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Life Health > Health Insurance

Elders’ Risk of Falling Is Falling

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According to the Centers for Disease Control and Prevention, millions of seniors fall every year, with one out of every three people over 65 taking a tumble.

Not only are falls the chief cause of both fatal and nonfatal injuries—in 2013, 25,500 older adults died from injuries sustained in a fall—but 20% to 30% of fall survivors incur moderate to severe injuries.

In 2013, direct medical costs alone amounted to $34 billion. When you add in other costs—not just to the patient, but also to relatives and friends who help the injured senior—you can imagine how that total increases.

LifePlans Inc., a Munich Re subsidiary that provides health assessments, care management and administrative services, has developed a fall intervention program that has, according to the company, been proven “to significantly reduce the risk and rate of falls” and to “lower the incidence of insurance claims.”

According to LifePlans, the LIFT Wellness Program (Living Independently and Falls-Free Together) is the result of a multiyear research study on fall prevention with the U.S. Department of Health and Human Services. The study, which began in 2004, found that an intervention made up of a comprehensive in-home assessment of physical, emotional and cognitive functioning, falls history, home environment and medications could be used to create customized recommendations for the person assessed, as well as for that individual’s doctor. Once implemented, the program not only enabled people to lower instances of falling, it also made it safer for them to remain in their own homes and made them less afraid of falling.

That last part is important because people who fall, whether or not they get hurt, develop a fear of falling that can make them withdraw from certain activities. That, in turn, leads to loss of mobility and impairs their physical fitness, thus putting them, ironically, at greater risk of falling.

The results of the federally funded study, published in the June 2015 issue of the peer-reviewed health policy journal Health Affairs, found that the LIFT program significantly reduced the rate of falls over a one-year study period. The study found that those who received the intervention had a 13% lower rate of falls compared with the control group, as well as having a “significantly lower rate of injurious falls.”

Not only that, but LTCI claims were 33% lower over a three-year period. The study also indicated that participants were almost 20% more likely to make fall-preventing modifications to their home than nonparticipants.

According to Dr. Marc Cohen, chief research and development officer at LifePlans, the risks the program educates participants about are either “intrinsic, meaning they are associated with the person’s health and habits, or extrinsic, meaning they are associated with the home environment.”

Cohen said, “Educating people about the risks in general and […] their specific risks is an important part of intervention. For instance, many people get up during the night to use the bathroom. Using a nightlight and making sure the path to the bathroom is clear and well-lit is important, but so many people assume that they are familiar enough with their own homes that they don’t consider it to be important.”

Advisors should note something else Cohen pointed out: “Financial planning for seniors likely always includes a health cost component, wherein certain investments associated with falls prevention are weighed against the chances of having a high-cost episodic event related to a fall. It would seem that this is particularly relevant to those with high-deductible health plans or high out-of-pocket-maximums plans.”

If your business-owning clients might be interested in the program as part of a benefits package, Cohen suggested taking stock of the number of caregivers they employ. “Since the program results are most pronounced among people over age 75 […], the caregiver concern would probably be the value driver [to employers], as reduced caregiver and long-distance caregiver distractions would translate into higher productivity and lower absenteeism. That said, employer-sponsored group retirement plans would be a perfect fit for this program as it aligns with the retiree demographic.”


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