Introducing CDC’s Still Going Strong Program and More!
Colleagues, we commit to fall prevention of at-risk and vulnerable populations across all settings of care. Through our practice, we are dedicated to promoting function and independence, minimizing complications of disability and chronic diseases, promoting social confidence and integration, and excelling in patient safety outcomes. Yet, our impact on fall and fall injury prevention programs has been slow, especially in the community. We all know that falls among elderly persons, in particular, are a serious concern due to the high incidence of falls and the consequences of falls — fear, loss of function and independence, severity of injury and even loss of life.
However, not everyone knows that falls are a leading cause of unintentional injury deaths across all age groups as reported by the Center for Disease Control and Prevention (CDC) (CDC, 2021a).
Compelling Evidence to Participate
This year, CDC updated its report of death due to falls included in “unintentional injury” for both sexes, all ages by age groups, and all races. Analysis of 2019 unintentional injury deaths, which again includes death due to falls, was the third leading cause of unintended injury death for the entire US population.
By age group, unintentional injury death was the:
- 3rd leading cause of death in infants < 1 year of age;
- 1st leading cause of death in age groups 1-4, 5-9, 10-14, 15-24, 25-34, 35-44;
- 3rd leading cause of death in age groups 45-54, 55-64; and,
- 7th leading cause of death in older adults >65 and older.
However, falls was the leading reason for unintentional injury death for older adults. Out of a total of 60,257 unintentional injury deaths, the leading cause is falls, 56.5% of all causes of intentional injury death. The circumstances of falls were reported as:
- unspecified cause: 46.0%
- fall on same level: 38.2%
- fall on and from stairs and steps: 5.6%
- fall involving bed: 2.8%.
All clinicians know that 95% of hip fractures are caused by falls. CDC just reported that falls are the causes of 90% of emergency department visits among older adults (CDC, 2021b). These statistics inform our urgent call to action to protect all persons from falls, but especially older adults.
Indeed, falls are a common and significant health issue facing people aged 65 years or older (Rubenstein, 2021). Every year, approximately 3.7 million Americans turn 65. According to Factora, et al., (2021), older adults ages 65 years and older are twice as likely to fall than younger adults (OR 2.84 [1.77-4.53]).
Every 11 seconds, an older person visits the ER due to a fall (National Council on Aging [NCO, 2021). Every 20 minutes in the United States, an older adult dies from a fall (CDC STEADI, 2020). Many more are injured.
You must agree with me that falls are a threat to the health of older adults and can reduce their ability to remain independent; therefore, you/we must act.
My Ask of You
I am asking YOU to start your plans this month (August) within your organizations, fall and injury prevention committees, hospitals, and post-acute care settings, to lead and participate in National Fall Prevention Awareness Day, September 22, and Week, September 22-28 (NCOA, 2021).
For over a decade, National Falls Awareness Day has been held the first day of the Fall Season. The purpose of this designation is to raise awareness about how to prevent falls through national, state, and local partnerships. National Falls Awareness Day is September 22nd, and the focus is to prevent fall-related injuries among older adults (NCOA, 2021). I am asking you, with the support of Curbell Medical, Inc., to lead and engage in education of older adults, their families about the consequences of fall and the interventions that can be implemented to reduce their risks, promote safety, function and independence.
CDC and the National Council on Aging (NCOA) are dedicated to helping older adults to manage their fall risks and keep them independent longer. Their mission aligns with our mission to advance safety, independence and function of all persons. Yet, we know the reluctance of older adults to talk to their providers about falls and/or seek medical care due to falls. Thus, opportunities exist now to plan your participation in National Fall Awareness Day and Week as expert and trusted care providers. As a member of your health care organization and your community, you can learn about fall and fall injury prevention materials and programs, plan and lead participation for National Fall Awareness Day!
Fall and Injury Prevention Program Resources
In communities, healthcare providers are actively engaged in outreach to educate about prevention of chronic diseases, injuries, and disability. Community-based preventive interventions that reduce falls in older adults are well documented. To support you in your efforts to plan and participate in the 14th Annual National Fall Prevention Awareness Day and Week, below are some resources for tools, activities and education materials to assist you and your rehabilitation nursing and interdisciplinary team.
To Reduce Falls and Injuries and Remain Active:
CDC is launching an entirely new program: an injury prevention campaign for elders — Still Going Strong — to encourage elders to “age without injury”, still enjoying their activities and hobbies. This campaign is directly linked to their 2019 findings about the leading causes of unintentional injuries and deaths among older adults that I discussed above.
Still Going Strong Campaign Resources are available here
Please access this link. You will find a toolkit, full and half page adds, 8-second, 15-second and 30-second videos about Still Going Strong, and various podcasts.
- Information for Older Adults available here
- Information for Caregivers available here
- Information for Healthcare Providers available here
- Common Injuries as We Age available here
For implementation of this program, CDC has prioritized roll-out in 4 states: Maine, Oklahoma, Oregon and Wisconsin. These states were selected because of their incidence of older adults falls, fall injuries, motor vehicle crashes and deaths caused by injuries. But the materials are available for your access.
Of course, CDC’s familiar materials are available to make your National Fall Awareness Day so meaningful for your community.
Patient Education Materials
Make these fall and fall injury prevention brochures available to patients and caregivers. Here are some:
- CDC STEADI (https://www.cdc.gov/steadi/patient.html)
- Staying Independent: Are you at risk? (English)
- What you can do to prevent falls (English, Spanish, Chinese)
- Chair Risk Exercise (English, Spanish)
- Postural Hypotension (English, Spanish)
- Check for Safety Brochure (English, Spanish)
- NCOA Tools (https://www.ncoa.org/older-adults/health/prevention/falls-prevention)
- Falls Free CheckUp
- See if you’re at risk for falls
- Individuals’ Fall Prevention Stories
- Age Well Planner
Colleagues, I hope this information has been helpful to you, and creates a sense of urgency to participate in National Fall Prevention Awareness Week, and add community education/outreach program community efforts/practices. The burden of falls will only increase unless you, your clinical unit, and your organization step up to this call to action.
On behalf of Curbell Medical, Inc., the older adults we care for, your mother, father, grandmother, grandfather, I hope you will join with CDC and the National Council on Aging (NCOA) to address this problem and focus on prevention of fall related injuries, and that you will report your efforts back to ARN and NCOA. Each year, NCOA prepares a compendium of program offerings — showcase your fall and injury prevention program!
Your Participation is Essential!
Thank you for reading my message,
Patricia A. Quigley, PhD ARNP CRRN FAAN FAANP FARN
CDC (2021a, February 11). National Center for Injury Prevention and Control. Leading causes of death and injury, 2001-2019. Available here Accessed June 4, 2021.
CDC (2021b). Emergency department visits and hospitalizations for selected nonfatal injuries among adults aged > 65 years – United States, 2018. Morbidity and Mortality Weekly Report. May, 2021, 70(18): 661-666. Available here Accessed June 5, 2021.
CDC STEADI (Stopping Elderly Accidents, Deaths and Injuries) (2020, July 9). Available here Accessed June 5, 2021
CDC. (2017). Important Falls about Falls. Available here Accessed Jun 2, 2021
CDC debuts injury prevention campaign for elders, says most ED visits due to falls. McKnight’s Long-Term Care News. ARN pulse. May 13, 2021
Factora, R., Thomas, D., & Darowshi, A. (2021). Evaluation of falls in the elderly. BMJ Best Practice, https://bestpractice.bmj.com/topics/en-us/880
National Council On Aging. Date Sept. 22: Fall Prevention Awareness Day.
https://www.seniorfallsprevention.org/falls-prevention-awareness-day.html (accessed June 5, 2021)
Rubenstein, L. (2021, April). Fall in older people. Merck Manual Consumer Version. Available: https://www.merckmanuals.com/home/older-people%E2%80%99s-health-issues/falls-in-older-people/falls-in-older-people Accessed Jun 2, 2021
VA National Center for Patient Safety. Hip Protector Resources. https://www.patientsafety.va.gov/professionals/onthejob/falls.asp Accessed Jun 6, 2021
World Health Organization (2021, April 26). Falls. Available https://www.who.int/news-room/fact-sheets/detail/falls Accessed Jun 2, 2021
Dr. Patricia Quigley is a Nurse Consultant, Nurse Scientist, Former Associate Director and VISN 8 Patient Safety Center of Inquiry. She is both a Clinical Nurse Specialist and a Nurse Practitioner in Rehabilitation, and her contributions to patient safety, nursing and rehabilitation are evident at a national level, with emphasis on clinical practice innovations designed to promote elders’ independence and safety. She is nationally known for her program of research in patient safety, particularly in fall prevention. The falls program research agenda continues to drive research efforts across health services and rehabilitation researchers.