“Walk like what?” Elaine asked. “Tell him to walk like a penguin!” I responded. “Tell him to keep his center of gravity low and use his arms as stabilizers.” Once again, Elaine had called to tell me that my father had fallen. With each call she would explain how he fell and how they managed to get him up off the floor. These calls have become part of our everyday life.

If you were to use any fall risk assessment tool for my dad you would quickly realize he needs an adult-sized baby walker, and for quick identification purposes he should be entirely encased in yellow. (Locally, yellow is the color which signifies a patient who is at risk of falling.)

Fall risk assessment tools are widely implemented in every hospital and nursing home across the country. They tell us how likely a person is to fall while in our care. What they don’t tell us is how stubborn a person can be or how willing (or unwilling) the person is to achieve compliance.

Medically, Dad was a statistic waiting to happen. He was 65, took multiple medications for hypertension and diabetes, had failing eye-sight, decreased stability and was ferociously in denial.

To convey the sheer magnitude of falls and the consequences of them, first we present some background information.

The Statistics

• 1 out of 3 aged 65 or older will fall each year.
• Falls are the leading cause of accidental death and injury-related visits to the emergency room, at nearly 1.8 million per year.
• As you reach the age of 80, the number of falls increases to one out of two.
• 5-15 percent will incur serious injury, including head trauma, soft tissue injury, fractures and dislocations.
• Hip fractures account for 90 percent of all fall fractures. Hip fractures can also result in permanent disability or nursing home placement when the person is no longer able to care for themselves.
• In 2005 more than 15,000 deaths were attributed to unintentional falls.
• Men are more likely to die as a result of a fall.
• Women are twice as likely to sustain a fracture as men.
• Hip fractures alone account for $2 billion a year in health care costs.
• 60 percent have restricted mobility after a fall.
• Fear of falling can reduce mobility, increase isolation and further increase decline of health status.
• As baby boomers age the health care costs associated with falls are projected to increase to $54 billion per year.

Normal changes of aging, which can lead to falls, include elongated  reaction time; decreased righting reflexes; decreased sense of one’s body in relation to space; slower gait; decreased gait speed and length; increased kyphosis; and increased lateral sway.