Avoiding Falls and Accidents

Falls and accidents in the Medicare population are inevitable. Not only do these cause extraordinary expense to our healthcare system, but often they can lead to an accelerated end-of-life scenario for the patients.  But it is very possible to take affirmative measures to decrease falls and accidents.  Here are some thoughts on that subject.

Of key importance is the annual measurement of a person’s strength and factors such as dizziness and lightheadedness. WellTrackONE provides these key measurements in its Annual Wellness Visit screening that it conducts for its patients year after year.  The measurements of strength, known as “Functional Capacity” must be assessed in person by direct observation.  We have seen too many instances of inferior wellness systems that survey the patients about Functional Capacity.  You cannot determine a person’s Functional Capacity level by survey; it must be done by observation.  At WellTrackONE we put the patient through a rigorous array of exercises to simulate activities at home so we can determine their failure points.

Encouraging patients to exercise is incredibly important in the prevention of falls. Judy A. Stevens,  an epidemiologist at the Centers for Disease Control and Prevention stresses that among those who do fall, “if you’re in better physical condition, you’re less likely to be injured1.”  Exercise doesn’t have to be strenuous to be successful.  Tai chi has been shown to be of significant help.  Before and after participants at the Sequoias-Portola Valley retirement facility near San Francisco are tested how many times they can rise from a chair without using their arms.  Dr Kati Murray, a geriatrician who is medical director of The Sequoias said there was marked improvement after the tai chi2.

Several studies have shown that Vitamin D, which can improve muscle strength and balance, also helps to reduce falls. Remaining properly hydrated is also important for people at risk of low blood pressure.

Psychotropic drugs (antidepressants, antipsychotics and benzodiazepines) have a strong implication in falls. “Antidepressants can directly affect your balance,” according to Dr Mary Tinetti, a geriatrician at Yale who studies falls3.

Blood pressure medication is another culprit in the increased rate of falls, particularly in the 70% of people over 70 years of age. A JAMA Internal Medicine publication in April of 2014 found that among older people with hypertension, the risk of serious fall injuries was significantly higher for those who took hypertension drugs than those who did not4.

Also, sleep medications are implicated in causing issues such as “wobbly gait.” Patricia Quigley, a fall prevention expert at the James A. Haley VA hospital in Tampa, FL suggests “Instead of taking sleeping pills, people can drink warm milk, or listen to talking books or soft music. 5

When issues with weakness in muscles, joints and bones is detected, what can be done? At WellTrackONE, we have added an aging center known as “ActiveRxtm” to our Clinical Triggers Partner program known as “CTSelecttm” to help physicians with an immediate action item at the point of care.  Using Clinical Triggers, which is embedded with the WellTrackONE tablet software, a caregiver can make an immediate referral directly to an ActiveRx Aging Center while the patient is in the office completing their Annual Wellness Visit.  WellTrackONE sends the referral and pertinent clinical data to ActiveRx using a secure email connection to maintain HIPAA compliance.

Taken as a whole, there is a LOT to be gained by focusing on the prevention of falls and accidents in the senior population. Keep in mind that falls and fractures result in ambulance rides, ER visits, XRays, MRIs, hospital stays, Long Term Care stays and Rehabilitation encounters.  These can add up to tens of thousands if not hundreds of thousands of dollars – all billable to Medicare.  If our goal is to help keep Medicare in business (and it should be), we need to make it OUR business to help prevent falls and accidents in the senior population


1-5  –  Source and quotations from a New York Times article by Katie Hafner, November 3, 2014


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