By: Rosemary Kennedy, PhD, RN, MBA, FAAN, Chief Informatics Officer
Every second of every day in the United States an older adult falls. Every 11 seconds, an elderly person is treated in an emergency room for a fall; every 19 minutes, a senior dies from a fall.
The High Cost of Falls
Falls are the leading cause of fatal and nonfatal injuries among the elderly. Each year, more than one in four older adults aged 65 and older will fall, representing 29 million falls, 3 million emergency department visits, 800,000 hospitalizations and 28,000 deaths. 1-2 As alarming as these statistics are, they fall short of the actual numbers. There are potentially millions of falls that go unreported.3
Not only can a fall adversely impact an individual’s quality of life and independence but falls also have a tremendous effect on healthcare costs. The average hospital costs for a fall-related injury total $30,000. Falls and fall injuries account for 25% of all hospital admissions and 40% of all nursing home admissions. Additionally, 40% of those admitted will never return to independent living, and 25% will die within one year.4-5
The costs of falls and their long-term effects have an enormous burden on the U.S health care system. According to the Centers for Disease Control and Prevention (CDC), the estimated medical costs for falls were more than $50 billion last year, and by 2030 these costs are expected to double. As the elderly population increases, the rates of falls and the healthcare costs associated with fall injuries will continue to rise substantially.6-7
In addition to the physical and economic costs, there are also the psychological effects of falls that can negatively impact an older adult’s quality of life and well-being. A fall can cause severe implications including injuries, hospitalizations, early admission into a long-term care facility, disability, and even death. Seniors who fall once are at a higher risk of falling again. Often the fear of falling can cause an individual to reduce physical activity, leading to physical deterioration, further increasing the risk of another fall or injury. Preventive efforts to help reduce falls are an essential part of senior care that can lead to a substantial reduction in health care costs.
Risk Factors for Falls
Most falls are caused by a combination of risk factors. The more risk factors an individual has, the greater their chances of falling. Some risk factors are not modifiable such as age, gender and certain health conditions. Other risk factors and conditions can be improved to help lower an individual’s risk of falling. According to the CDC, risk factors for falls can be classified into two categories: intrinsic factors (i.e., age-related physiologic changes, disease and medications) or extrinsic factors (environmental hazards).8-9
Intrinsic Risk Factors
Intrinsic risks may include factors such as age, gender, ethnicity, medicines, medical conditions, impaired mobility and gait, a history of falls, fear of falling, nutritional deficiencies, impaired cognition, visual impairments and foot problems.
Extrinsic Risk Factors
Extrinsic risks may include factors such as environmental hazards such as lighting, slippery floors, uneven surfaces, inappropriate footwear, and unsuitable walking aids or assistive devices.
Modifiable Risk Factors
Falls are not an inevitable part of aging; many risk factors are modifiable. Healthcare providers, seniors and caregivers can work together to help lower an individual’s risk of falling. (For example, addressing risks such as ensuring appropriate lighting and safety features in the home, reducing clutter, fixing uneven flooring surfaces and using well-fitted footwear.)9-10
Bringing Connected Health in the Home
Traditional prevention methods such as reducing modifiable risk factors play a critical and necessary role in senior care and fall prevention. However, traditional measures alone are sometimes not enough to ensure safety in the home. Technologies such as remote patient monitoring (RPM), personal emergency response systems and medication management solutions can help with fall prevention, fall detection, earlier interventions and chronic care management. These solutions deliver access to an individual’s ongoing mobility and health by providing critical data that enables healthcare providers to provide more comprehensive care while reducing unnecessary hospital admissions and keeping patients healthy and independent in their homes.
Personal Emergency Response Systems
Research has shown that getting help quickly after a fall can help reduce the risk of further injury, hospitalization and even death. In cases such as these, every second matters. Personal Emergency Response System (PERS) are a proven, simple and cost-effective technology that provides users with 24/7 access to emergency assistance and care with just the push of a button.
For individuals at a high risk of falling or who may be at risk of experiencing a medical emergency that might result in a fall, PERS devices can automatically detect a fall and contact an emergency operator, even if the individual cannot push the button. PERS GPS locating capabilities are designed to identify a user’s location and direct help and care quickly. This technology can be lifesaving for older adults who may have dementia or Alzheimer’s and are at an increased risk of falling and wandering.
PERS provides quick access to a caregiver or emergency assistance, helping to lower costs from unnecessary emergency department (ED) visits and hospitalizations. In fact, research has shown that PERS can help reduce hospital admissions by as much as 26%.10 PERS help keep seniors safe and independent while lowering overall healthcare utilization and providing peace of mind for individuals and their families.10
Medication Management Systems
Medication nonadherence is especially common in older adults and has been associated with a 50% increase in the rate of falls, according to a study published in the Journals of Gerontology. Medication nonadherence is a major cause of poor outcomes, disease progression, and morbidity in the elderly. It is connected to increased healthcare utilization and is estimated to cost the U.S. billions per year in avoidable healthcare costs.11
Medication management systems can help ensure medication adherence and reduce the chances of over-medicating or missing a dose. These solutions can be programmed to dispense medication according to an individual’s specific prescriptions, making poor outcomes and falls due to medication nonadherence less likely.
Remote Patient Monitoring
Remote Patient Monitoring (RPM) is another way connected health technology is changing how care is being delivered by hospitals, healthcare facilities and outpatient care settings across the nation. RPM enables providers to monitor and care for their patients’ remotely by delivering increased visibility into an individual’s health and adherence over time.
Healthcare providers can review and analyze patients’ daily vitals while receiving actionable data to monitor, triage and treat patients’ faster. RPM technologies are effective for chronic disease management, post-acute care and monitoring the safety of the elderly population. The technology can be used to monitor a wide range of health conditions, including diabetes, congestive heart failure, COPD, HTN-stroke, pneumonia, sepsis and post- surgical cases. It can also be used to identify and prevent falls, allowing patients to remain more independent while aging safely in their homes.
RPM technology is helping healthcare providers deliver more effective, comprehensive, preventative care, resulting in fewer hospitalizations, better outcomes and reduced costs. According to research from the New England Healthcare Institute (NEHI), RPM helped reduce hospital readmissions by up to 60% compared to standard care. It has also been shown to help lower hospitalizations and ED visits, increase patient satisfaction, improve medication compliance and decrease utilization costs.12-13
Connected Health Technology, the Future of Healthcare in the Home
By bridging the gap between patients, caregivers and clinicians, connected health technologies can help detect and prevent falls while reducing unnecessary emergency medical services and hospitalizations and allowing patients to live safely and independently in their homes. As the healthcare industry continues to face the rising costs of caring for an aging population, new and innovative connected health technologies will help pave the way for fall prevention, better healthcare, reduced costs and improved outcomes.
3. https:// pubmed.ncbi.nlm.nih.gov/29665016/
10. Koch, J. Emergency response system assists in discharge planning. Dimensions in Health Service, 61, 30-31.
13. https://www.beckershospitalreview.com/telehealth/klas-remote-patient-monitoring-reduces-admissions- readmissions-er-visits.html