The US Senate Select Committee on Aging has released a report on falls prevention that presses for more concerted efforts to prevent falls among the elderly—including wider access to physical therapy and community-based programs. APTA 's comments submitted in advance of the report helped to shape the committee's final recommendations.
Writing that "the statistics are staggering, and the stakes are high," the committee asserts that despite ample evidence supporting the effectiveness of falls prevention strategies, such programs aren't used widely enough in the country's health care system. The lack of attention to falls prevention comes at a cost to public health, the report states, with an estimated 25% of adults 65 and older experiencing a fall each year, resulting in falls now being ranked as the leading cause of death from unintentional injury among older adults in the US. And the costs are literal as well, according to the report, which cites estimates that falls-related health care spending topped $50 billion in 2015.
The report calls for improvements in 4 broad areas: raising awareness, screening and referrals for preventive care, addressing modifiable risk factors such as home safety, and better understanding of the impacts of drugs—and drug combinations—on falls risk. Specific recommendations include a call for the Centers for Medicare and Medicaid Services (CMS) to better incorporate falls risk screening and medication review in its Annual Wellness Visit benefit, more research into the effects of polypharmacy on falls risk, and "continued investment in the development of and expanded access to evidence-based falls prevention programs."
On the day the report was released, the committee held a special hearing on the topic that included representatives from the National Council on Aging (NCOA), the National Osteoporosis Foundation (NOF), and MaineHealth, a hospital system that has incorporated an effective falls prevention program throughout its facilities and in communities. Nearly every speaker mentioned the importance of physical therapy and physical therapists (PTs) in effective prevention and rehabilitation programs, with NCOA Senior Director for Healthy Aging Kathleen Cameron calling for expanding payment to physical and occupational therapists in the Welcome-to-Medicare and Annual Wellness Visit programs, and the witness for NOF describing physical and occupational therapy as "critically important" to recovery from a fall.
"The evidence is clear that falls prevention efforts work, and there are a host of prevention programs out there that have a potential to make a difference in what is becoming an increasingly alarming trend," said Justin Elliott, APTA's vice president of governmental affairs. "We're extremely pleased to see that the select committee not only understands the need for change, but sees the role physical therapists and physical therapist assistants can play in responding to this public health challenge."
That understanding of physical therapy's role after a fall wasn't just theoretical, at least for Committee Chair Sen Susan Collins (ME).
Before entering all stakeholder remarks—including APTA's—into the record, Collins recounted her own experience of recovering from a broken ankle she sustained after a fall a few years ago. "I am forever grateful to the [occupational therapist] and PT who helped me gain function again," Collins said. "It was the [occupational therapist] and PT who really got me back on my feet and walking again."
APTA offers a wide range of resources related to balance and falls. Check out this PT in Motion News article from September for links to tests and measures, learning opportunities, patient-focused resources, and more.
