John Bazemore, Associated Press
In this Sept. 18, 2018 file photo, former President Jimmy Carter speaks during a news conference, in Plains, Ga. A spokeswoman says Carter has broken his hip. She said that Carter underwent surgery at a medical center in Americus, Ga.

SALT LAKE CITY — Former President Jimmy Carter, 94, is among the latest to experience one of the great challenges impacting senior Americans, their families and taxpayers.

Injuries that result from falls rack up a $34 billion annual price tag in direct medical costs, most of the cost covered by taxpayer-funded programs including Medicare and Medicaid. That figure doesn't include other direct costs, like unexpected time off work for adult children and other caregivers.

But the greatest cost is less tangible and more life-altering.

"Independence and quality of life" are incredibly important to older people, Katherine A. Bennett recently told the U.S. Senate Committee on Health, Education, Labor and Pensions. Bennett is a geriatrician and assistant professor of medicine at the University of Washington School of Medicine.

Carter, who holds the record as the U.S. president with greatest longevity, is recovering from hip surgery after falling at home in Plains, Georgia, according to The Associated Press.

At great cost

Efforts to prevent falls can benefit not just older adults, but society overall, reducing health care costs, allowing independence and reducing the challenges of caregiving, among others. Consider this, from the National Council on Aging:

  • Falls are the leading cause of injury and death for those 65 and older. An estimated 25,000 older adults die from falls each year.
  • Medicare, a program with predicted funding challenges likely within the decade, picks up close to 80 percent of the medical cost of falls. The council reports that Medicare costs related to falls could exceed $50 billion annually by 2020.
  • Hospitalization costs related to falls average $35,000 per incident, according to the same report.
  • Each year, more than a quarter-million older Americans suffer hip fractures — women at twice the number as men. One-fourth end up in a nursing home for at least a year, the cost most often borne by Medicaid.
  • Many who suffer broken hips die within six months.

Reducing falls

Bennett said reducing or eliminating most of the fall risk is both doable and desirable, noting that falls are more costly overall than diabetes.

Evidence-based fall prevention can be simple and cost-effective, according to the National Council on Aging, which touts clinical assessments, physical therapy and community-based programs.

Johns Hopkins University created a fall risk assessment tool to use with patients in 2003. What it learned about who is most at risk is also often true in home settings: people 60 and older, those who have fallen before, those who often have urgent need to get to the bathroom quickly, people on high fall-risk drugs like opiates or sedatives, people with balance or gait challenges, those who can't see or hear well and seniors who have decreased cognition.

To that list of risk factors, the Centers for Disease Control and Prevention adds people with lower body weakness, not enough vitamin D, foot pain, inadequate footwear and "home hazards" like throw rugs and uneven steps.

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Families can take steps to make home environments safer and improve aspects of senior health to reduce risk of fall. CDC recommendations include:

  • Have a doctor evaluate fall risk and provide suggestions.
  • Do strength and balance exercise. (Some experts say tai chi is especially effective as a prevention tool.)
  • Make sure eyeglasses are up to date.
  • Go through the house looking specifically for tripping hazards like rugs and make needed changes.
  • Add grab bars in the bathroom.
  • Put railings on both sides of stairs.
  • Add more or brighter bulbs to illuminate the house.