This is a message especially for you from FJMC
Now a joint publication of the FJMC and MRJ
Issue #48 - November 20, 2017
This Issue of Health Wealth and Retirement brings you insight into a health issue that many of us will experience ourselves or through our loved ones – “Falls Can Be Prevented!”, an article created especially for HWR by James Nussbaum, PT, PhD, SCS, EMT at the request of our Medical Editor, Stephen Mandel, MD.
Falls Can Be Prevented!
Falls and fall related injuries are an epidemic in the United States, particularly in adults 60 years of age and older. Head injuries, fractures, and decreased mobility are some of the catastrophic results of falls. The medical literature clearly shows that a significant portion of falls can be prevented with appropriate interventions.
There are numerous studies looking at different fall prevention programs and methods aimed to decrease the incidence of falls, decrease the risk factors for falls, and limit injuries sustained when people fall. They include protective hip pads in older adults, group exercise classes (particularly Tai Chi), and home-based nurse directed balance programs for seniors. Physical or occupational therapy interventions have proven successful, and are specifically tailored to an individual’s needs, and are often covered by medical insurance. Due to many factors, including time constraints, poor reimbursement, lack of education on the importance or implementation of fall screenings and prevention programs, most primary care physicians do not assess their patients’ fall risk, nor do they refer patients to fall prevention programs. Assessing for falls risk, or referring out for a falls risk assessment, and possible treatment or programming, can be lifesaving actions by physicians.
Eliminating risk factors are a focus of many programs. Risk factors are often divided into 2 categories, intrinsic, or factors associated with bodily characteristics, and extrinsic risk factors, those outside one’s body. Extrinsic risk factors are often more easily modifiable, than their intrinsic counterparts. Examples of each are listed as follows:
INTRINSIC: Weakness (specifically lower extremity weakness), poor sensation (possibly worsened by certain conditions such as diabetes), dizziness (may occur due to changes in blood pressure – orthostatic hypotension, vertigo, etc), taking more than 4 medications, slow reflexes, and poor vision (i.e. macular degeneration) are examples of intrinsic risk factors for falling.
EXTRINSIC: Having throw rugs, poor lighting, ill-fitting or inappropriate assistive devices, lack of proper footwear, not having grab bars in the bathroom, are examples of extrinsic risk factors.
In a review article by Sherrington et al. in 2008 in the Journal of the American Geriatric Society, they concluded that exercise can prevent falls and that a successful fall prevention program should:
What does this mean?
In summary, falls are a big problem. They significantly contribute to morbidity and mortality, can be fatal, cause a financial burden to society, and negatively impact individuals’ quality of life. Balance is a multi-dimensional and factorial bio-motor ability, which includes strength, reflexes, coordination, sensory integration, awareness, and more. Identifying an individual’s risk and an intervention aimed at minimizing those risks, promote positive changes in fall risk tests and measures. Repetition of successful balance strategies, which help to turn the purposeful into the habitual are a keystone in fall prevention programming and safe mobility. A number of home based and community programs have proven successful in reducing falls, and falls risk. Individualized fall prevention programs supervised by skilled PTs and OTs can be covered by Medicare and other insurers, and may significantly reduce your risk. Speak to your doctor today to intervene before it is too late!
James Nussbaum, PT, PhD, SCS, EMT is the Research and Clinical Director at ProHealth & Fitness PT OT, a rehabilitation organization in New York City. He has been an active member of the New York State Department of Health Fall Prevention Task Force, and has presented his research in Barcelona, Beijing, Berlin, and throughout the United States. Dr. Nussbaum sits on numerous medical and academic advisory boards, and leads his clinical team which is a proud member of the Hospital for Special Surgery Rehabilitation Network. He is a Clinical Instructor for Doctoral PT students, and is the Clinical Coordinator for Clinical Education at ProHealth, partnering with many of the Doctoral Physical Therapy programs in New York State. Dr. Nussbaum and his team of PTs and OTs have been working with patients and their physicians on fall prevention strategies through skilled physical and occupational therapy for many years. Dr. Nussbaum and his colleagues at ProHealth & Fitness PT OT collaborate with physicians affiliated with many of NYC’s finest medical institutions and they provide highly skilled outpatient, home based, and clinical research programming throughout Manhattan.
We would like to thank our sponsor RCA, Retirement Corporation of America. They have graciously been our primary sponsor for the last 2 years.
For our Wealth tip we bring you a podcast interview with Ellen Langer, PhD., about “The Science of Mindfulness and Mindlessness” that should help us take more positive control of our lives, inherently making us Wealthier and better prepared for the future.
It is linked here at the “On Being” web site.
Her unconventional studies have long suggested what neuroscience is now revealing: Our experiences are formed by the words and ideas we attach to them. Naming something play rather than work — or exercise rather than labor — can mean the difference between delight and drudgery, fatigue or weight loss. What makes a vacation a vacation is not only a change of scenery, but the fact that we let go of the mindless everyday illusion that we are in control. Ellen Langer says mindfulness is achievable without meditation or yoga. She defines it as “the simple act of actively noticing things.”
Ms. Tippett: So one of the things you’ve said is that most of us live mindlessly, virtually all of the time. And you say that with a smile on your face, but you mean it.
Ms. Langer: Yes. Yes. Oh, I mean it. [laughs] And I find that I’m not infrequently — not frequently, but not infrequently, I, too, am mindless. As I’m fond of saying, whatever you’re doing, you’re doing it either mindfully or mindlessly. And the consequences of being in one state of mind or the other are enormous. So in study after study, we plug in — we manipulate this mindfulness and change the measures from study to study, and almost no matter what we put in, that when we encourage people to be more mindful, we find enormous improvements.
This issue is prepared by a bunch of guys who are continuing to GIVE BACK to FJMC. We invite you to also give back to FJMC through your participation and most importantly through donations supporting FJMC as Friends of FJMC. Participate by clicking on “Become a Friend of FJMC” on www.FJMC.org or contact Gary Smith at firstname.lastname@example.org.
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Email sent at approximately 11:45 pm, November 20, 2017
LEGAL DISCLAIMER: This work is based on current events, interviews, corporate press releases, and what we've learned from several mentioned health and wealth newsletters. It is also based on some personal experiences. It may contain errors and you shouldn't make any investment decision based solely on what you read here. It's your money and your responsibility. FJMC is not making specific recomendations of stocks or bonds just possible ideas that might be considered for research and investing purposes. This information is being provided for informational purposes only.
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