cited by his patients suffering hip fractures.

Each year, according to the Centers for Disease Control and Prevention, 1 in 3 adults 65 and older falls. Falls are the leading cause of injury death in that age group and are the most common cause of nonfatal injuries and hospital admissions for trauma.

The CDC reports that in 2008 2.1 million nonfatal fall injuries were treated in emergency rooms across the country and more than 559,000 of those treated were admitted.

According to the National Safety Council, falls in the home are the most common cause of accidental death for those 65 and older.

“The incidence and impact of falls by the elderly is startling to many,” says Jack Mills, continuous quality improvement specialist for the Lake County Public Health Department.

Mills has been tracking Lake County fall-related injuries and hospital admissions as part of a countywide goal of reducing mortality due to unintentional injury.

“It's the No. 1 trauma-related injury in Lake County and the state,” Mills says.

He reports that based on hospital discharge records, 1,697 Lake County residents were admitted to hospitals due to falls in 2008 and 1,954 were admitted in 2009.

“Nationally, only 25 percent to 30 percent of those who fall come to the hospital and need to be admitted,” Mills says. “So real numbers could be much greater.”

Fall-related hospitalizations also increase as people age, Mills said.

“These falls have a dramatic and life-altering impact,” he said. “It's not a simple matter of getting back to previous routines. As baby boomers age in Lake County, it appears that without intervention and early prevention these numbers will continue to rise.”

Lake County has taken the lead in trying to battle the trend with several community partnerships that pair hospitals and senior centers.

“Accidents can happen at any age, but they occur more commonly and cause more serious injuries in older adults,” said Kathy Phelan, trauma coordinator and certified trauma nurse specialist at Advocate Good Shepherd Hospital in Barrington.

As a member of a special Lake County fall prevention work group, Phelan is among a cadre of trained facilitators for a fall prevention program called A Matter of Balance.

Created by Boston University's Roybal Center in Applied Gerontology and the New England Research Institutes with funding from the National Institute on Aging, the group-based program focuses on practical ways to reduce both the fear of falling and the risks.

The balance program was presented last spring and fall through a partnership pairing VISTA Health System physical therapists and seniors at the Waukegan Senior Center.

Katherine Schulte, a physical therapist from Northwestern Lake Forest Hospital, will bring the program to residents at the Lake Forest and Lake Bluff Senior Center, 100 Old Mill Road, Lake Forest, for an eight-session program beginning Tuesday, Jan. 4.

In the Chicago metropolitan area, Kane County has recently completed facilitator training for the Matter of Balance program. Paul Hinkel, senior services director for the Kane County Health Department, said he hopes to schedule programs in Aurora and Yorkville in 2011.

Neither Cook nor DuPage counties have community outreach fall prevention programs for seniors.

Phelan and Advocate Good Shepherd experts recently teamed with dozens of seniors at the Lake Barrington Woods retirement community for a series of classes designed to help seniors understand their fear of falling, identify risk factors and develop ways to reduce risks, increase safety and improve the muscle strength needed to be able to get up following a fall.

“Falls are an all-encompassing problem,” Phelan said. “Fearing the possibility of a fall, many seniors become homebound and actually place themselves at greater risk by becoming less active. We work to identify those fears, change attitudes, set realistic goals for increasing activity, change the environment to reduce falls and promote exercise to increase strength and balance.”

Phelan says the No. 1 fear expressed by seniors she has worked with centers on street curbs.

“We exercised to help the seniors lift their legs to avoid a fall and stressed the importance of taking your time, looking for safer options like curb cutouts, ramps and even calling ahead to identify the safest route.”

Among the group's most enthusiastic participants was Stewart Grant, who says many seniors hope the program becomes an ongoing resident-driven fall prevention program.

Today, Grant said he is walking a mile three times a week and participates in a special “sit and move” exercise class to strengthen muscles. He's an active member of the community's food committee and volunteers twice a week at the Country Store.

“I've learned to take things a bit slower,” Grant admits. “I also changed my behavior and sit more gently when it comes to that lounge chair.”

Risk factors and solutions

<p>Here are some risk factors and suggestions on how to decrease the chances of a fall:</p>

<p>• Poor vision: Check your vision annually</p>

<p>• Gait and balance: Exercise regularly, it makes you stronger and improves your coordination </p>

<p>• Cardiovascular: Get up slowly after you sit or lie down </p>

<p>• Arthritis: Because of restricted movements, carry a cordless phone with you so you don't have to hurry to answer the phone </p>

<p>• Alcohol: Drink alcohol with caution due to the effects it can have on balance </p>

<p>• Medications: Have a doctor or pharmacist review prescriptions and over-the-counter medications, since some medications can cause dizziness or drowsiness </p>

<p>Create a safe environment around the house: </p>

<p>• Have adequate lighting throughout the home, especially in the bathroom </p>

<p>• Secure cords and wires from traffic areas </p>

<p>• Wipe up all spills immediately</p>

<p>• Make sure you can easily reach the phone and lamp from your bed</p>

<p>• Place nightlights between the bedroom and bathroom</p>

<p>• Remove throw rugs</p>

<p>• Clear passageways of clutter such as shoes, blankets, boxes, etc.</p>

<p>• Install grab bars, especially near the toilet and shower; never trust a towel bar to support your weight</p>

<p>• If you live alone, be sure someone checks on you daily </p>

<p>Source: Kathy Phelan, Advocate Good Shepherd Hospital trauma coordinator</p>