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The cost of falls keeps adding up for seniors

JANESVILLE — Jane Ramstad lay on the floor for three hours last week after breaking her hip.

She thinks she became dizzy when she stood too quickly from her bed in the middle of the night. She fell and fractured her left hip.

Ramstad, 73, lay on the floor until she could move to a phone and call for help.

Her surgery Wednesday at St. Mary's Janesville Hospital went well. She was headed to a rehabilitation center for a couple weeks before returning to her Janesville home.

"Lifeline is a must when I get home," she said.

Ramstad recommends seniors have cordless phones with a lighted dial.

Older people are especially susceptible to injury from falls. Statewide data indicate seven in 10 people hospitalized in Wisconsin in 2008 because of falls were 65 and older.

Several upcoming free workshops offered through St. Mary's and Mercy Health System will provide other tips to prevent falls among seniors.

The state has an initiative to prevent falls among older adults, and the action plan "clearly says we can prevent falls among older adults and that falls are not a normal part of aging," said AmyJo Ruthe, rehabilitation services director at St. Mary's Janesville Hospital.

Falls increase accidental death, loss of independence and decrease the quality of life among seniors while also increasing health care costs, she said.

Falls are the leading cause of accidental death among those 65 and older in Wisconsin. In 2008, 918 people died from injuries related to a fall, and almost 90 percent of those were people 65 and older, Ruthe said, citing stats from the state. That compares to 571 deaths from motor vehicle accidents.

Falls among people 65 and older resulted in $496 million in hospital and emergency care costs in 2008, just in Wisconsin. Ninety-three percent of those costs were charged to government-sponsored insurance programs.

Most of the people who wind up at the hospital fall at home, said Dr. Lance Wehrly, an orthopedic surgeon at St. Mary's.

People are aware of things outside—curbs and such—but a home presents many trip hazards.

"At the house, the things we worry about are poor lighting, irregular floors, slippery surfaces and unsafe stairs," he said. "One of the big things we talk about are throw rugs and area rugs."

Wehrly also commonly sees people who have tripped over their small dogs.

The most common injuries he sees from falls in seniors are hip and wrist fractures as well as ankle fractures.

Like Ramstad, many injuries don't allow the person to go home right after the hospital. Of those with hip fractures, 99.9 percent go to a rehab center, Wehrly said.

That time has allowed Ramstad's family to make changes in her home to help prevent another fall. Her family tore out the bathtub for a walk-in shower and installed a high-rise toilet, she said. They also brought her washer, dryer and freezer up from the basement into another bedroom.

Ruthe and Wehrly offered other tips, many that family members can do:

-- Look at the lighting throughout the house.

-- Look at the surfaces on the floors and stairs.

"Do you have handrails? … Grab bars will help," Wehrly said.

-- Decrease the clutter and organize your work. Don't try to do too much at once—take periods of rest.

"Things like getting morning routine items together so you're not doing that in the morning, then going to the shower," Ruthe said. "It's working smarter, not harder."

-- Have often-used items at waist height in the kitchen.

-- Consume more calcium and vitamin D, Wehrly said.

"Most of the time, it's simple things that can be beneficial to hopefully prevent another fall," Wehrly said.

When providers do home safety assessments, some of their recommendations can be challenging for residents, such as giving up their throw rugs, she said. See if there's a safer place for a rug or a way to keep it from moving.

"It's looking at what's important to that person and making it work for them," she said.

Ruthe also encourages seniors to talk with their primary physician about health factors such as medication, blood pressure or vision.

"Sometimes falls are one single, obvious issue, but there are also multifactorial—a lot of different things that can occur," she said.