There’s no real debate on whether or not preventing a fall is a good idea. But what can people do to prevent them? What can people do to move around more confidently?

In short, what can people do to safely and assertively live the lives they want to lead?

Sanford Health’s "A Matter of Balance" classes and Fall Prevention and Education screening events answer those questions.

"A Matter of Balance" classes are on-going and include eight sessions lasting two hours each. Fall prevention and education screening events are scheduled periodically at Active Generations and regularly at the Van Demark Building. They take 10-to-15 minutes and are free.

Intuitively, one might guess falling less often is just a matter of being more cautious and restricting activity. But there’s more to it than that.

“Ultimately our goal is to keep individuals as independent as they’re able to be,” says Natalie Fick, an A Matter of Balance master trainer and Sanford Health physical therapist. “I think that’s a big part of what people are taking from this and what they’re most excited about.”

Preventing falls, building confidence

Susan Schave is one of the people who has taken the course. Susan, a longtime Sanford employee now retired, was having problems with her balance when she began taking the class. She found it very helpful, particularly so because it was not about restricting activity. To the contrary, actually.

“It helped me understand how not to be embarrassed about a fall and not be afraid to go out and do things for fear of falling,” Susan says. “I know how to protect myself from falling now. They tell you how to rearrange your house to make it more friendly for walking around.”

Included are instructions on the best places to put grab bars and the best ways to arrange carpets. It’s common sense in many cases, but also a reminder that there are ways to improve your capacity to move around while maintaining safety.

“I’ve told a number of people I’m taking the class,” Susan says. “I think it would be beneficial for anybody who is having problems – or even before you start having problems. If you’re getting a little older and you feel like you’re not as stable physically as you used to be, I would encourage anybody to take the class.”

Instructors encourage exercises that focus on strengthening weak muscle groups. For Susan, that meant targeting her ankles and thighs.

“They’re not very strong, especially from quarantine and all that sitting around,” Susan says. “I’m strengthening them and they’re helping my balance.”

By the numbers

Statistics from the Centers for Disease Control and Prevention bear out a definite cause for concern. The state of South Dakota, for instance, ranks fifth in the country for death from falls among older adults.

Nationally, every 11 seconds an older adult is treated in the emergency room for a fall and every 19 minutes an older adult dies from a fall.

As a level II trauma center, Sanford Health records and reviews causes of injury that bring people to the hospital. Carly Farner-Cordell, Sanford Health trauma coordinator, sees the numbers.

“Falls are definitely our No 1 cause of injury for head injury, hip fractures and arm fractures,” Carly says.

Carly did a needs-assessment for the programs Sanford Health had in place to prevent falls. That’s where “A Matter of Balance” began.

“A lot of people believe that falling is a natural part of aging,” Carly says. “But the research shows that’s not the case. So the goal for our prevention injury programming is to make sure that we have education opportunities in place in the community that will let people know that they should talk to their provider if they’re afraid of falling. Or if they feel dizzy, they should have their medications reviewed.”

Screening questions

Falls prevention also addresses other possible causes for falling and the ramifications that can extend beyond the actual injury. In some instances, individuals may be hesitant to report falls for fear it could lead to a loss of independence.

“I think sometimes they don’t want to tell anybody,” says Karla Cazer, an A Matter of Balance master trainer and Sanford Health geriatric clinical nurse specialist. “They could be thinking ‘Oh my gosh, my family might make me move to an assisted living facility.’ Or they might be thinking people will say they need more help in the home.”

Falls can be the cause of injury, obviously, but also could be a sign of other issues that need to be addressed. It could be an indication that the inactivity brought on by the pandemic has become a problem, for instance. It could something as serious as a heart problem or a stroke. Or, as easy to remedy as moving furniture around.

When screening for susceptibility to a fall, the top three factors are these:

Have you fallen in the last year?

Do you feel unsteady when you’re standing or walking?

Do you worry about falling or have a fear of falling?

“Our classes are centered around reducing the fear of falling so that people can become more active and increase their strength and ability to feel more steady,” Karla says. “It’s about how to be more assertive for yourself.”

Several options

Both Sanford and the Good Samaritan Society employ STEADI (Stop Elderly Accidents, Deaths and Injuries) initiatives that were created by the CDC to assist physicians and healthcare providers in preventing falls. STEADI serves to screen patients to identify their fall risk, assess risk factors that can be changed, and find ways to reduce risk using clinical and community-based strategies.

“We utilize the evidence-based program, STEADI to help identify if an individual has a fall risk," says Martha Frohwein, Good Samaritan Society clinical director. "Within the Good Samaritan Society and across our service lines and various levels of care, A Matter of Balance is one of the programs we use to help support individuals who would benefit."

Most important is conveying the message that there are several options available via Sanford and the Good Samaritan Society that can potentially serve as valuable resources for those who want to be safer -- and more aware -- about how to keep moving.

"One of the things we really want to do is to educate people that falling is not an inevitable part of aging," Martha says. "There are specific strategies or things people can do to decrease their risks of falling whether they're living alone, in a senior living setting or in a long term care environment.  Encouraging people to talk openly with their health care provider can be a great way to initiate that conversation."