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Personal Emergency Response Systems (PERS) help give individuals the opportunity to live a safer and more independent life. However, PERS does not actually prevent falls, they just help better the outcome of one. So how can we help members fall less overall and potentially avoid these tragic situations? Before we get into Fall Prevention tips, here are the facts on why it’s critical we work to prevent falls as much as possible and what questions should we consider when developing LTSS plans. Below depicts how often falls happen within the elderly population

1 Out of 3 People Falls each year

Falls Every Two Year

Fall Every Year

What should WE CONSIDER

History of falls: All clients with a recent history of falls should be considered at higher risk for future falls.

Mobility problems and use of assistive devices: Clients who have problems with their gait or require an assistive device for mobility are more likely to fall.

Medications:: Clients on a large number of prescription medications, or taking medicines that could cause sedation, confusion, impaired balance, or blood pressure changes are at higher risk.

Mental status: Clients with delirium, dementia, or psychosis may be agitated and confused, putting them at risk.

Continence:: Clients who have urinary frequency or who have frequent toileting needs are at higher fall risk.

Other risk factors include: being tethered to equipment, such as an IV pole; impairment in vision that could cause a patient not to see an environmental hazard; and orthostatic hypotension, which could cause the patient to become lightheaded or pass out when standing.

Falls Are Serious and Costly

*Important facts about falls according to the CDC’s home and recreational safety guidance*

https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Each year, millions of those 65 and older, fall. In fact, more than one out of three older people falls each year. Falling once doubles your chances of falling again.

One out of five falls causes a serious injury such as broken bones or a head injury. Each year, 3 million older people are treated in emergency departments for fall injuries.

Each year at least 300,000 older people are hospitalized for hip fractures.

✅ More than 95% of hip fractures are caused by falling, usually by falling sideways.

✅ The estimated medical costs attributable to both fatal and nonfatal falls was approximately $50.0 billion. Medicare and Medicaid shouldered 75% of these costs.

What Conditions Make Your Client More Likely to Fall?

Research has identified many conditions that contribute to falling. A big idea to understand is that risk factors can be changed or modified to help prevent falls. They include:

◉ Lower body weakness

◉ Vitamin D deficiency

◉ Difficulties with walking and balance

◉ Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.

◉ Vision problems

◉ Foot pain or poor footwear

◉ Home hazards or dangers such as broken or uneven steps, throw rugs, or clutter

60 percent of falls happen inside the home

Common rooms for elderly falls--

➥ Living rooms

➥ Kitchens

➥ Bedrooms

➥ Bedrooms

➥ Bathrooms — see shower comments below

➥ Hallways

How can PERS help
with In-Home Falls?

A question we get a lot is, “Will PERS devices work in the shower?” and the answer is, YES. All PERS Devices are shower resistant and should always be worn in the shower. This is extremely important to know because Case Managers and Members are not always aware of this.

30 percent of falls happen inside the home

⦿ Curb, street or sidewalk falls

⦿ Gardening or yard work

⦿ Gardening or yard work

⦿ Public Transportation

How can PERS help outside the Home? What If my member is active and independent?

Yes, PERS devices do in fact work outside the home. This is a solution that is also overlooked. GPS PERS relies on Cellular network coverage so members can travel anywhere at any time with a GPS PERS. So in the event your member is gardening in their backyard or going for a walk in the park, they’ll be covered in the event of an emergency.

Do you report to case managers when a member uses their PERS?

More than half of LTSS members who do have a fall, DO NOT tell their Service Coordinator. This is a problem because all Critical Incidents and Trigger Events must be reported in LTSS plans. What can we do about that?

See how we make your job easier in our article on critical incident reporting:

It’s Another reason why PERS should be part of any LTSS plan!

What if someone can’t press their button?

As we know, falls can occur when they’re least expected. Anything from seizures to fainting are common reasons why someone may fall. PERS can help with it’s Fall Detection Capability! All PERS devices are equipped with a sensor that can detect when a fall occurs. This is a great alternative in the event a member is at HIGH RISKFalling is common among the aging but it does not have to be normal. Together the Service Coordinator community with AMA PERS devices can make a huge impact. Let’s Start with our Annual Falls Prevention Awareness Week. This YEAR  September 18-24, 2022! Its Fall Y’all is not meant to be literal. But when they happen, AMA can be a great ally for service coordinators.

References

  1. Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:993–998. DOI: http://dx.doi.org/10.15585/mmwr.mm6537a2
  2. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare Population. Am J Prev Med 2012;43:59–62.
  3. O’Loughlin J et al. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. American journal of epidemiology, 1993, 137:342-54.
  4. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall–related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
  5. Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9
  6. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 5, 2016.
  7. Healthcare Cost and Utilization Project (HCUP). 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://hcupnet.ahrq.gov
  8. External
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  10. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 1993;52:192-198.
  11. Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Järvinen M. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int, 1999;65:183–7.
  12. Jager TE, Weiss HB, Coben JH, Pepe PE. Traumatic brain injuries evaluated in U.S. emergency departments, 1992–1994. Academic Emergency Medicine 2000&359;7(2):134–40.
  13. Florence CS, Bergen G, Atherly A, Burns ER, Stevens JA, Drake C. Medical Costs of Fatal and Nonfatal Falls in Older Adults. Journal of the American Geriatrics Society, 2018 March, DOI:10.1111/jgs.15304
  14. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:189–193.