New Law, Falls Free Initiative Help Stop Seniors' Free Fall
Beattie, Bonita Lynn, Aging Today
A sense of urgency is a growing in the United States to address the issue of falls and fall-related injuries among the rapidly expanding population of older adults. Several reports by the National Center for Injury Prevention and Control and its Traumatic Brain Injury Awareness campaign have heightened recent interest in this issue. In 2004, the National Council on Aging (NCOA), with support from the Archstone Foundation and the Home Safety Council, launched the national Falls Free Initiative, which resulted in a consensus document titled the National Action Plan; strategies contained within are intended to minimize falls among elders and maximize their independence and quality of life.
Experts and advocates in aging have long known that well-researched interventions can reduce falls and related injuries. Interventions can address such risk factors as physical mobility limitations, inactivity, poor medication management, vision impairment and safety hazards in homes and communities. For instance, inadequate interior lighting or broken sidewalks may be just annoyances to most people but are dangerous for frail elders.
NEW FEDERAL LAW
One major challenge is the need to bring healthcare providers and the agingservices network together with community leaders to promote evidence-based fallrisk screening initiatives and appropriate interventions for adults at all levels of risk.
Aging members of Congress are not immune to falls, as has been evidenced by recent injuries sustained by Sen. Robert Byrd, D-W.V, and Rep. Edward Markey, D-Mass., as well as the fall-related death of Rep. Paul E. Gillmor, R-Ohio, last autumn. Not surprisingly, the Safety of Seniors Act had nearly unanimous support as it made its way through the House and the Senate, and was signed into law in April 2008.
This statute addresses one aspect of the national action plan and the Falls Free Coalition. (For information about FFC, see article on page 10). The legislation articulates specific strategies to bring about change and includes provisions for a public-awareness campaign, provider education programs and community demonstration projects to provide access to evidence-based screening and prevention programs for millions of elders. However, the bill passed without funding, and FFC members have petitioned Congress to appropriate adequate funds to realize the provisions of the law.
Several surveys have revealed a widespread lack of understanding about the growing public-health issue of falls. In an article published earlier this year in the American Journal of Public Health (98: 351-357), Karen Hughes and coauthors reviewed data from several international surveys conducted to inform fall-prevention campaigns and found that more than 60% of participants rated their risk as low-yet that impression flies in the face of the national statistics on falls among U.S. elders. Lucy Yardley and colleagues concluded in a 2006 article in The Gerontologist (46: 650-660) that such denial led many older people to reject addressing issues of risk or participating in fall-prevention interventions.
More alarming is the prevalent fear of falling documented among community-dwelling older adults, a concern that can affect elders' daily functioning and quality of life. In a review published in the Canadian journal Geriatrics and Aging (2003, 6:15-17), Nadine Gagnon and Alastair Flint noted that the fear of falling affects 2O%-6o% of community-dwelling older adults but skyrockets to as high at 83% in elders who have already fallen. They also found that 70% of older adults who have fallen report making significant changes in their daily activities, limiting their mobility-and their quality of life-because they fear losing independence. Family members are also worried. That is why advocates for elders-and the new law-call for a public-awareness campaign that combines education with strategies to reduce risk. …