Last Updated: August 2019

Author: Injury Prevention Program Team, Vermont Department of Health

Risk of falls increases with age but falls should not be considered an inevitable part of the aging process. Because there are many reasons an individual might fall, and these can act synergistically, falls prevention must be multifactorial and comprehensive. Traditionally, the evidence base supports programming that includes early assessment, exercise, medication management, and safety within environmental design. Often those individuals at risk of falling (in this instance, defined as those Vermonters age 65 and older) experience: a fear of falling, limiting mobility which affects strength and stability, and medication which may cause drowsiness or impair balance. There has been a wealth of research on elderly falls prevention interventions that has been incorporated into a variety of evidenced based programming and strategies. We are working to more fully incorporate these strategies into Vermont’s community services and statewide systems.

The Area Agencies on Aging, community hospitals, and other community organizations offer Tai Chi and Matter of Balance for older adult fall prevention programming. A listing of nationally determined evidence-based programs can be found on the website of the National Council on Aging.

Falls are the leading cause of injury among older adults. In fact, 1 in every 3 adults ages 65 and older fall each year. Some falls are minor, but others can result in serious injury, such as a broken hip or a head injury, as well as a loss of independence and mobility.

DAIL,

Vermont EMS Agencies

Vermont Area Agencies on Aging (AAA)

Hospitals

Visiting Nurses Association (VNA)

Support and Services at Home (SASH)

Blueprint for Health

Studies show that a combination of behavior changes can significantly reduce falls among older adults. Experts recommend:

• Participating in a physical activity regimen with balance, strength training, and flexibility components.
• Consulting with a health professional about getting a fall risk assessment.
• Having medications reviewed periodically.
• Getting eyes and ears checked annually.
• Making sure the home environment is safe and supportive.

The Vermont Department of Health received grant funding to run a state falls prevention program for 2014-2017. The falls prevention program goals were to reduce falls related injury and deaths in older adults in Vermont.

• Strategies:
  • Coordinate with Falls Free Coalition and local Area Agencies on Aging (AAA) on a statewide Falls Prevention Awareness Day media messaging.
  • Coordinate with Falls Free Coalition to enhance activities statewide to increase fall prevention programs in communities.
  • Assess the numbers/types of stakeholders engaged in efforts to reduce falls among adults over age 60.
  • Create a statewide, searchable database accessible to older adults, community organizations and providers to offer information on falls prevention programming and assessment.
  • Work with hospital service areas (HSAs) to establish systems for screening of falls risk and referral to appropriate services

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on injury indicators, check out our Public Health Data Explorer.

The Vermont Department of Health (VDH) Falls Prevention Program helps older adults to improve their health, receive education and training, and find resources to prevent falls-related injuries and death. This program is housed within the Division of Emergency Preparedness, Response, and Injury Prevention. Through partnerships with community organizations, such as Area Agencies on Aging (AAAs), Emergency Medical Service (EMS) agencies, and community hospitals and health care providers, VDH coordinates referrals for and trainings on evidenced-based falls prevention programs. VDH continues to build a multifactorial infrastructure focusing on screening and assessment, exercise and strength building, medication management and reconciliation, and home safety. Additionally, VDH is involved in Vermont’s state falls prevention coalition, Falls Free Vermont, which is a collaboration of key stakeholders and health care professionals committed to reducing preventable falls through building capacities related to networking, referral systems, and resources.

Falls prevention programs are available to Vermont older adults who:

• Are at risk for falling.
• Have had previous falls.
• Worry about falling.

Additionally, VDH serves community partners engaged in falls prevention work through offering resources, data, trainings, and facilitated discussions to staff.

Falls Prevention Screening and Assessment

Falls are preventable and not a normal part of aging. In the U.S., 1 in 4 older adults reported experiencing a fall and an older adult falls every second of every day throughout the country. While the risk of falls increases with age, less than half of older adults talk to their doctor about their fall. In Vermont, 1 in 3 adults ages 65 and older reported having a fall in the past year and falls are the leading cause of accidental deaths in the state.

VDH promotes the use of the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit, which was created to help patients and health care providers with simple, evidenced-based tools through effective education materials, screening and assessment tools, and interventions that prevent falls-related injuries and deaths. Through collaborative partnerships and coordinated activities, VDH is working to build a sustainable statewide falls prevention program that promotes healthy aging and mitigates costly injuries for both older Vermonters and health care systems.

Indications of Progress through Data Collection

VDH uses various databases and data sources to track progress of the state’s falls prevention program. Through review and analysis of data on falls-related injuries and deaths, as well as the number of individuals screened, assessed, and referred to falls prevention programs, VDH continually evaluates this program to ensure there is improvement in health outcomes. The falls prevention program consistently seeks feedback from community members, health care providers, and partnering organizations to continue building a robust statewide falls prevention program.

Data source is the VT Uniform Hospital Discharge Dataset and includes all Vermont residents, including those seen in hospitals out of state. As a result of incorporating out of state data, there is a delay that affects the ability to perform final calculations for more recent years. Additionally, data from 2015 is not represented as this year includes the transition from the 9th to the 10th revision of ICD clinical modification diagnosis codes. Due to fundamental changes in the coding system, data prior to 2015 cannot be used for comparison to data 2016 and later.