The dangers of falls to seniors is back in the news, a reminder of how we’re increasingly at risk as a society…physically, psychologically and financially.
This isn’t news to us. My team and I are getting more fall-related claims involving seniors, as our nation’s workforce continues to gray and seniors remain active longer. These claimants present with a myriad of pre-existing health conditions and medications and often do not return to baseline health after injury. We’re seeing death cases even two years after a fall and in which a plaintiff is asserting that the fall contributed to a death.
Here’s what the Journal of the American Medical Association reported. A recent study published in the JAMA found that for people over 75 in the U.S., the rate of mortality from falls more than doubled from 2000 to 2016. According to data from the U.S. National Vital Statistics System mortality files:
…an estimated 28.7% of adults aged 65 years or older fell in 2014. Falls result in increased morbidity, mortality, and health care costs. Risk factors for falls include age, medication use, poor balance, and chronic conditions (ie, depression, diabetes). Fall prevention strategies are typically recommended for adults older than 65 years. In several European countries, an increase in mortality from falls has been observed since 2000, particularly among adults older than 75 years. This age group has the highest fall risk and potential for cost-effective interventions.
The study concludes that the “circumstances behind the increasing trends in mortality from falls are not fully understood. Future studies should focus on explaining the recent increase in mortality from falls, especially among the oldest age groups and what can be done to tailor interventions for these older age cohorts.”
In its coverage of the JAMA study, the New York Times turned to Elizabeth Burns, one of the authors of the study and a health scientist with the Centers for Disease Control and Prevention, to get her perspective on the rise in fall-related mortality. She explained that the “most likely reason is that people are living longer with conditions that in the past they might have died from” and that older adults are on medications that increase their risk of falling.
What to do about it
The Times article offers a good list of things seniors can do to lessen the inherent risk of falling. While we can’t do much to change age as a risk factor for falls, the Times offers five things that can mitigate it:
1. Exercise! At least 20 minutes a day is suggested, combining aerobic and anaerobic exercise. Weight lifting, particularly for strengthening the legs, is a good idea
2. Mind your meds Medications, especially those that help with sleep, can compromise balance.
3. Re-accessorize Avoid bifocal or progressive lenses when walking outside. Plus, wear sensible footwear; avoid, for example, high heels, slide-in sandals, slippers and the like.
4. Eliminate tripping hazards Get rid of small scatter rugs in your home, and eliminate extension cords that stretch across a floor. Keep on a night-light where a threshold might be tricky.
5. Early and often to the bathroom Hydration is a good way to fight dizziness. Drink plenty of water throughout the day and don’t wait to go to the bathroom and need to rush. Plus, going from sitting to standing is really good exercise and good for balance.
These findings are consistent with what we’ve observed after years in the field. As we note in “It’s Not Just Physical”, falling — particularly among seniors – is a result of complex, neuro-physiological interactions. Our brains assess slippery or tricky walking surfaces as we’re walking, looking ahead expectantly to see if the path is safe. We continue our evaluation as we walk forward, shifting our weight or changing our gait if the path turns out to be slippery or uneven.
In addition, our medical training and experience has taught us that not all falls are created equal, “The injury from a slip, for instance, could be completely different from a stumble or a trip,” we explain. “Knowing how the fall initially occurred will give you a foundation for what body part struck the ground or another object first.
“…[T]here are multiple kinds of falls. Rotational, same level, elevated level, tumble, free fall, trip, stumble and slip are among them. Many overlap in dynamics and biomechanic identifiers.”
Of course, all of this complexity raises practical concerns when analyzing a fall-related insurance claim or court case. In another fall-related article of ours, we pinpoint key questions that relate to the claimant’s age, including their medical history – specifically illnesses or medications that may cause dizziness, confusion or disorientation – as well as what was the claimant doing just before the fall.
While falls and deaths can be related, it is typically under clear circumstances such as a blunt trauma to the head or a fracture with secondary complications. The point is that the carrier needs to CAREFULLY REVIEW the case and to get experienced, technically sound medical review and analysis.