Navigating Fall Risks in Long-Term Care

Falls are very common among older adults but often go unreported or untreated by healthcare providers. There may be lots of reasons behind this. Patients may feel like falls are just part of normal aging. Providers may feel a sense of nihilism, that there just isn't anything they can do to decrease the risk of falling. On this week's podcast, we try to blow up this nihilism with our guest Sarah Berry.

Sarah is a geriatrician at Hebrew SeniorLife in Boston where she does research on falls, fractures, and osteoporosis in older adults.  We pepper Sarah with questions ranging from:

• Why should we care about falls?

• What are ways we should screen for falls?

• What are evidence based interventions to decrease the risk of falls?

• What about Vitamin D and falls???

• How should we assess for fracture risk?

• What are some evidence-based ways to decrease fracture risk?

• When should we prescribe vs deprescribe bisphosphonate therapy?  How does life expectancy fit in with all of this?

If you want to do a deeper dive into some of the articles we discuss, take a look at the following:

• An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults.

• The Fracture Risk Assessment in Long term care (FRAiL) website

• James Deardorff’s JAMA IM article on “Time to Benefit of Bisphosphonate Therapy for the Prevention of Fractures Among Postmenopausal Women With Osteoporosis

• Sarah’s article on “Controversies in Osteoporosis Treatment of Nursing Home Residents”, which includes this helpful flow chart on starting/stopping osteoporosis drugs in nursing homes