When George Tetreault, 88, of South Burlington fell down a few times recently, he and his daughter Mary were worried. They knew that this was not a good sign for his general health, and they thought that his many medications might be responsible for his unsteadiness. Tetreault's physician modified his medications and referred him to FAHC's Falls Prevention Clinic on the Fanny Allen campus in Colchester.

Seniors have good reason to be afraid of falling. One in three people 65 and over fall each year. Although most people experience little damage in a fall, almost a third suffer seriously with head injuries and hip fractures. Hip fractures are particularly dangerous because about 25 per cent of the people injured die within six months. Of the hip fracture survivors who had been able to live independently before they fell, 25 per cent enter a nursing home after falling and stay there for at least a year. Hospital stays are almost twice as long for people admitted after a fall than for older people admitted for other reasons. Falls are the leading cause of injury death and nursing home placement among seniors

Even the fear of falling can be harmful. It can cause people to limit their activities - reducing their mobility and physical fitness- and thus, ironically, increase their risk of falling.

"Anyone who works with elderly people is concerned with falls," says Clifford Singer, MD, co-medical director of Elder Care Services at Fletcher Allen Health Care and associate professor of Psychiatry at UVM. "Good falls risk assessment is the key to prevention."

The Falls Prevention Clinic aims to make that key more readily available to older people and to area health care providers. The clinic provides a comprehensive multi-disciplinary assessment for seniors at risk of falling. The three- hour initial assessment includes visits with a registered nurse and with physical and occupational therapists. They review your condition in detail and make recommendations to address deficiencies. Falls Clinic staff may also conduct a safety check of your home. Medicare will pay for the risk assessment and many of the recommended treatments.

Dr. Singer recommends that physicians ask all their patients who are 65 and older if they have fallen. Also, he advises the simple "Get Up and Go" test for fall risk: Have the patient get up from a chair without using his or her hands, then walk a few paces and sit down again. If the patient relies on her arms to rise from the chair, walks very slowly, or shows unsteadiness, she is at risk for falling, Singer says, and this warrants a full assessment.

"Studies show that a comprehensive multi-disciplinary approach to assessing and addressing fall risks really makes a difference," says Julie. S. Adams, PT, DPT, supervisor of the Rehabilitation Outpatient Center at FAHC. "We develop detailed care plans for each patient."

At the Falls Prevention Clinic, a nurse will review your medications, checking for those that may make you groggy at night, feel faint, or confused. A physical therapist will evaluate other factors related to falls, like your balance. He or she may recommend a cane or walker for safety. She may suggest changing your shoes to ones which lace-up, have flat soles, and good arch support. She may recommend an exercise program, like tai-chi, or outpatient physical therapy. An occupational therapist will assess your sense perception, including vision, your cognition, and your abilities in personal care, like dressing and bathing. She may recommend helpful devices, such as a bath bench and a dressing stick. She may recommend referrals to an optometrist or psychiatrist.

On another day, staff may visit you at home for a detailed safety check. They may recommend, for example, better lighting, installing grab bars in the shower, using a high contrast color on thresholds, and getting rid of your throw rugs.

"I have been wickedly impressed with the clinic," says Mary Tetreault. "They cover those gray areas that never get addressed by physicians." Clinic therapists found that a major reason for Tetreault's falls was weakness in his calf muscles and a resulting posture that does not center his weight over his body. He is currently getting physical therapy to strengthen his calves. "I really like the fact that they did not recommend a cane or a walker – just a Band-Aid to cover up the problem," Mary says. "They did not write his falls off to old age." She and her father report that they feel more confident now about George's balance and walking ability.

Most falls occur in and around the home, but many occur in health care institutions like hospitals and nursing homes. In fact, although only 5 per cent of people 65 and over live in nursing homes, according to the national Center for Disease Control, they account for 20 per cent of the falls in that group. Nursing home residents are welcome to come to the clinic for assessment.

Besides serving older people directly, the Falls Clinic also provides information and classes about fall risks to physicians and nurses, with such topics as: balance disorders and diseases that affect muscle strength and the sensory system

Contact: Falls Prevention Clinic: 802-847-1902, Elder Care Services: 802-847-0329

Barbara Leitenberg writes on senior issues for the Champlain Valley Agency on Aging. This article originally appeared in the Burlington Free Press.