Prevention of falls and injuries among the elderly

It can happen in an instant: reaching on a wobbly stool for something located on a high shelf, tripping over uneven pavement, slipping on a rug or a patch of ice, or getting up from a bed, a bath, a toilet or a chair. It can happen in a person’s home, in the community, while a patient is in an acute care hospital, or as a resident in a long-term care home. There are numerous ways a person can suddenly trip or lose his or her balance, and the result is often an
injury, hospitalization – or even death.

It is estimated that one in three persons over the age of 65 is likely to fall at least once each year. In B.C., this means that an estimated 147,000 British Columbians over age 65 are likely to fall this year. Almost half of those who fall experience a minor injury and between 5 to 25 per cent sustain a more serious injury, such as a fracture or a sprain. In 2001 alone, 771 people over the age of 65 died from falls in B.C. and more than 10,000 were hospitalized.

B.C. data show that over the last decade there has been no improvement in the rate of deaths from falls in any of the three age groups over age 65; the death rates have remained consistent. In addition, the number of persons aged 65 years and older admitted to hospital due to a fall-related injury has increased from 9,181 in 1992/93 to 10,242 in 2000/01, with the majority of this increase being accounted for by those age 85 years and older. The impact of falls in this age group is a public health problem of huge proportions that will only intensify as our population ages.

In this report, we outline the impact of falls and the resulting injuries on elderly individuals, their families, and society. We also present new data that confirm the seriousness of this public health concern in British Columbia. We examine the physical, environmental, behavioural and social/economic factors that increase the risk of falling. And we discuss what is known about where and why falls happen in the community, in long-term care homes, and in acute care hospitals. In addition, we examine emerging, evidence based, strategies to prevent, assess and reduce the risks of falls and injuries in all settings, we note gaps in the research information and outline promising new areas for further investigation. Finally, we present a series of recommendations from the Provincial Health Officer, for actions by individuals, seniors’ groups, health providers, regional health authorities and the provincial government to help reduce the toll exerted by falls and the resulting injuries upon our elderly population and our society in general.

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