Falls Projected to Cost Nearly $60 Billion by 2020

Falls among seniors—most of which occur in the home—are projected to kill thousands more older adults and cost tens of billions of dollars by the year 2020.

That’s according to a new report from the U.S. Department of Housing and Urban Development (HUD) titled “Overcoming Obstacles to Policies for Preventing Falls by the Elderly,” which aims to bring awareness to senior fall prevention efforts and coordinated care policies and programs throughout the U.S.

Healthy Housing Solutions, an Office of Lead Hazard Control and Healthy Homes (OLHCHH) contractor, developed the report based on a review of literature and feedback from industry experts relating to senior falls.


Falls are a rapidly growing problem for adults age 65 years or older. Roughly one-third of all seniors fall each year, mostly at home. Though most seniors who fall sustain minor injuries, up to 30% suffer moderate to severe injuries, including some that are fatal, according to the report.

Falling is the fifth-leading cause of death among seniors. Currently, just over 20,000 seniors die each year due to fall injuries, a number that could increase to more than 40,000 in 2020.

The problem is also getting pricier, the report shows. Expenditures related to injuries sustained as a result of seniors falling could grow to $59.7 billon by 2020.


Still, despite the growing risk and cost, “comparatively few communities” are adopting the kind of programs and policies that would reduce falls, the report noted. But there are ways to help mitigate the risk of falling for seniors.

Reducing fall risks 

Coordination of care and the promotion of aging-in-place practices can help prevent mishaps or injuries related to falling. Specifically, the report recommends three programs:

  • SASH (Support And Services at Home), a Vermont-based program, provides seniors with comprehensive service management of their housing, health care and social service needs. In this program, coordinators and wellness nurses help seniors navigate the health care system to receive the medical care and assistance they need to age in their homes.
  • Capable (Community Aging in Place, Advancing Better Living for Elders) is a program that combines nursing care, occupational therapy services and home improvement work to help older adults live at home longer. Seniors in the program identify functional goals they’d like to achieve, such as walking up stairs without pain or taking a shower more easily, then work with an occupational therapist, nurse and handyman to help facilitate those goals. Currently, Capable operates in Maryland, Colorado, Michigan, North Carolina, California, Vermont and Pennsylvania.
  • PACE (Program of All-Inclusive Care for the Elderly) is a Medicaid-sponsored program that provides coordinated care through an interdisciplinary team of health professionals. Financing for the program is capitated, meaning providers can deliver all of the services to participants rather than only those reimbursable under Medicare and Medicaid fee-for-service plans.

Another way to help mitigate fall risks is through the use of Medicaid waivers and managed care plans for assessments, interventions and home modifications. The report suggests allowing an expansion of Medicare coverage to include home modifications and more ways for seniors to age in place, such as funding and reimbursement for assessments and training with assistive devices.

Expanding programs such as CDBG, Older Americans Act, and Americans with Disabilities Act to cover modifications like ramps and chair slides would allow seniors to remain at home and significantly reduce the need for funding of nursing homes, the report also suggests.

For more findings, read the full report on the HUD website.

Written by Tim Regan

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