NFPA Journal - Summer 2022 - 77

Scaling up
The first version of Remembering
When was launched in 1999, and the
program was revised into its current
form in 2013. However, despite best
efforts, death rates from falls among
seniors in the United States have
increased by about 30 percent since
2009, according to the US Centers for
Disease Control and Prevention (CDC).
More than 3 million older adults are
now treated annually in US emergency
rooms from accidental falls, the CDC
says, resulting in about $50 billion in
inpatient and outpatient hospital costs.
The total number of falls among older
adults, most of which are not captured
by hospital or fire data, is closer to 36
million per year, resulting in 8 million
injuries; by 2030, there will be a staggering
52 million falls each year, the
CDC predicts.
One of the explanations for these
developments is that the population
of older adults in the US has surged in
recent decades, a trend that is expected
to accelerate. Since 2009, the number
of people aged 65 and over has risen
36 percent, to 54 million people, far
outpacing the 3 percent population
gain of all other age groups over that
span, according to US Census data. By
2040, there are expected to be nearly
81 million older adults, and they will
make up more than 21 percent of the
population, compared to about 16
percent today. Similar trends are also
happening in Canada.
Cultural factors are also contributing
to the fall problem, experts say.
" People all across North America are
staying in their homes longer-they
aren't moving to assisted living until
they are well into their 80s, whereas
20 years ago that was happening in
their 70s, " Krahn told me. " There is
this cultural mindset shift to independence
and it's a good thing-but
the unintended consequences include
more falls and more lifts. "
More older adults are also living
alone. According to a 2019 report by the
Harvard Joint Center for Housing Studies,
42 percent of households headed
by someone 65 or older contained only
one person, and 57 percent of households
headed by someone 80 or older
had only one person. If the trend continues,
by 2038 there will be more than
10 million single-person households in
the US with someone 80 or older.
These large-scale demographic
trends have been emerging for a while
and have the attention of the public
'People all across North
America are staying
in their homes longer-
they aren't moving to
assisted living until they
are well into their 80s,
whereas 20 years ago
that was happening in
their 70s. There is this
cultural mindset shift
to independence and it's
a good thing-but the
unintended consequences
include more falls and
more lifts.'
safety community. Even before the
pandemic sent much of the world into
isolation, there was consensus among
educators that Remembering When
needed to be more dynamic and more
digital. For more than a decade, the
program's content and approach had
changed little. At its core are two key
activities: an in-person presentation
to a group of seniors centered around
fall and fire prevention messages, and
a home visit where an educator walks
through asking questions and pointing
CONFERENCE
SESSIONS
Steps to Safety™
:
A Community Approach to
Prevention of Fire and
Falls Among Older Adults
Monday, June 6, 8-9 a.m.
Andrea Vastis, NFPA;
Jamie McAllister, FireTox
The Impact of Drugs
on Fire Risk
Tuesday, June 7, 10:30 a.m.-noon
Robert Wachter, UCSF;
Zelda Zhao, Brendan McCarrick,
and Jamie McAllister, FireTox
out changes that would help reduce the
resident's risk of a fall or fire.
While those efforts have helped
countless seniors avoid injury in communities
across the US and Canada,
they are time consuming and not
particularly scalable, especially considering
the size of the problem. To
make matters worse, Vastis said, " both
approaches are very much pre-COVID
constructs, " and further, they are out
of step with the digital direction that
the world, including many seniors, is
moving.
To better align Steps to Safety with
how people live and communicate, a
library of digital resources is being created
to supplement traditional outreach
methods, which will allow fire departments
and others to continuously push
out messages to seniors through online
platforms and social media. In lieu of
attending a group presentation, which
has been impossible during COVID,
older adults can watch them at home
and on their phones. A portion of the
new videos will feature seniors talking
directly to their peers about their own
struggles with falls and how they were
able to make simple changes around
their homes that made a difference.
The idea is to help seniors overcome
the stigma and embarrassment many
feel about admitting they are aging and
that they may need more help-a significant
hurdle to making safety changes,
public educators told me.
" So many people will just say, 'I'm
not that old-this is not happening to
me,' " Krahn said. " And when they do
fall, they are too embarrassed to talk
about it. They think, 'well, that's not
going to happen again.' When it does
happen again, they rationalize it by telling
themselves 'that wasn't really a fall,
I just slipped getting out of bed.' People
are really good at redefining things to
fit their mindset. "
Better and more efficient ways to
reach seniors, however, is just one part
of the plan to improve the reach of
Steps to Safety. The other is to vastly
increase the number of people trained
in delivering its safety messaging. The
number of educators implementing
Remembering When was always relatively
small, especially considering the
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NFPA Journal - Summer 2022

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