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Fall-related traumatic brain injury is a silent epidemic; we can do more to curb it

Minnesota programs to provide education, exercises and home assessments for the elderly should be expanded as the large baby boom cohort ages.

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Joseline Haizel-Cobina
It happened so fast! One moment Nonny was chatting happily with friends and family who had gathered at home to celebrate her 80th birthday; soon after, she was in a hospital bed fighting for her life. She had excused herself to use the bathroom but was gone for an unusually long time. A look into her bathroom revealed Nonny lying on floor, unable to move. She was immediately rushed to the ER with loved ones worrying that she had broken her hip, only to be told she had suffered a severe traumatic brain injury (TBI).  She had slipped and hit her head on the floor. It has been over a year now, and she is recovering slowly with the aid of physical therapy.

According to Minnesota Department of Health, unintentional falls are the leading cause of TBI in older adults and Minnesota ranks fourth in the U.S for deaths from falls. TBI is often referred to as a silent epidemic because its awareness among the general public is limited. Within this silent epidemic is a silent population: older adults. Most people assume when older adults fall, the only serious injury they may have is a broken bone. However, research has shown that only 3 to 5 percent of falls in older adults result in fractures, while 5 to 10 percent result in other severe injuries such as TBI.

Environmental hazards

Even though we wish to remain healthy and fit for a long time, growing old comes along with its own health challenges that affect quality of life. Environmental hazards such as slippery and uneven floors greatly increase the risk of falls under such circumstances. A significant number of fall-related TBIs in older adults are associated with environmental hazards with about 35.7 percent of injuries occurring in the bathroom.

The long-term disabilities associated with a TBI can be devastating for seniors as they try to enjoy their last few years with family and friends. Beyond the physical impact, the high cost of medical care (an estimatee $85,000 – $941,000 is spent on medical care for a single person with TBI, depending on severity) and rehabilitation after recovery adds an additional financial burden on affected individuals, family and the public. Imagine living with a long-term disability, all because you stepped on an uneven floor, couldn’t balance properly and slipped, causing you to land on the floor and hitting your head against a hard surface in the process. It almost looks like the momentary loss of consciousness that may follow the injury is the only time you may get to take a “break” before all the problems start flooding in.

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Falls and TBI-related deaths

According to the Centers for Disease Control and Prevention, falls are a leading cause of TBI-related deaths in older adults. The rate of fatal falls in Minnesota is climbing faster than the national rate, which is alarming. How best do we deal with this silent epidemic claiming the lives of older adults? Though we cannot prevent our bodies from aging or prevent diseases which increase our risk of a fall, we can create a safe environment wherever we choose to live. This will ensure our needs are accommodated as we age, considering the fact that the environment plays a role in about half of all falls among the elderly.

Initial steps have been taken in the right direction. Fall prevention programs funded by the state are run by many organizations. These provide education, exercises and home assessments for the elderly. Home assessments are aimed at evaluating seniors’ functional abilities and how those abilities interact with their home features. Environmental hazards are identified and recommendations are made to suit the needs of the individual.

These programs should be further expanded to reach out to many more older adults and baby boomers who will contribute a significant number to the aged population in the next couple of years. This will enable many older adults to “age in place” as desired instead of being institutionalized. Above all, health care costs will decrease and many more lives will be saved.

Joseline Haizel-Cobbina, M.D., is an MPH candidate in the School of Public Health, University of Minnesota.


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