Usc Center Shows Safety's Gold Standard Includes Three Factors

By Bezaitis, Athan G. | Aging Today, July/August 2008 | Go to article overview

Usc Center Shows Safety's Gold Standard Includes Three Factors


Bezaitis, Athan G., Aging Today


The facts about falls in the United States speak loud and clear. According to the Centers for Disease Control and Prevention, treating elders for the adverse effects of falls in 2000 cost more than $ 19 billion that year in the United States: $12 billion for hospitalizations, $4 billion for emergency room visits and $3 billion for outpatient care. Medicare pays for most of these expenses. The Centers for Medicare and Medicaid Services projects that by 2020, direct-treatment costs from elder falls will escalate to $43.8 billion a year.

Loss of life, the onset of disability and the burden of exorbitant medical costs have done little to raise awareness of the issue. Adding insult to injury, experts estimate that up to 30% of falls are avoidable. An important sign of progress on fall prevention was the passage by Congress of the Safety of Seniors Act, signed into law by President Bush in April. (For more details, see the article by Bonita Lynn Beattie elsewhere in this "In Focus" section.) Although this legislation identifies key strategies for reducing falls, such as better training for professionals and targeting of at-risk groups, Congress has yet to fund the provisions of the bill.

LITTLE COHESION

The enactment-and eventual funding-of the new law will go a long way toward knitting together the numerous fall-prevention efforts around the United States, according to Jon Pynoos, codirector of the Fall Prevention Center of Excellence (FPCE), a consortium of four organizations based at the University of Southern California's Andrus Gerontology Center.

Throughout the United States, the largely community-based infrastructure for fall prevention has little cohesion, according to Pynoos. The current patchwork of outreach initiatives varies by target population served, geographic location, services provided and funding source. Until recently, most interventions have been implemented with varying degrees of success in doctor's offices, patients' homes, hospitals, nursing homes, senior centers and specialized research centers. The long-term goal for Pynoos and other advocates is to establish and coordinate model fall-prevention programs that other organizations can replicate and sustain throughout the United States.

Research has shown that the gold standard for fall prevention is a multifactorial approach requiring input and analysis from three medical professionals. Although ostensibly expensive, a fall-prevention evaluation should include a physical examination performed by a doctor; a progressive exercise regimen implemented by a physical therapist; and an environmental precautions analysis, especially of potential home hazards, conducted by an occupational therapist. The medical evaluation of at-risk individuals requires a physician to analyze risk factors, such as medications, vision, gait and fall history. Following this assessment, the doctor recommends appropriate types and levels of exercise.

"Major dangers for falls are the socalled intrinsic risk factors, or those coming from an individual-as opposed to the extrinsic or environmental risk factors," said FPCE codirector Laurence Rubenstein, who also codirects the UCLA/VA Greater Los Angeles Healthcare System, long run by the University of California, Los Angeles, and the Veterans Affairs hospital system. "The most important intrinsic risk factors are muscle weakness and gait or balance problems. A person with these factors has a three-to-four-times greater likelihood of falling as someone without them," he said.

OTHER FACTORS

Other important risk factors are also known to nearly double the likelihood of a fall, Rubenstein said. These include functional impairment of daily activities, depression, cognitive impairment, being age 80 or older, or taking psychoactive medications. Some of these deficits can be improved with proper detection and treatment adjustments, he noted.

Rubenstein added that the majority of older adults do not exercise regularly, and 35% of people ages 65-plus fail to participate in any leisure activities at all. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Usc Center Shows Safety's Gold Standard Includes Three Factors
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.