Falls: A Common Occurrence with Wildly Different Outcomes

Common falls can have an unpredictable impact on the bodies of older people. Falls are now recognized as complex, often preventable events with multiple causes and consequences, calling for a wide range of interventions, both psychological and physiological, that many patients never receive. Even falls that cause only minor can be a real warning sign that something serious is wrong.

A recent article in the New York TImes by John Leland on November 7, 2008, contained an interesting discussion about falls and the various outcomes that can result from them.Each year, 1.8 million Americans over age 65 are injured in falls, according to the Centers for Disease Control and Prevention.

For some, the fall sets off a downward spiral of physical and emotional problems including pneumonia, depression, social isolation, infection and muscle loss that become too much for their bodies to withstand. In 2005, the last year for which statistics are available, 433,000 people over 65 were admitted to hospitals after falling, and 15,800 died as a direct result of the fall.

One in five hip-fracture patients over age 65 die within a year after surgery, according to the C.D.C.; one in four have to spend a year or more in a nursing home. When younger people fall, they tend to break their wrists catching themselves, but in older people, who have slower reactions and less upper-body strength, the weight more often falls on their hips or heads. Any underlying conditions, like heart disease or respiratory problems, increase the chances of a downward health spiral.

Dr. Mary E. Tinetti, a falls expert at Yale University medical school, compared falls to strokes in their harmfulness, adding that people do not always report them or seek help, for fear their families will try to put them in nursing homes. For some people, Dr. Tinetti said, admitting that they fall is tantamount to admitting that they are no longer competent to take care of themselves. Older bodies typically have several weakened systems that are dependent on one another, and rely on drugs that may or may not work well together.

If you take 70-year-olds, on average they’re taking five medications, Dr. Tinetti said. When you get to 10 medications, as a patient might after a fall, the likelihood of adverse effects is close to 100 percent. Psychological factors can be as devastating as the physical trauma, Dr. Tinetti said. Its the fear of falling, the lost confidence. Good walkers stop walking, stop going to church. They become socially isolated and depressed.

The period of immobility after a fall is particularly dangerous, said Dr. Gray-Miceli, whose research includes studying a group of patients after falls. Being immobile, you’re not taking deep breaths, you’re more prone to orthostatic pneumonia, or older people can develop urinary incontinence. And that can have a whole cascade of emotional consequences as well as the physical consequences, such as skin breakdown, pressure sores, bladder infection, lung infection. Temporary confusion from infection can lead to someones demise.

The lawyers at Levine & Slavit have decades of experience getting results for our clients, including personal injury claims of pedestrians injured by negligently operated motor vehicles. We have offices in Manhattan and Long Island, handling cases in New York City, the Bronx, Brooklyn, Queens and surrounding areas. To learn more, contact the personal injury lawyers at Levine & Slavit for their help, or watch our videos.

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