Fatal Falls Rising in Older Adults

The Centers for Disease Control released a sobering report on mortality due to falls and other unintentional injuries in older adults. The good news: death from motor vehicle accidents has fallen since 2000, and death from other unintentional injuries such as suffocation, fire, and poisoning remain relatively rare. The bad news: between 2000 and 2013, the age-adjusted rate of death from falls in older adults nearly doubled, from 30 deaths per 100,000 adults to 57 deaths per 100,000 adults. Among adults at the upper reaches of age, the death toll from falls is even more striking. In 2012-13, there were 226 deaths due to falls per 100,000 adults.

Figure 2. Age-adjusted death rates, by cause of death among adults aged 65 and over: United States, 2000–2013

While concerning, these numbers only scratch the surface of the total burden of falls in older adults. According to the CDC, in any given year, one in three older adults will have a fall, and 20-30% of adults who fall will suffer a moderate or severe injury. These injuries and the fear of falling can have profound impacts on quality of life and subsequent morbidity and mortality. As a results, the total mortality burden from falls likely far exceeds the immediate risk of fall-related death cited in the CDC's latest report.

Why are fall-related deaths increasing? The answer likely is complex, and includes changes in the distribution of underlying chronic illnesses as well as better reporting of falls as a contributor to death. Whatever the cause, more action is needed, and emerging initiatives and interventions - such as a falls reduction program being studied by a consortium of Pepper Centers - will be vital to the solution.

by: Mike Steinman

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Lost in Translation: Google’s Translation of Palliative Care to ‘Do-Nothing Care’

by: Cynthia X. Pan, MD, FACP, AGSF (@Cxpan5X)

My colleagues often ask me: “Why are Chinese patients so resistant to hospice and palliative care?” “Why are they so unrealistic?” “Don’t they understand that death is part of life?” “Is it true that with Chinese patients you cannot discuss advance directives?”

As a Chinese speaking geriatrician and palliative care physician practicing in Flushing, NY, I have cared for countless Chinese patients with serious illnesses or at end of life. Invariably, when Chinese patients or families see me, they ask me if I speak Chinese. When I reply “I do” in Mandarin, the relief and instant trust I see on their faces make my day meaningful and worthwhile.

At my hospital, the patient population is about 30% Asian, with the majority of these being Chinese. Most of these patients require language interpretation. It becomes an interesting challenge and opportunity, as we often need to discuss advance directives, goals of care, and end of life care options…

Elderhood: Podcast with Louise Aronson

In this week's podcast we talk with Louise Aronson MD, MFA, Professor of Geriatrics at UCSF about her new book Elderhood, available for purchase now for delivery on the release date June 11th.

We are one of the first to interview Louise, as she has interviews scheduled with other lesser media outlets to follow (CBS This Morning and Fresh Air with Terry...somebody).

This book is tremendously rich, covering a history of aging/geriatrics, Louise's own journey as a geriatrician facing burnout, aging and death of family of Louise's members, insightful stories of patients, and more.

We focus therefore on the 3 main things we think our listeners and readers will be interested in.

First - why the word "Elder" and "Elderhood" when JAGS/AGS and others recently decided that the preferred terminology was "older adult"?

Second - Robert Butler coined the term ageism in 1969 - where do we see ageism in contemporary writing/thinking? We focus on Louise's…

Psychedelics: Podcast with Ira Byock

In this week's podcast, we talk with Dr. Ira Byock, a leading palliative care physician, author, and public advocate for improving care through the end of life.

Ira Byock wrote a provocative and compelling paper in the Journal of Pain and Symptom Management titled, "Taking Psychedelics Seriously."

In this podcast we challenge Ira Byock about the use of psychedelics for patients with serious and life-limiting illness. Guest host Josh Biddle (UCSF Palliative care fellow) asks, "Should clinicians who prescribe psychedelics try them first to understand what their patient's are going through?" The answer is "yes" -- read or listen on for more!

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Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

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