Monday, November 03, 2014 NYT: Aging Population Causes Facilities to Look at New Ways to Reduce Falls Risk The ever-increasing numbers of falls occurring among a growing US elderly population are challenging care facilities to re-think nearly every part of their operations, from policies on exercise and the use of restraints to the color of toilet seats, according to a recent story in the New York Times. In "Bracing for the Falls of an Aging Nation," NYT reporter Katie Hafner focuses on the Sequoias, a retirement community in San Francisco. Hafner's report touches on the design and structural changes the facility is making to reduce falls likelihood, and the efforts being taken to educate residents on falls prevention. Hafner writes that the Sequoias must take on these projects while respecting the "feisty independence" of its residents, who she describes as "former professors, physicians, and executives" who are "accustomed to telling others what to do, not the other way around." The NYT report includes descriptions of how architects and interior designers are reexamining buildings from the perspective of a person who is elderly with failing eyesight. Designers are now looking at features such as stairs, thresholds, and shower stalls through special glasses that cloud and discolor their vision to simulate the challenges faced by a resident, Hafner writes, and making changes that they hope will reduce falls. Some of those changes at the Sequoias include installing dramatically contrasting color strips at the tops and bottoms of stairs, more clearly visible shower stall thresholds, and black toilet seats on white toilets. The NYT article includes video links that show how low-contrast steps and showers appear to individuals with cataracts and glaucoma. Hafner's report also examines the challenges faced by facilities to better educate residents on the importance of exercise, the realities of falls risk with age, and mitigation and response options. Often, she writes, residents deny the dangers and forgo exercise until it's too late. "Though the risk of a fall increases significantly once people reach their 80s, researchers have found that people 85 and older in excellent health have no greater risk than someone 20 years younger," Hafner writes. The article explains how, once bedridden after a fall, individuals who are elderly can lose muscle mass at a rate of 1% per day; however, the gradual decreases in mobility or balance that can lead to a serious fall are often discounted—or purposefully ignored. The real work for facilities, Hafner writes, is to get residents to move past a sense of denial that causes them to "pay scant attention to their risk for a fall until it happens." APTA offers a wealth of resources on balance and falls, most of them accessible via the association's Balance and Falls webpage. Offerings range from consumer-focused information including a video, a PT's guide to falls, handouts on falls prevention and physical therapy and the balance system (members-only .pdfs), to PT- and PTA-focused information on how to develop community events on balance, falls, and exercise. Members can also access several continuing education courses related to falls at the Balance and Falls page, and the PTNow evidence-based practice resource includes a clinical practice guideline on falls and fall injuries in the older adult and a clinical summary on falls risk in community-dwelling elderly people.