I’ve Fallen and I Can’t Get Up!

Notes from the Nurse Logo**Editor’s Note: This is part of an informational series called Notes from the Nurse to increase awareness and understanding of health or clinical issues that could impact our clients and their families.

We’ve all seen the commercial and probably made fun of it– “Help! I’ve fallen and I can’t get up!”

While it seems campy and dramatic, this situation happens to millions of people annually and it is no joke.

Falls account for broken bones, head injuries and worse case, death. While falls can happen to anyone at any time, I’ve tripped and hit the ground a few times in my lifetime, they are especially risky as we age. The basic rule is the older a person is, the more risk, expense and recovery are involved with a fall.

One in four adults (28%) age 65 and older, report falling in the United States, resulting in about 36 million falls each year. While not all falls result in an injury, about 37% of those who fall reported an injury that required medical treatment or restricted their activity for at least one day, resulting in an estimated 8 million fall injuries. In New Jersey, 21.3% of older adults fall, according to the most recent CDC data.

Alarmingly, the death rate from falls increased more than 30% in less than 10 years in 30 states and Washington, DC. New Jersey had 29 fall deaths per 100,000 people (I did the math and that’s 2,577 people) in 2018, which fortunately is the second-lowest in the nation.

The estimated medical cost of falls across the U.S. healthcare system is $50 billion annually, according to a recent CDC study. This includes $38 billion paid by Medicare and Medicaid and $12 billion paid by private and other payers.

In New Jersey, that amounts to $1.349 billion in total costs. Of that, $912 million is paid by Medicare, $218 million is paid by Medicaid and $219 million is paid out-of-pocket.

The Dreaded Broken Hip

Breaking a hip is one of the most serious fall injuries. What exactly is the dreaded broken hip? A hip fracture is a break occurring in the upper third of the femur, your thigh bone, and/or around the hip joint itself.

It is hard to recover from a hip fracture, which may require surgical repair or replacement to fix. This is followed by physical therapy. Many people are not able to live on their own afterward because of physical limitations brought on by the fall. 

More than 95% of hip fractures are caused by falling, usually by falling sideways.

How to Reduce Fall Risk

Fall prevention and home safety are two of the topics I discuss in-depth with our caregivers during their onboarding and training sessions. When I do a home assessment, I look for hazards and conditions in the home that could lead to a fall and recommend remediations to increase safety for the residents and caregivers.

Implementing a single intervention could prevent between 9,563 and 45,164 medically treated falls and avert $94–$442 million in direct medical costs annually, depending on the size of the eligible population, according to the American Journal of Preventive Medicine.

 Knowing your risk factors for a fall helps with fall prevention. Contributors fall risk include:

  • Medical conditions such as vertigo, which impacts your inner ear and the body’s balancing mechanisms
  • Recovering from a surgical procedure
  • Infections (for example, a urinary tract infection can cause vertigo)
  • Lower body weakness
  • Osteoporosis
  • Loss of muscle mass
  • Cognitive impairments such as Alzheimer’s or dementia
  • Vitamin D deficiency (that is, not enough vitamin D in your system)
  • Difficulties with walking and balance
  • Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
  • Vision problems
  • Foot pain or poor footwear
  • Poor lighting
  • Improper use of durable medical equipment (dragging the walker along instead of moving it each step could set up a trip hazard)
  • Home hazards or dangers such as
    • broken or uneven steps
    • throw rugs
    • uneven flooring 
    • clutter that can be tripped over

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

The Brain Injury Alliance of New Jersey has a fall prevention checklist that can be printed. When I come to visit, ask me how you can prevent a fall in your home or at your loved one’s home, we don’t want them to become another statistic.

Yours in good health,

Stephen Hoelle, RN-BC, Director of Nursing, Assisting Hands Home Care

Learn about and register for our special fall prevention webinar taking place on September 22.



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