Marilyn Davidman knows from experience that one bad fall can put you down for the count when you least expect it. A friendly greeting from two boisterous dogs landed her on the ground with a fractured wrist.
“If I had been steady enough to keep my balance, that might not have happened,” she says.
An active tutor who takes a good number of classes and volunteers in the Albuquerque Oasis office, Marilyn is simply too busy to let getting tripped up trip her up.
“I have a lot of good reasons to stay on my feet,” she says.
Marilyn turned to Oasis for help. She took a Better Balance class as part of an Oasis fall prevention program supported by a grant from Blue Cross Blue Shield New Mexico.
She’s glad she did. In addition to having more stamina, she has a better understanding of muscle movement and how she can prevent future falls.
“It makes you feel like you are not alone,” she says. “There are people there with you trying to do something about it.”
Older adults like Marilyn across the country can avoid costly injuries that threaten their independence through prevention programs supported by partnerships between community-based organizations like Oasis, healthcare providers and managed care. These alliances are a path to lower healthcare costs, improved population health and better patient care—a health policy model known as the Triple Aim.
A common problem
One in four adults ages 65 and older will fall this year. Those who fall are more likely to fall again, and each fall increases the likelihood of more serious injury or death. Falls also impact individuals and families by affecting independence and mobility.
It can be difficult to pinpoint the reason for a fall. It could be due to a change in gait or balance, muscle loss, home environment, medications, vision or hearing changes or even a fear of falling. This fear can be present even if someone hasn’t experienced a fall.
Lois Brazil is one of those people. She didn’t fall, but a car accident that resulted in a concussion left her sidelined from one of the things she loves most, swing dancing. A Tuesday night regular with a local dance club near her home in Florissant, Missouri, Lois found herself scared to get back out on the dance floor.
“I was afraid I might fall,” she says. “People offered to take me, but I would make excuses. I quit going.”
Encouraged by family to do something to get her confidence back, Lois started taking A Matter of Balance classes offered by Oasis. The classes proved to be the turnaround she needed to overcome the fear that was getting in the way of a social life. Her Tuesday night dance card is full again.
“I’m grateful to be back in the ‘swing’ of things,” she says.
An answer to rising costs
The community-based model addresses another serious factor: falls are costly. An estimated
$67 billion will be spent on falls by 2020.
According to a study by the Centers for Medicare and Medicaid Services, A Matter of Balance saves an average of $938 per participant in healthcare costs.
Oasis is expanding evidence-based programs like A Matter of Balance in places where adults live and work by collaborating with libraries, senior residences, community centers and houses of faith. These familiar neighborhood settings attract diverse audiences, and maximize weekly attendance so participants get the full benefit of programs that have demonstrated positive results.
Leading the way in Missouri and beyond
A report from the Centers for Disease Control and Prevention identified falls as the leading cause of unintentional injury deaths among seniors. In 2014, falls were the major contributor to hospital charges for injuries to seniors in Missouri.
In 2015, Oasis received a grant from the U.S. Administration on Community Living to offer A Matter of Balance as part of Missouri’s statewide fall prevention efforts. Since receiving the grant, 18 partners have hosted 83 workshops reaching 945 Missourians. With 82 percent completing the program, that’s a savings of approximately $726,950 in healthcare costs.
Juliet Simone, MPH, is community health manager for St. Louis Oasis evidence-based health programs, and state coordinator for the Show Me Falls Free Missouri Coalition. She says the success in Missouri has laid the groundwork for broader impact across the country.
“Oasis took on this effort to learn firsthand how networks of community partners can collaborate to reach more adults with evidence-based health programs,” says Juliet.
The U.S. Administration on Community Living recognizes the role community-based programs can play and has provided grants to many states to expand capacity and increase sustainability. When New Mexico was awarded a statewide fall prevention grant, Albuquerque Oasis applied lessons learned from Missouri to build fall prevention programs in the state.
Fall prevention programs are increasing at other Oasis centers as well. In San Diego, balance and exercise classes helped Leanna Clark recover from a fall and get strong enough that she no longer needs a cane.
“For me, exercise has become as irresistible as a box of chocolates . . . I’m kind of addicted,” Leanna says. “I’m the oldest student in my class and I enjoy the independence I have regained.”
Falls are costly – in dollars and in quality of life. But falling is not an inevitable part of aging. Through grant funding, Oasis is demonstrating how we can keep more adults on their feet so they can stay active, healthy and involved in their communities.
The bigger opportunity lies in building innovative partnerships to expand these programs. With the ever-changing healthcare environment, we know that health providers alone cannot serve the growing older adult population.
Through contracts with health providers and managed care, community-based organizations like Oasis can reach older adults earlier and on a broader scale to prevent falls and reduce costs for everyone.