Don’t Fall into a Fear of Falling This Fall

falling_in_autumnAs we transition from summer to fall, don’t let a fear of falling keep you from being active.  That’s the alliterative advice of Helen Lach, Ph.D., associate professor of nursing at Saint Louis University School of Nursing.  And she should know!  Lach specializes in gerontological nursing, and has studied ways to prevent falls for more than 20 years.

While falls can cause problems, we want people to be both cautious and still maintain an active quality of life,” Lach said. “You can’t get rid of all of the risk in your life. But older adults need to maintain their strength, function and activity to the level they are able.”

Lach recently wrote a review article that appeared in the Journal of the American Medical Directors Association that showed fear of falling is a significant problem in nursing homes.

People in nursing homes tend to be frailer and have more health problems and physical limitations than older adults who are in the community,” Lach said.

?????????????????????????????????????????The fear of falling can stop some nursing home residents from doing anything, even participating in their own daily care. They become frozen in inactivity, which makes them depressed and bored. They get more out of shape, which creates more health problems that actually increase their risk of falling.”

Lach notes that the fear of falling is part of a cycle that can lead to a frailty and a downward spiral in health.

As people do less, they become less able to engage in activities. They have difficulty moving around, and their gait and balance deteriorates. This puts them at an increased risk of falling, which unfortunately means the fear of falling actually becomes a self-fulfilling prophesy.”

It’s important that nursing home staff members recognize that about half of residents have such a deep fear of falling that they limit their activities, and develop a way to assuage those fears. Exercise programs offered in a safe and supportive environment can be valuable in helping residents feel better – both physically and psychologically.

fall prevention exercisesSenior adults who aren’t in long term care facilities also may need to confront their fear of falling. Tai Chi, walking, weight training and simple exercises to increase muscle strength – such as practicing sitting and standing to strengthen leg muscles or standing on one foot with a chair at arm’s reach can make a world of difference.

Good Advice for all of us.

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Hospital errors affect 1:3 patients

How common are hospital errors?

A shocking new study suggests that the number of “adverse events” befalling patients in U.S. hospitals may be 10 times higher than previous estimates.

If the authors are correct, this would mean that medical mistakes affect one in three people hospitalized  in the US. The study, published in the journal Health Affairs involved a review of almost 800 patient charts at three U.S. hospitals. Using a review technique known as the “global trigger tool,”  researchers detected a whopping 354 adverse events. Scarier still,  that figure might actually understate the enormity of the problem as it was based on potentially incomplete medical records rather than on direct observation in real time.

Dr. David C. Classen of the University of Utah believes his study gives a more reliable tally of hospital errors than other studies, including a 1999 landmark study from the Institute of Medicine entitled To Err is Human showing that hospital errors caused up to 98,000 Americans each year.

So what sorts of events were uncovered in the new review? According to Classen, there were three big ones:

The question many are now asking: is the new estimate accurate?

It is hard to know that to make of the trigger tool,” admits Dr. Peter J. Pronovost, a Professor in the Johns Hopkins University School of Medicine (Departments of Anesthesiology and Critical Care Medicine, and Surgery) and Medical Director for the Center for Innovation in Quality Patient Care.

However, “Far too many patients suffer preventable harm in the U.S.” he added.

Other recent studies appear to confirm Classen’s findings.

Earlier this month the US government released data for the first time, showing how often patients are injured by certain medical errors in hospitals.  However, only eight types of serious, preventable errors were included in the comparison.

They were: air in the bloodstream, falls, bedsores, transfusions with the wrong blood type, urinary tract infections, blood infections, uncontrolled blood-sugar levels and foreign objects left in the body after surgery.

Other serious events, including wrong-site surgeries and medication errors, were not included.

And late last year, the Office of Inspector General for the U.S. Department of Health and Human Services said 180,000 Medicare recipients die each year from hospital mistakes. That’s more people than are killed every year in car crashes, or from diabetes or pneumonia.

Without doubt, health care has improved over the past decade, but it’s clear that there is still a great deal of work to do in order to achieve a health care system that safe, effective, patient-centered, efficient, timely, and devoid of disparities based on race or ethnicity.

Until then, SRxA’s Word on Health advises that if you think something is amiss or wrong with your hospital care, speak up.

(Wo)Man’s Best Friend???

The press recently reported how an accidental head butt from Martha Stewart’s French Bulldog Francesca resulted in an injury requiring nine stitches to repair the damage to the domestic diva’s lip.

I feel your pain, Ms. Stewart, I really do.

This post is brought to you as your Word on Health blogger recovers from knee surgery stemming from another pet-related injury. And while I wish the analgesia would take away not only the pain, but also the humiliating memory of being dragged face first along a muddy riverbank by my canine companions as they attempted to become better acquainted with a passing pooch, I take some comfort from the fact that Martha and I are not alone.

People, it seems are not only falling for their pets, apparently, large numbers of us are falling over them, too.

In fact, a national sample of ER visits from 60 hospitals over a six year period reported 7,456 visits were related to falls caused by pets. On a national level, this translates to nearly 90,000 fall injuries associated with cats and dogs per year. Dogs are 7 times more likely to cause falls than cats and women are twice as likely as men to be injured as a result.

That’s the equivalent of 240 ER trips a day, and roughly 1% of the 8 million visits for falls of all sorts.

Exactly how many of the falls occurred isn’t known. Nevertheless, the study, gives a rough sketch of hazardous activities. Almost 35% of injuries are caused by tripping over the animal while about 25% occurred during walks. Surprisingly, less than 3% result from running away from a dog, and <0.5% percent while breaking up a dog-fight.  Being pulled by the animal caused a fifth of the falls.

While one-third of the falls broke bones, about one-quarter caused bruises, one-fifth caused sprains and a little more than one-tenth caused cuts.   Nothing on the list, I note, about tearing a cartilage – trust my dogs to  go one step better!

Been injured by Fido or Fluffy?  Share your stories with us.