Falls are among the most common and most serious problems for older adults. They’re associated with increased mortality, morbidity, reduced function, and premature nursing home admissions, as well as diminished quality of life.
Deeper dive
Older adults are frequently not aware of their risks of falling, and physicians can also overlook those risks, which sometimes only become evident after the fact. According to the US Preventive Services Task Force, both incidence and severity of fall-related complications increase after age 65. More than one-third (35%) of otherwise healthy, community-dwelling people over age 65 fall annually. After age 75 rates are even higher
They recommend exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. USPSTF also recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls.
Depending upon severity of risk, various assessments are used:
- Timed up and go test.
- Berg Functional Balance Scale.
- Tinetti Falls Efficacy Scale.
- Hendrich II Fall Risk Model.
- 4-Stage Balance Test.
- 30-Second Chair Stand.
The 4-Stage Balance Test and 30-Second Chair Stand are part of the CDC’s STEADI Toolkit for Health Providers (Stopping Elderly Accidents, Death, and Injuries). STEADI also offers a variety of fall risk information, including reports on fall risk factors and integrating fall awareness into a healthcare practice. The other tests were devised by various gerontological researchers and have been shown to be effective at indicating fall risk.
A medication risk assessment is also recommended as part of an overall fall risk assessment. Taking four or more medications significantly increases the risk for falling because both the number and intensity of side effects increases with multiple medication use. Additionally, older people metabolize medications differently than younger people, which can increase the risk for falling.
Filial piety
Filial piety is a Confucian virtue of respect for one’s parents, elders, and ancestors. In more general terms, filial piety means to be good to one’s parents, to take care of one’s parents, to engage in good conduct not just towards parents but also outside the home so as to bring a good name to one’s parents and ancestors.
Deeper dive
Filial piety plays a key role in caregiving among Chinese families. Some studies point to increased depression and stress among Chinese Americans while others find that filial piety serves as a protective function to reduce the negative effects of stressors and to enhance the positive effects on caregiving burden.
In China the concept is so strong that the government mandated that adult children regularly visit their elderly parents or risk fines or even jail. Other cultures around the world also embrace similar concepts of honoring and caring for their elders. But in the U.S. and elsewhere, modern life is taking a toll on this tradition.
In the U.S. a related concept of filial responsibility extends to parents’ financial debts. As of 2019, 29 states and Puerto Rico with filial responsibility laws on the books, adult children may be held legally responsible for their care under certain circumstances, such as when parents are ailing and without sufficient financial resources to take care of themselves.