PTSD in Seniors Who Experience Falls - A New Field of Research
by Don Drake, Connelly Law Offices, Ltd.
"Falls for seniors do not just involve physical injuries but emotional ones as well," stated professional fiduciary and certified elder law Attorney RJ Connelly III. "Many of us are familiar with Post Traumatic Stress Disorder (PTSD) among those who serve in the armed forces, but did you know that seniors may also suffer PTSD following a serious fall or an injury?"
"PTSD is a mental health issue triggered by witnessing or experiencing a traumatic event. In most cases, the symptoms begin within one month of the event, but for some, it may appear years later. Symptoms can be severe enough to interfere in social relationships and may even impact a person's ability to engage in daily tasks."
"Interestingly enough, not everyone who experiences PTSD may have been through a terrifying event. Some can experience it after learning a friend or family member experienced trauma, for instance, receiving a phone call that a loved one has been in an accident," said Attorney Connelly. "The National Institute of Mental Health reports that six out of every one hundred people will experience PTSD at some time in their life and that women are more likely to develop the disorder than men."
Anna was a single mom living in New Bedford, Massachusetts, working as a secretary in an office downtown until her retirement. She was proud to have raised three boys independently after her husband was killed in an industrial accident. "I did everything with those kids," Anna said. "From playing baseball with them to attending weddings, I was always on the go. My neighbors would kid with me about how nimble I was on my feet, but as I got older, that nimbleness began to disappear."
"Much of this was due to diabetes and then peripheral neuropathy. Just walking sometimes became a chore, and the burning and numbness kept me off my feet for extended periods," stated Anna. "Along with the neuropathy came a constant feeling of being off balance. But I couldn't stay on my couch all day, and there was still plenty to do around the house and even with my grandkids."
As Anna tried to stay busy, she began to experience minor falls where she would catch herself, but her first major one occurred when she slipped on the sidewalk during a snowstorm. "That fall was horrible. I broke my shoulder and fractured my wrist. After that, I was terrified to go outside, and the injury landed me in rehab, and more problems followed, including who would take care of my house since all my kids lived out of state," Anna said.
"That's when Anna called our office, and we were able to set up some maintenance and security services to keep an eye on her home and ensure everything was working inside," said Attorney Connelly. "But when she returned home, she fell a second time walking up the stairs to her bedroom. This time she fractured her hip. We knew some things needed to be put in place for her."
"After a second rehab, RJ had a home healthcare agency come in for me to assess my house. They put a lot of safety equipment in for me," Anna said. "That helped me physically, but I feared falling again and refused to leave my house. Just the thought of going outside made me anxious and even physically sick. I would have nightmares of falling and waking up trying to catch my breath. Sometimes, I was afraid to go to sleep. Then I began to worry about my next fall. Would it be my last? Would I go to the hospital and never return home again? I didn't want to do anything for fear of falling, I was really a prisoner in my house. My homecare provider finally told me my fears were unhealthy and suggested counseling, which I did. It took a while, but I am finally returning to the senior center and going places with friends. I'm feeling much better."
A Serious Issue
"The Centers for Disease Control (CDC) states that millions of seniors fall annually. That's one in four of those over the age of sixty-five," said Attorney Connelly. "And the risk of falling once doubles the risks of falling again." Here are some statistics from the CDC about falls in older adults:
One of five falls causes a severe injury such as broken bones or a head injury.
Each year, three million older people are treated in emergency departments for fall injuries.
Over 800,000 patients are hospitalized yearly because of a fall injury, often a head injury or hip fracture.
Each year at least 300,000 older people are hospitalized for hip fractures.
More than 95% of hip fractures are caused by falling, usually by falling sideways.
Falls are the most common cause of traumatic brain injuries (TBI).
In 2015, the medical costs for falls totaled more than $50 billion. Medicare and Medicaid shouldered 75% of these costs.
"Those numbers are telling, but only account for the physical injuries," stated Attorney Connelly. "Emotional damage is also present, and this is often not addressed. Thankfully, the Department of Psychiatry at Weill Cornell University in New York is researching this. In a preliminary report, the researchers report that twenty-seven out of one hundred seniors who fell had symptoms of PTSD. So as the study progresses, we must recognize that falls also have an emotional impact that cannot be ignored, and the impact on a senior's life can be just as consequential as a physical injury."
Some of the most common symptoms of PTSD are experienced by seniors who fall. They include:
Nightmares or flashbacks of the event.
Intense feelings of fear, anxiety, or guilt about the fall or inability to be a part of social events.
Difficulty remembering what happened during and after the fall, including being removed from the house and the rehab experience.
Avoiding talking about the incident or anything related to it.
Knowing the signs of PTSD and catching it early can help a senior avoid long-term issues resulting from not treating it.
What Can Help
"There are several things that can be put into place to help those experiencing PTSD or any emotional or behavioral response to their falls and the trauma associated with them," stated Attorney Connelly. These services include:
Individual Therapy - Meeting with a therapist one-to-one to help the senior cope with the anxiety associated with the event. Today, these treatments can begin in the home and even over the phone with Telehealth services, eventually progressing to leaving the house and going to the therapist's office.
Group Therapy - Such therapy is beneficial in letting those with PTSD from fall traumas understand that they are not alone in what they feel.
Family Therapy - This type of therapy is essential if family members are involved in the caretaking of the senior or if they spend considerable time with the senior. This therapy helps all concerned understand what the senior is experiencing and learn ways to support them.
Medication - Some pharmaceuticals can help seniors who cannot manage their symptoms through therapy alone. Most of these medicines are in the categories of antidepressants or anti-anxiety medications.
"Exploring the possibility of PTSD in seniors who experience falls is research still in its infancy," stated Attorney Connelly. "But it does make sense regarding the symptoms they experience following such an event and the treatment they need to address their mental health needs. We must also consider the other issues after the physical injury that could contribute to the development of PTSD, such as removal from the home, spending considerable time in rehab away from familiar surroundings, and anxiety about losing their independence. We truly need to do much more to meet the mental health needs of our seniors."