Fall Prevention Programs in Emergency Departments May Help Older Adults After Discharge
Fall-related ER visits can include practical steps to help older adults stay safer once they return home.
Falls are one of the most common reasons older adults are treated in the emergency department, and many patients are discharged home the same day. That transition can be a vulnerable moment, especially if the factors that led to the fall aren’t fully addressed. A new study suggests that emergency departments may be able to take meaningful steps during visits to help older adults stay safer once they return home.
The findings come from the GAPcare II trial, “Emergency Department Visit Outcomes of a Multicenter Randomized Trial of a Fall Prevention Intervention,” which was published in Academic Emergency Medicine. Researchers evaluated whether a fall prevention program could be delivered during emergency department visits to adults aged 65 and older, within seven days of an accidental fall, who were expected to be discharged and were without mobility-limiting injuries. The intervention paired 852 patients with physical therapists to assess balance and mobility and pharmacists to review medications that may increase fall risk.
Researchers found that these consultations were feasible to complete during the emergency visit and yielded individualized recommendations, including mobility aids, medication adjustments, and referrals for follow-up care. Patients received bedside pharmacy and physical therapy consultations. Pharmacists recommended changing medication timing (26%), stopping fall risk medications (19%), and dose adjustments (18%). Physical therapists recommended assistive devices (66%), outpatient services (36%), and skilled nursing facility admission (25%).
“A fall is often a signal that something in a person’s health or environment needs attention,” said Sarah D. Berry, MD, MPH, senior scientist at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research and chief of the Division of Gerontology at Beth Israel Deaconess Medical Center. “This study shows that emergency departments can go beyond treating the immediate injury and help identify factors that may lead to future falls, giving patients and caregivers a plan to prevent future falls as they return home.”
While the research focused on how well the program could be implemented rather than long-term outcomes, it highlights the emergency department as a potential point of intervention to support safer recovery after discharge.
The study was conducted by a multidisciplinary team of emergency medicine physicians, geriatric specialists, physical therapists, pharmacists, and health services researchers. In addition to Dr. Berry, researchers include Elizabeth M. Goldberg, MD, ScM, emergency medicine physician and researcher at the University of Colorado Anschutz Medical Campus; Sarah Keene, MD, PhD, assistant professor, Emergency Medicine in the Warren Alpert Medical School at Brown University; Megan Bounds, MPH, University of Colorado Anschutz Medical Campus; Linda Resnik, PhD, PT, professor of health services, policy, and practice at Brown University School of Public Health; Samantha Roberts, MS, research scientist, Department of Biostatistics and Informatics, Colorado School of Public Health; Andrew Leroux, PhD, assistant professor, Department of Biostatistics and Informatics, Colorado School of Public Health; Jonathan Gomez-Picazo, research assistant, Department of Emergency Medicine, University of Colorado Anschutz Medical Campus; Mark Magdaleno, physical therapist, Department of Inpatient Acute Care Rehabilitation, University of Colorado Anschutz Medical Campus; Amelia Nelson, PharmD, BCCCP, BCEMP, pharmacy supervisor, Department of Inpatient Pharmacy, UCHealth, University of Colorado Anschutz Medical Campus; Vincent Mor, PhD, professor, health services policy and practice, Florence Pierce Grant University Professor, Center of Gerontology and Healthcare Research, Brown University School of Public Health; and Roland C. Merchant, MD, MPH, ScD, Vice Chair of Research, Department of Emergency Medicine, Morsani College of Medicine, University of South Florida.
About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across seven campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; Jack Satter House, Revere; and Leyland Community, Dorchester. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $87 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, follow us on our blog, Facebook, Instagram, and LinkedIn.
About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.
