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Dr. Kruschke is Associate Professor, Regis University, Rueckert Hartman College for Health Professions, Loretto Heights School of Nursing, Denver, Colorado.
The author has disclosed no potential conflicts of interest, financial or otherwise.
Copyright © 2017 Csomay Center for Gerontological Excellence.
Falls continue to be a leading cause of injury and death in individuals 65 and older. According to the Centers for Disease Control and Prevention ( CDC; 2017 ), millions of individuals fall each year, with one in five falls resulting in serious injury, including death. The chances of an older adult falling again doubles with the first fall. The cost of falls continues to rise with expenditures currently exceeding $31 billion in 2015 for non-fatal falls ( Burns, Stevens, & Lee, 2016 ). The Centers for Medicare & Medicaid Services (2008) has identified fall prevention as a key element in the survey process for long-term care facilities, and now designates falls in the acute care setting as "never events" with restricted payment for treatment of injuries or other adverse effects of falls.
Older adults are at risk for falls due to a variety of risk factors: age; gender; health conditions, including comorbidities; medication use, including side effects; poor mobility; and environmental factors ( World Health Organization [WHO], 2016 ). There are a variety of setting-specific risk factors that need to be considered as well. Individuals living in the home setting may fall for different reasons than individuals living in the nursing home setting ( Panel on Prevention of Falls in Older Persons, American Geriatrics Society [AGS], & British Geriatrics Society, 2011 ). Individuals living in the community have multifactorial reasons for falls, including immobility, balance issues, frailty, and physical inactivity. Environmental hazards can also play a role in the aging individual's risk for falls, including stairways, the absence of hand-rails, and uneven floors, such as hard wood floors next to carpeted floors. In addition, individuals living in the community are at risk for falls due to their ability to access the outdoors. This access brings with it a higher risk for falls based on current health conditions and a greater potential for accidental falls ( Hellstrom et al., 2013 ). In comparison, falls in health care settings carry risks that tend to focus on...