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Facts and Stats

For elderly people who live alone, becoming incapacitated and unable to get help is a common event, which usually marks the end of their ability to live independently.

In a typical case, a neighbor notices that mail has piled up at an elderly person’s home and calls emergency services.

Statistics show that patients who are helpless for more than 72 hours have a mortality rate of 67%, as opposed to 12% for those who get help within an hour.

For patients who survive prolonged periods of time spent helpless in their homes, tremendous suffering could be reduced by early intervention.

Examples:

  • An 82-year old woman was found by a neighbor during a routine check. She was lying on the floor, soiled by dirt, feces and urine, and had garbled speech. She was estimated to have been incapacitated for more than 72 hours. She was admitted with decubitus ulcers and dehydration.
  • A 78-year old woman was found on her bed by the paramedics after a neighbor called for help. She stated that she had been unable to get up for two days. She denied falling. She appeared dehydrated, and her lips had cracked and bled. She then spent nine days in the intensive care unit.
  • A 95-year old man was found by his caretaker wedged between the toilet and the bathtub. The patient said that he had sat on the toilet at noon the day before and was unable to get up. He tried to move to the floor but mistakenly lowered himself between the toilet and the bathtub.
    – New England Journal of Medicine, Jun ’96.

Falls

How Often do Falls Occur?

  • More than one-third of adults 65 and older fall each year. The risk of falling and fall-related problems rises with age.
    – Centers for Disease Control and Prevention, ’05
  • Falls occur in 30% of women in the 65-69 age group and in more than 50% of women over the age of 85.
  • 7% of older people that fell once fell again at least once in the following year.
  • 50% of falls occur within the home and immediate surroundings. The other 50% occur in public places and other people’s homes.
  • Falling rates increase in those with stroke or Parkinson’s disease.

Benefits of Early Intervention

  • 50% of those who lie on the floor for an hour or longer die within 6 months, even if there is no direct injury from the fall
  • 47% of non-injured fallers are unable to get off the floor without assistance.
  • 20% of patients admitted to a hospital because of a fall had been on the ground for an hour or longer
  • The cost per injured elderly person resulting from a call was $7399 in 1994.
    – FALLS in older people. Risk factors and strategies for prevention. Cambridge University Press, 2001.

Heart Attacks

How Often do Falls Occur?

  • Heart failure affects approximately 5 million Americans, half of whom are at least 75 years of age, and is the leading cause of hospital admissions among older adults. Additionally, the prevalence of heart failure is increasing, largely owing to the aging of the population.
    – The Medical Clinics of North America, Sep ’96.
  • Approximately two-thirds of all out-of-hospital SCA cases are 65 years of age and older.
    – The American Journal of Geriatric Cardiology, Oct ’97.
  • Age is the major risk factor for cardiovascular disease. Heart disease and stroke incidence rises steeply after age 65, accounting for more than 40 percent of all deaths among people ages 65 to 74 and almost 60 percent for those 85 and older.
    – Richard J. Hodes, MD, Director, National Institute on Aging.

Benefits of Early Intervention

  • The survival rate of out-of-hospital cardiac arrest victims who are able to call 911 is 71% higher than for those who are not. This is partially the result of the decreased time from collapse to cardiopulmonary resuscitation (CPR) and to first shock (if in ventricular fibrillation [VF]).
    – The American Journal of Emergency Medicine, May ’93.
  • The survival rate of out-of-hospital cardiac arrest is just 15%. What is the common denominator among survivors? Shorter intervals from collapse to CPR (1.7 vs. 5.2 minutes) and to defibrillation (7.4 vs. 9.5 minutes.)
    – Annals of Emergency Medicine, Nov 93.
  • Many heart attack victims die before they reach a hospital. The sooner someone gets to the emergency room, the better the chance of survival. Prompt medical treatment also reduces the amount of damage done to the heart following an attack.
    – National Institutes of Health.
  • When someone collapses from sudden cardiac arrest (SCA), immediate cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) are essential for any chance of recovery. The rate of survival after a SCA drops 10% after each minute that CPR and AED are not provided. Actually as many as 30 to 50 percent would likely survive if CPR and AEDs were used within five minutes of collapse.
    – Sudden Cardiac Arrest Association, Jun ’08.

Strokes

How Often do Falls Occur?

  • Strokes are the third most common cause of death and the most common cause of disabling neurologic damage.
  • Over two thirds of all strokes occur in people older than 65.
  • 80% of strokes are ischemic (blocked artery) and 20% are hemorrhagic (ruptured artery.)
    – The Merck Manual of Medical Information

Benefits of Early Intervention

  • The damage from a stroke depends on how long brain cells are deprived of blood – just several minutes can cause brain cells to die and some functions to be lost.
    – The Merck Manual of Medical Information
  • Of all people that have a stroke, about a third are likely to die within the first ten days, about a third are likely to make a recovery within one month and about a third are likely to be left with disabilities and needing rehabilitation. However this rule of thirds could and should be broken if stroke is treated as a medical emergency.
    – Joe Korner, Director of Communications, The Stroke Association, UK
  • From emergency department arrival to initial physician evaluation should last less than 10 minutes.
    – National Health Institute National Symposium Recommendations, Feb ’08.
  • Late arrival to the hospital after the onset of acute stroke symptoms is a plague of unheralded proportion.
    – Stroke. American Stroke Association, ’07
  • Time is Brain. The typical patient loses 1.9 million neurons each minute in which stroke is untreated.
    – Stroke. American Stroke Association, ’06
  • Time Lost is Brain Lost
    – American Stroke Association
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