4 steps toward keeping clients from stepping into a world of hurt

July 01, 2015 at 03:38 AM
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Comedians used to get easy laughs by joking about TV commercials for a wearable alert system. The actors in the commercials told viewers, "I've fallen, and I can't get up."

Focusing on the stiff line readings let viewers avoid thinking about a frightening problem: Falling kills many older Americans. Some of the people who die from falling in the coming year may be your clients, or your loved ones.

The U.S. Centers for Disease Control and Prevention (CDC) has data showing that age-adjusted death rates from unintentional falls have been soaring.

The fall-related death rate for men ages 65 and older increased to about 68 per 100,000 in 2013 for men, from 38 per 100,000 in 2000.

The rate for women increased to 49 per 100,000 in 2013, from 25 in 2000.

Having a 1 in 2,000 chance of dying in a fall may not sound so terrible, but the numbers mean that, if your clients are otherwise on track to live to age 95, there's a 1.5 percent chance that the women and a 2 percent chance that the men will eventually die because of a fall. They may be mentally alert and getting on with their lives, and they may lose everything because of something as easily remedied as uncertainty about how to cope with dizziness or lack of a sturdy bannister on stairs leading up to a home's front door.

Federal health and aging policymakers are so worried about the problem that organizers of the upcoming White House Council of Aging (WHCOA) recently held a one-day fall preventions summit together with the National Council on Aging.

At the summit, the CDC released a 216-page report on ideas for keeping older Americans from dying from what, in many cases, is an easily avoided problem.

You may have a hard time helping clients buy all the stand-alone long-term care insurance (LTCI) they wish they could afford, or giving them surefire tips for avoiding Alzheimer's, but you might be able to reduce the risk that they'll suffer from a severe, life-ruining, or life-ending, fall.

Simply telling older people, "Don't fall!" may backfire, by decreasing their physical activity level and making them more vulnerable to falling.

Marc Cohen, a researcher at LifePlans Inc., a research center active in the LTCI industry, recently led a project to test a fall prevention program. For adults ages 75 and older who participate, the risk of suffering serious, injury-causing falls fell 18 percent.

For a look at some of the steps Cohen's team took that seemed to reduce the risk of participants falling, read on. Cohen's team used nurses to do the assessments and coach the participants, but it seems as if agents who take the time to learn about fall prevention might be able to take similar steps themselves, or work with nurses or home care services in the community to copy the LifePlans method.

House

1. Visit an older person at home and do a fall vulnerability assessment.

Cohen's team had a nurse look into matters such as the participant's level of physical activity and possible hazards in the home.

 Checkboxes

2. Give the older person or caregivers ideas about how to minimize fall risk.

Parents now focus on babyproofing their homes with electric socket covers and stairwell gates.

The Cohen team nurses gave comparable advice aimed at fallproofing the participants, by encouraging them to exercise more and address health-related risk factors, and by fallproofing their homes. 

 Phone

3. Call to make sure the older person understood the advice, and give ideas about coping with any problems or confusion. 

During the coaching call, which came two weeks after the nurse provided the action plan, the nurse went over the suggestions and encouraged the participant to talk to a primary care physician about the contents of the action plan.

 Mailbox

4. Send participants a quarterly fall prevention newsletter.

The newsletters simply gave participants more ideas about how to avoid falls. You might be able to copy this step by figuring out how to get permission to send clients the same newsletters the Cohen team sent to study participants.

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