ABSTRACT
Unintentional injury, which almost always results from a fall, ranks as the sixth
leading cause of death in the elderly population. Besides mortality, there is significant
morbidity associated with falls. In the United States, 20% of older people who sustain
a hip fracture from a fall will die within a year. Another 20% will be moved to an
inpatient long-term care center for the first time. Of those who sustain hip fractures,
49% will die within 6 months. Elderly people who fall are ten times more likely to
be hospitalized and are eight times more likely to die than are children who fall.
Also, it is known that 75% of the deaths due to falls that occur each year occur in
elderly people, who constitute 12% of the population. The cost of caring for the elderly
people who fall has been estimated to be 10 to 12.4 billion dollars per year. Accordingly,
falls in the elderly population are associated with significant morbidity, mortality,
and expense to our health care system. It is possible that the human and monetary
costs associated with falls could be managed if those at greatest risk for falling
were identified ahead of time and measures were employed to reduce or eliminate the
risks. These are the objectives of the Risk of Falls Assessment Clinic (RFAC) that
we have developed and implemented at Henry Ford Hospital. In the RFAC, factors known
to place elderly people at risk for falling are assessed systematically. Patient performance
is evaluated against normative data. The product of the assessment is a description
for the referring physician of those factors where the patient has demonstrated increased
risk for falling and possible interventions to decrease the risk. This article describes
this clinic, the assessment tools used, possible interventions, and provides a summary
of our early experience.
KEYWORDS
Elderly population - falls - morbidity - mortality
