Bracing for the Falls of an Aging Nation

Posted on January 17, 2018 by ECR Louisville in Blog, Caregiver Education, Community Resources

Ramin Rahimian for The New York Times

SAN FRANCISCO — Eleanor Hammer, 92, executes a tightly choreographed, slow-motion pas de deux with her walker during meal times at The Sequoias, a retirement community here. She makes her way to the buffet, places her food on the walker’s built-in tray and returns to her table.

Her small act of independence has not come easily. To eliminate trips that could lead to falls, management at The Sequoias required residents to have walkers valet parked once they reached their table, then remain seated while staff served the meal.

That lasted until a woman sued to stop the policy, infuriated that it infringed on her freedom of movement. A compromise was reached: Residents are now allowed to take their walkers to the buffet at less busy times.

“I do like to pick out my own food,” said Mrs. Hammer, a retired music teacher. “I can tell you, as a child of the Depression, they always bring me too much.”

As the population ages and people live longer in bad shape, the number of older Americans who fall and suffer serious, even fatal, injuries is soaring. So the retirement communities, assisted living facilities and nursing homes where millions of Americans live are trying to balance safety and their residents’ desire to live as they choose.

Those who study and manage retirement facilities and nursing homes say there is heightened attention to preventing falls. Trying to anticipate hazardous conditions, retirement facilities like The Sequoias hire architects and interior designers, some of whom wear special glasses that show the building as an old person would see it.

The dangers are real. The number of people over 65 who died after a fall reached nearly 24,000 in 2012, the most recent year for which fatality numbers are available — almost double the number 10 years earlier, according to the Centers for Disease Control and Prevention.

And more than 2.4 million people over 65 were treated in emergency departments for injuries from falls in 2012 alone, an increase of 50 percent over a decade. All told, in the decade from 2002-2012, more than 200,000 Americans over 65 died after falls. Falls are the leading cause of injury-related death in that age group.

Some facilities have begun to install floor lighting, much like that on airplanes, that automatically turns on when a resident gets out of bed, illuminating a pathway to the bathroom, said Dr. Lewis A. Lipsitz, a professor of medicine at Harvard who is also vice president of academic medicine at Hebrew SeniorLife, a senior housing, research and health care organization in the Boston area. Others are installing energy-absorbing flooring in bathrooms, to reduce the impact of a fall.

The Patient-Centered Outcomes Research Institute, a nonprofit organization, and the National Institute on Aging recently embarked on a five-year, $30-million study of fall prevention among seniors living independently, the largest such study to date.

But many residents do not, or refuse to, recognize their own gradual deterioration, leaving them vulnerable despite efforts to protect them. Institutions offer sessions on avoiding falls and improving balance and fitness. But some residents will not go near them – until after they have fallen.

“As the saying goes in the Army,” Mrs. Hammer said, “they can’t make you do anything, but they can make you wish you had.”

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The New York Times