Healthcare Headlines Blog

allison2cisThe Centers for Disease Control reports that "every 20 minutes an older adult dies from a fall in the U.S."

Combine that eye-opening statistic with the reality of an aging U.S. population and the fact that the rate of falls increases with age and it's clear why the 2015 Kindred Clinical Impact Symposium is focused squarely on fall prevention.

Speaker Leslie Allison, PT, PhD, an associate professor at Winston-Salem State University, says one of her friends, a geriatrician, calls the upcoming anticipated surge of falls the Silver Tsunami.

Allison says that by 2050, experts expect to face 1,800 hip fractures a day, a doubling of today's numbers. Of those, data suggests that only a quarter will make a full recovery, a quarter will die and 40 percent will need nursing home care. Fifty percent will need a cane or walker. In fact, Allison says, by 2050 there will not be enough specialists to treat the hip fractures that occur.

Allison's goal in her Tuesday session at the Symposium was to give an overview of the challenges and opportunities of fall prevention and where it fits into the healthcare continuum. Hers was the first of four related sessions on the topic.

She first explained the difference between best practices and evidence-based practices, noting that the first is based on the best evidence available and is applied in a one-to-one situation with each patient. Evidence-based practice is integrating individual clinical expertise with the best available external clinical information from systemic research. Allison also talked about evidence-based programs, a "set of coordinated services and activities that demonstrate effectiveness based on research."

Allison then dove right into the subject of fall prevention and where it fits into the continuum of care.

The short answer is at every stage - from the EMT who responds to an emergency call, to the acute care hospital which treats an injury from a fall, to the facilities which provide rehab services. She highlighted several studies, conducted in various settings, showing that there are many successful fall prevention interventions.

"Falling is a chronic syndrome with intermittent emergency events that may be preventable," she says. It's important for healthcare providers to remember that, as a chronic condition for many patients, "when they're done with us, they're NOT done.

allison6cisShe compares the approach to patients who experience falls to a patient who is in treatment for myocardial infarction. Once the patient undergoes rehab, the goal is to maintain the gains that have been achieved and to prevent recurrence with long-term behavior changes. The goals should be similar for falls, she says. Ongoing treatment should include support and encouragement for patients in the areas of consistent exercise, vision care, home safety modifications and management of medications.

Overall, Allison is a proponent of the multi-factorial approach, which brings in different disciplines to help uncover the reasons why a patient may be falling.

She is also a big believer in tailoring the care approach to the specific needs of the individual. While exercise is beneficial for everyone who has experienced an injury after falling, some patients may need to address vision issues, while others may need to have their medications re-evaluated. Ultimately, the idea isn't to have one treatment for all patients, but to have the training and resources in each setting to address the patient's needs at that time and to ensure they will continue to have the information and support they need once they leave that setting and return home.

Allison began her remarks by thanking all of the attendees for the quality care they provide every day. She gave special thanks to those who were there to participate in the CIS poster session to present information on fall prevention research projects at their facilities.

Each year the Kindred Clinical Impact Symposium focuses on a topic to enhance clinical practice in the post-acute continuum and to maintain Kindred as a leader in clinical excellence. This seventh symposium focuses on effective care management and, specifically, fall prevention and medication management across the continuum. At this week's symposium, held in Louisville, Kentucky, national speakers discuss these topics broadly, while internal speakers bring it home to Kindred attendees from across the country. 

By Leslie Leite