Falls are a major health issue for older adults, leading to injury, loss of independence, and increased healthcare costs. The CDC created the STEADI initiative to help healthcare providers screen for fall risk factors and implement prevention programs. Following STEADI, providers assess patients annually for falls history, balance, and fear of falling. Identified risks like medications or poor vision can then be addressed through medication management, exercise referrals, and home safety evaluations. Proper fall screening and prevention can help older patients live independently and safely.

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A Guide to Reducing Falls in the PACE
Population
Falls are a serious and costly issue facing millions of adults age 65 and older.
They’re the leading cause of fatal injury and the most common cause of nonfatal
trauma-related hospital admissions among older adults.
According to the Centers for Disease Control and
Prevention (CDC), at least one older adult falls every
second of every day in the United States. Every
11 seconds, an older adult is treated in the emergency
room for a fall. Every 19 minutes, an older adult dies
from a fall.
Physical injury isn’t the only consequence of a fall.
Falls, with or without injury, also impact a PACE
participant’s quality of life. An increasing number of
older adults fear falling and, as a result, limit their
activities and social engagements. This may result in
further physical decline, depression, social isolation,
and feelings of helplessness.
Why Do Falls Happen?
Falls don’t just occur out of the blue or because PACE
participants are older. There’s usually an underlying
cause or risk factor involved in the fall. These risk
factors include a participant’s physical condition
or medical problems, but may also include safety
hazards in the environment such as extension cords,
clutter on the floor or stairs, uneven rugs or flooring,
and inadequate stair railing and shower handles.
It’s important to identify risk factors so that you can
work to reduce them and the likelihood of a fall
among your PACE participants. These risk factors
include muscle weakness, balance deficiencies,
postural hypotension, decreased reflexes, impaired
vision, and the use of certain medications.
What Providers Can Do
As healthcare providers, it’s important to increase
public awareness and educate both participants and
their caregivers about the risks of falls and how to
prevent falls. It’s beneficial to support the implemen-
tation, dissemination, and sustainability of evidence-
based fall prevention programs and strategies to
reduce the incidence of falls among older adults.
Falls are a major concern for seniors. The aftermath
of a fall can affect a participant as much as the fall
itself. The number of older adults who fall each year
is expected to increase as our population ages. As
healthcare providers, it’s vital to stay up to date on the
newest evidence-based strategies and implement
them into your practice.
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2. Understanding the STEADI Initiative
The CDC has created the Stopping Elderly Acci-
dents, Deaths, and Injuries (STEADI) initiative to help
healthcare providers make fall prevention part of their
routine exams and participant interactions. STEADI is
based on clinical guidelines and provides information
and resources to participants, their caregivers, and
all members of the healthcare team. The initiative
includes information about how to screen for falls,
online training for providers, videos on how to conduct
functional assessments, and informational brochures.
How to Include STEADI in Your Routine
Participant Interaction
Incorporating STEADI into a routine visit for a PACE
participant age 65 and older is simple. The STEADI
program begins with 3 questions:
● • Have you fallen in the past year?
● • Do you feel unsteady when standing or
walking?
● • Do you worry about falling?
What Are the Results of Falls?
Falls in older Americans usually signal the end of
independence. Falling once tends to make partici-
pants fearful of another fall. This increased fear can
manifest as physical and social isolation.
As the PACE participant avoids daily activities, his or
her muscle strength can decrease, putting him or
her at further risk for another fall. Falls, and the
resulting injuries, are largely dependent on a partici-
pant’s health status. The rates at which older adults
are injured by falls are almost seven times higher
for older adults in poor health than for those in
excellent health.
How Can Participants Reduce
Their Risk of Falling?
PACE participants and their caregivers can take a
few steps of their own to prevent falls. These include:
● • Talking to their healthcare provider about
falls and fall prevention. One in four older
Americans fall each year, but less than half
of them tell their doctor. It’s important that
participants feel comfortable sharing their
fall history.
● • Talking to their provider or pharmacist about
both prescription and over-the-counter medi-
cations that may increase their likelihood of
falling and what changes should be made to
their medication regimen
● • Having their eyes checked by an eye doctor
once a year and updating their eyeglasses or
contact lenses as needed
● • Reviewing the home environment and remov-
ing any hazards, such as clutter, loose rugs, and
electrical or phone cords. It’s also important
to make adjustments to the home, including
improving lighting and installing handrails.
● • Participating in activities, such as tai chi, that can
improve their balance and strengthen their legs.
Resources such as the local Council on Aging
can provide participants with information on
what is available in their community.
STEADI in PACE Centers
The CDC stresses that falls are not an inevitable part
of aging. PACE providers have an important role in
caring for older adults and have a responsibility to
reduce falls and their associated injuries. The CDC
believes falls can be—and should be—prevented.
PACE centers have a duty to their participants to
provide reasonable care, which includes taking
all measures possible to prevent falls. These
measures include:
● • Reviewing and managing any medications
linked to falls
● • Making referrals for physical therapy and gait
assistance equipment
● • Recommending supplements to improve bone,
muscle, and nerve health
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White Paper I A Guide to Reducing Falls in the PACE Population
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The STEADI program provides resources
and guidelines to improve participant safety.
Grane Rx can help support your efforts
to follow the STEADI program, improve
participant safety, and reduce fall risk. More
information about the STEADI program can be
found at www.cdc.gov/steadi.

3. Pharmacy Made Simple
White Paper I A Guide to Reducing Falls in the PACE Population
GraneRx.com
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1 in 4
Americans age 65 and older fall each year.
+
$
H
Falls result in more than
2.8 million
visits to the ER each year.
Some falls are even more severe, leading to more than
800,000 hospitalizations
and more than 27,000 deaths annually.
By 2020, that number is expected to increase to
$
67.7 billion.
The annual financial cost of fall-related injuries is more than
$
30 billion.
FALLS IN SENIORS: BY THE NUMBERS
Source of statistics: National Council on Aging