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How to Prevent Broken Hips

You reach old age, you fall, or so it is widely believed. But new findings show that falling need not be as inevitable as white hair when we get older. A Yale study has found that making fall prevention a regular part of healthcare for older adults will go a long way towards preventing serious injuries.

 

Fall-related injuries account for 10% of all emergency room visits.

Previous pilot studies at Yale and other medical centers have demonstrated that for the elderly, the risk of falling can be predicted based on a number of risk factors, including a person’s medication mix, vision problems, foot issues, and trouble with walking and balance. Managing and reducing those risk factors reduced fall-related injuries by more than 30 percent under research conditions. Now Yale geriatrics authority Mary E. Tinetti, who led several of those past experiments, has shown that the same techniques can also prevent falls in a real-world setting. (The study was published in the July 17 issue of the New England Journal of Medicine.)

First, Tinetti’s team produced a media campaign in the greater Hartford region about preventing falls. They also trained 3,000 area healthcare providers and administrators to assess and reduce older patients' risks for falls. Compared with the control group of similar hospitals, the number of patients needing emergency care declined by 11 percent and the rate of serious injury by 9 percent. That translates into 1,800 fewer emergency visits.

Nationally, fall-related injuries account for 10 percent of all emergency department visits and 6 percent of hospitalizations among persons over the age of 65. The injuries and debility resulting from falls can lead to functional decline, nursing-home placement, restricted activity, and early death. Therefore, getting clinicians to assess their patients' falling risks, and then taking steps to help reduce those risks, says Tinetti, “should really be part of good health care for all older people. The research is done. It’s time to put what we know into action.”

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…And How to Get Help Fast

A low-cost, non-intrusive monitoring system that sends a cell-phone alert when someone falls? The world may just beat a path to Eugenio Culurciello’s door. “What’s different about this system is that it can summon help automatically,” says Culurciello, an engineering professor. “It doesn’t require television cameras monitored by observers or a device that has buttons that must be pushed.”

 

“This is not a ‘Big Brother is watching you’ application.”

Culurciello’s device combines a high-speed camera and a microprocessor programmed to image the world as a collection of imprecise outlines. Using students as models, the engineer and his team created an algorithm that enables the device to distinguish a human fall from, say, a person deliberately kneeling down, a box falling from a counter, or a cat leaping off a table. Once a fall has been detected, the device waits 30 seconds. If there’s no movement during that time, it sends out an alert. The device, which has been tested in the laboratory but not in a nursing home or assisted-living situation, is described in an upcoming paper in IEEE Transactions on Biomedical Circuits and Systems.

“This is not a ‘Big Brother is watching you’ application—it doesn’t violate anyone’s privacy,” Culurciello explains. “It’s a system of watchful eyes to help seniors be safe in their daily routines.”  the end

 
   
 
 
 
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