Are falls really a serious health issue?

Falls are a major cause of injury for older adults in Maryland.  In fact, studies show that one in three people age 65 and over fall each year.  Maryland data for the year 2006 shows that falls were the leading cause of emergency room visits and accounted for almost one quarter of the 513,034 emergency room visits for the year.
 For some people, falls result in serious injuries like hip fractures, which can mean long-term hospital or nursing home stays, or even death.  Seniors who fall are two to three times more likely to fall again. Plus, seniors who fall once are likely to restrict their activity level for fear of falling again, which can reduce their quality of life.

Maryland Falls Adults 65 Years and Older

But aren’t falls just accidents?

Falls are not an inevitable part of aging. While many people think of falls as accidents, the truth is that many falls can be prevented. Studies show that most falls have one or more causes related to the following:

• Physical mobility problems (poor strength or balance, foot and ankle problems, arthritis, diabetes, and depression)
• Vision loss or low vision
• Medication issues
• Home and environmental hazards

How can falls be prevented?

Fall prevention programs focus on promoting healthy behaviors and creating safe environments.  Older adults can reduce their risk of falling by beginning a regular exercise program, making the home safer; having a health care provider review medications; and having their vision checked and corrected. Effective falls reduction programs address these multiple risk factors.

What is DHMH doing to prevent falls in Maryland?

Safe Steps for Seniors: A Fall Prevention Program for Older Adults is a mini-grant program through which the Department of Health and Mental Hygiene provides funding for county-level fall prevention programs aimed at adults age 65 and older.
In FY2010, four Maryland counties are implementing fall prevention programs: Caroline County, Kent County, Washington County, and Worcester County.

Where can I get more information about fall prevention activities in Maryland?

Contact Jade Leung, Injury Prevention Coordinator, at 410-767-2919, or email at leungj@dhmh.state.md.us

What are some evidence-based fall prevention programs?

The following are proven, evidence-based fall prevention programs that have worked in communities all over the United States and Canada:

 Chronic Disease Self-Management Program

The Chronic Disease Self-Management Program (CDSMP), developed out of Stanford University, is designed to help people gain self-confidence in their ability to control their symptoms and how their health problems affect their lives. Small-group, highly interactive workshops are generally 6 weeks long, meeting once a week for about 2 hours, and are facilitated by a pair of leaders one or both of whom are non-health professionals with a chronic diseases themselves.
Web site:

 Enhance Wellness

EnhanceWellness is an individualized, motivational self-care intervention that encourages older adults to take on health challenges and maintain control of their lives. A team of two professionals, typically a nurse and social worker, work with the individual to develop a plan and help that individual achieve his/her goals.
Web site:

Enhance Fitness

EnhanceFitness (formerly Lifetime Fitness Program), is a low-cost, highly adaptable exercise program offeringlevels that are challenging enough for active older adults and levels that are safe enough for the unfit or near frail. One-hour group classes include stretching, flexibility, balance, low-impact aerobics, and strength-training. Web site:

Active Choices

Active Choices is a six-month physical activity program that emphasizes participating in individually selected activities that are facilitated with ongoing, brief telephone and mail follow-up delivered to participants’ homes. The program teaches strategies that help individuals incorporate preferred physical activities into their daily lives, with a focus on individualizing the program for each person. Staff or volunteers are trained to provide regular, brief telephone-based guidance and support.

Active Living Every Day

Active Living Every Day (ALED) uses facilitated group-based problem solving methods to integrate physical activity into everyday living. Developed by behavioral scientists at the Cooper Institute in Dallas, TX, and offered through a partnership with Human Kinetics, this comprehensive program utilizes the Active Living Every Day book and offers optional online support resources for participants and facilitators. The ALED program allows the flexibility of being offered independently or in conjunction with existing community-based physical activity programs. 2 of 5.

Strong for Life

Strong for Life is a strengthening exercise program designed by physical therapists for home use by older adults to improve strength, balance, and overall health. The program consists of videotaped exercise routines performed with elastic bands of varying thickness.

A Matter of Balance

A Matter of Balance emphasizes practical strategies to reduce fear of falling and increase activity levels. Participants learn to view falls and fear of falling as controllable, set realistic goals to increase activity, change their environment to reduce fall risk factors, and exercise to increase strength and balance. This program has been adapted from the original intervention to be more suitable for community-dwelling older adults by allowing small group sessions to be led by a trained facilitator.

Healthy IDEAS or PEARLS

Healthy IDEAS (Identifying Depression, Empowering Activities for Seniors) is a depression self-management program that includes screening and assessment, education for clients and family caregivers, referral and linkages to appropriate health professionals, and behavioral activation. The Healthy IDEAS program has been designed to be conducted by case managers.

Prevention & Management of Alcohol Problems in Older Adults: A Brief Intervention

The brief alcohol intervention approach is designed specifically for an older adult population and relies on concepts of motivational interviewing to enhance participants’ commitment to change their behavior. Program components include: alcohol screening, assessments, brief interventions, and a guide to referral for more intensive care.

Other fall prevention links:

National Council on Aging Center for Healthy Aging