Health Care Professional
Educational Module
Module Goals
To increase:
 Health care professional knowledge
about falls-related issues and prevention
interventions among older adults
 The number of health care professionals
who attend the Stand Strong for Life:
Health Care Professional Educational
module
 The number of health care professionals
who educate older adults about fall
prevention using the Stand Strong for
Life intervention
Module Goals
To Increase:

The number of health care professionals
who attend the Stand Strong for Life:
Health Care Professional Educational
module

The number of emergency departments,
hospitals, and senior living facilities that
implement falls prevention initiatives

Community partnerships among health
agencies to increase falls prevention
among community-dwelling older adults
Intervention Content

Stand Strong for Life: Health Care
Professional Educational Module

Stand Strong for Life: Communitydwelling older adults PowerPoint
presentation

Four brochures that accompany the
community-dwelling older adult
presentation

Resources and Tools
Definition of Fall
A fall is “any event in which a person
unintentionally comes to rest on the
ground or another lower level such
as a chair, toilet, or bed.”12
Scope of the Problem

For adults 65+, falls are the leading cause
of injury-related death3,4

Each year, more than one-third of older
adults fall5-9

In 2004, 2.9 M older adults were treated
for non-fatal injuries in U.S. emergency
departments; of those, 1.9 M were the
result of falls10

Nearly one-half of all falls among older
adults occur in or around their homes10
Scope of the Problem

Of those who fall, 20% to 30% suffer
moderate to severe injuries13

Nearly 50% of those hospitalized after a
fall die within one year9

In 2003, nearly 13,820 older adults died
from fall-related injuries: of those,
approximately 50% were age 85 and
older.10
Cost of Falls Among
Older Adults

Fall-related injury costs $20 billion per
year21

By 2020, total annual direct cost is
expected to reach $32,4 million21

Direct costs do not account for the longterm consequences of these injuries22
Challenges to Be Met

Between 2000 and 2030, the older adult
population (65+) is projected to grow from
35 million (12.4% of the population) to
over 70 million (20% of the population)1,2

The U.S. public health service estimates
that 66 percent (2/3) of deaths related to
fall are preventable14

How do we go about facing the challenge
of reducing falls and fall-related injuries
among older adults?
Risk Factors


Internal – integral to patient’s
system

Medical conditions

Aging process
External – physical environment

Living environment

Emergency Department/Hospital/
Senior Living Facility

Outdoors
Falls among older adults are usually
not the result of a single risk factor,
but of a combination of internal and
external factors24
Internal Risk Factors

History of Falls (Previous Falls)

Medication use (Polypharmacy)

Balance, gait, and muscle strength
(Lack of Physical exercises)

Vision impairment

Podiatric problems
History of Falls
(Previous falls)

Older adults who have previously
fallen or who stumble frequently are 2
to 3 times more likely to fall within the
next year9,25,33

Previous falls often leads to fear of
falling, which may lead to decreased
activity and loss of self-confidence27
History of Falls
(Previous falls)
FEAR OF
FALLING
FALL
DECREASED
FUNCTIONAL
ABILITY
DECREASED
ACTIVITY
REDUCED
▪ MUSCLE
STRENGTH
▪ BALANCE
AND GAIT
▪ FLEXIBILITY
Visual Impairment

Poor visual acuity27

Older adults experience decreased
night vision, altered depth perception,
decline in peripheral vision, and glare
intolerance25,37

Also be aware of old or new
prescription glasses27
Medication Use
(Polypharmacy)

Types of medications25,32


Number of administered or prescribed
medications (polypharmacy)25,27


Psychoactive medicines
Rule of thumb: 4 or more medications
Number and types of over-the-counter
medication (NSAIDs, vitamins,
supplements, homeopathy, etc.)
Balance, Gait, and Muscle
Strength
(Lack of physical activity)

Less than 25% of older adults exercise
regularly40

By age 65, a 20% decrease in strength
and flexibility usually occurs41,42

After age 70, decrease in strength is even
greater 41,42
Podiatric Conditions

Nearly 75% of older adults have some
type of foot and ankle problems49

Decreased sensation in the feet21

Foot conditions can impair balance
function50
External Risk Factors

Unsafe home environment

Inadequate footwear

Unsafe outdoor environment

Unsafe emergency department/
hospital/facility environment
Unsafe Home
Environment22,25








Slippery flooring and carpeting
Use of throw rugs
Inadequate furnishing design and
position
Poor lighting
Lack of equipment in bathroom and
bathtub
Lack of or structurally unsecured
handrails
Clutter
Inadequate assistive devices
Inadequate Footwear
Improper shoes can:27




Lead to painful mobility
Increase potential for feet problems
Prevent older adults from staying active
Increase the risk for falls
Unsafe Outdoor
Environment

Uneven sidewalk, terrain, curbs,
sidewalks

Lack of or structurally unsecured
handrail

Hazardous materials (ice, snow,
gravel, etc.)

Poor lighting
Unsafe ED/Hospital/Facility
Environment

Transfer to or from a bed or chair17

Bed height16

Attachment to equipment (IV, oxygen)17

Slippery floors

Lack of assistive devices

Clutter, tripping hazard

Unreachable bell, side table

Improper lighting

Mechanical restraints19,20
How Can You Prevent
Falls From Occurring?
The goal of a falls prevention
program is to reduce the
number of risk factors
Intervention Model

Community Setting
Presentation/Intervention

Emergency department, hospital, senior
living community Intervention
Falls-Risk Assessment
(Previous falls)

Falls-Risk Assessment Tools

Morse Fall Scale (MFS)

Hendrich II Fall Risk Scale

Falls – Assessment/Screening/
Diagnosis Scale
Falls-Risk Assessment
(Previous falls)

Community Presentation


Conducted before presentation
Emergency Department, Hospital, or
Senior Living Community

Conduct screening when fitting
(triage, admission, move-in)
Vision Examination
(Visual impairment)

In all settings

Educate older adults

Refer to primary care provider for
regular eye examinations
Medication Review
(Polypharmacy)


Community Presentation
 Educate older adult
 Refer to primary care provider or
pharmacist
 Distribute Safe Medication Card
Emergency Department, Hospital, or
Senior Living Community
 Educate older adult
 Refer to primary care provider or
pharmacist
 Refer to Stand Strong for Life
 Distribute Safe Medication Card
Physical Activity
(Reduced balance, gait, and
muscle strength)


Community Presentation

Educate older adult

Distribute and Practice Healthy Movements

Distribute Health Calendar Contract

Refer to primary care provider or community
and home health services
Emergency Department, Hospital, or
Senior Living Community

Educate older adult

Distribute Healthy Movements

Refer to Stand Strong for Life (medium and
high risk)
Examples of Physical
Activities

Walking

Gardening

Dancing

Strength, resistance, and flexibility
exercises

Yoga

Tai Chi
In-Home safety
(Unsafe home environment)

Community Presentation




Educate older adult
Distribute Check for Safety: A Home Fall
Prevention Checklist for Older Adults
brochure
Refer to community and home health services
Emergency Department, Hospital, or
Senior Living Community




Educate older adult
Distribute Check for Safety brochure
Refer to Stand Strong for Life community
presentation (medium and high risk)
Refer to community and home health
services
In-Home Modifications
and Assistive Devices








Widening doorways
Remove any clutter (staircase, floor)
Remove throw rugs
Remove electric cords
Install railings on stairways
Install grab bars in bathtub, shower, and
by toilet
Use shower chair
Install raised toilet seat
Feet and Footwear Check
(Podiatric problems and inadequate
footwear)


Community Presentation
 Educate older adult
 Distribute Foot and Footwear Check
brochure
 Refer to primary care physician and home
health services, if needed
Emergency Department, Hospital, or Senior
Living Community
 Educate older adult
 Distribute Foot and Footwear Check
brochure
 Refer to Stand Strong for Life community
presentation
 Refer to primary care physician and home
health services, if needed
Adequate/Inadequate
Footwear


Adequate

Proper fit

Non slippery soles

Low heels
Inadequate

Floppy slippers

Loose fitting

Wearing socks only
Assistive Devices

Cane

Walker

Hip protectors

Grip bars

Shower chair

Raised toilet seat
Community Services and
Referrals

Home care service agencies

Personal trainer or exercise
program dedicated to older adults

Social services

Day care

Meals on Wheels