Who is your point guard for senior fall prevention?

More than 30% of adults age 65 years and older in the United States fall annually. Who is your point guard for senior fall prevention? I propose it is the emergency department, based on the below research link. They can get the STEADI (Stopping Elderly Accidents, Death & Injuries) protocol started! It has proven itself for fall prevention with evidenced based research, is fun and easy to do! I’ve used it for 15 years and had great results when used with motivational interviewing.


  • More than 30% of adults aged 65 years and older in the United States fall annually.
  • In 2005, there were an estimated 20,000 fatal falls and 7.9 million nonfatal falls in the United States, costing approximately $5.7 billion and $68.4 billion, respectively.
  • The below emergency department research study looks at how well we are looking at the causes of the falls in order to prevent future falls.
  • We can do better working as a comprehensive rehab team using STEADI!
  • Tirrell et al

Emergency Department Discordance with National Geriatric Fall Prevention Guidelines

There were 350 patients in this study. The mean (±SD) patient age was 80.1

            Half of the elements in the guidelines were recorded in fewer than 20% of patients.

  • Cause and location of fall were the two most frequently reported history items (85 and 81%, respectively), while asking about baseline vision was only reported 1% of the time.
  • Evaluating for sensory deficits and muscle strength were the two most frequently reported physical examinations (63 and 48%, respectively)
  • balance was evaluated with the lowest frequency (1%).
  • History of falls in the past 3 months, impairment with IADLs, and a history of diabetes were reported in a quarter or more of patients.
  • An evaluation of gait, balance, footwear, feet, and baseline vision; the amount of time on the ground or floor were all present in less than 5% of patient charts

The good news is STEADI can be started any time in the medical care of our seniors.

  • For the best value based care and cost efficiency, the emergency department is an excellent place to get the protocol started.
  • Then the treatment plan can be taught to the senior and caregivers throughout their rehabilitation stay and progressing to lesser levels of care.
  • It dovetails well with the quadruple aim and is confirmed by the multitude of evidenced based research for comprehensive senior fall prevention.
  • The CDC provides some excellent handouts when using STEADI with our seniors. See link: http://bit.ly/31iDVSg

STEADI coordinates well with the goals of value-based health care, better rehab outcomes, and decrease medical costs. Therefore, the quadruple aim is achieved. It has a multitude of evidenced based research. I’ve used STEADI successfully for 15 years. It is fun and easy to use!

EXCITING TIMES!  October 2019 U.S. Senate Committee on Aging report:  https://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf

  • How is your state doing, see page 10?
  • Upper State New York did a STEADI- based program and reduced hospitalizations due to falls by 40%! See pages 20-21
  • Examine how Epic EHR integrated STEADI. See how innovative programs in different states decreased senior falls with home environment safety changes, effective community balance programs, and medication recommendations

I provide Fall Prevention Classes to MDs, Medical Professionals, Insurance Companies and Senior Communities. Let’s decrease re‑hospitalizations! www.geriatricrehab.biz

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