FEAR OF FALLING
He won't start to walk normally until about July. The cost of treatment - paid by his health plan - could approach $150,000, said his wife, Ella.
"I was stunned at how dangerous such a little task could be. Now I know: Steps, water and slippers ... are an evil combination," Kovalcheck, 60, said from his bed at Sharp Cabrillo Skilled Nursing Center in San Diego.
The growing risk of falls for baby boomers such as Kovalcheck, owner of a bar near the beach, is the focus of public agencies and nonprofit organizations nationwide.
Those groups are trying to prevent falls particularly for people in their 50s to mid-60s, unlike past programs that targeted only those 65 and older.
Baby boomers generally don't think they're growing old, so they pay little attention to everyday hazards, said Beth Sise of the San Diego County Fall Prevention Task Force, a partnership of agencies and private health groups.
Many of these dangers exist in and around the home, including uneven sidewalks, bathtubs without wall bars and drugs that make people drowsy.
"We have so much on our plates and on our minds, we don't pay enough attention to what's going on. It's the fall of distraction," said Joanne Price, former chairwoman of the county's Fall Prevention Task Force and author of the book "Fall Injury Prevention for Older Adults."
It's unclear whether the rate of falls is keeping pace with the increase in older Americans. But the number of baby boomers is enough to cause concern, said Roger Trent at the Injury Control Branch of the California Department of Public Health.
"The baby boomer tsunami about to hit will make this a much more compelling issue," said Barbara Alberson, who is from the same agency.
In San Diego County, for example, of all patients 45 to 64 who were treated in hospital emergency rooms for 15 types of injuries in 2006, 27 percent came in because of a fall. The figure for people 65 and older was 57 percent, according to the county's Emergency Medical Services agency.
The national numbers are similar. They have surprised many health officials who once thought home fires and car accidents were bigger risks for seniors than falls, said John Pynoos, co-director of the Fall Prevention Center of Excellence at the University of Southern California.
Even if people do think of falls as a hazard, he said, "they tend to think falls just happen and that nothing can be done."
Medical experts said the importance of prevention can't be overstated.
About 80 percent of people who suffer a serious fall - one that lands them in the doctor's office or hospital emergency room - will have another fall within a year, according to state health officials and the U.S. Centers for Disease Control and Prevention.
Knowing that major falls cause permanent disability for many older adults, health experts want to help baby boomers maintain their productivity and quality of life.
"There's now momentum," said Lynn Beattie, vice president for injury prevention at the National Council on Aging in Washington, D.C.
"Many older adults, including baby boomers, are still working, volunteering, paying taxes. Or they're guardians for their grandchildren. They make a tremendous contribution that is lost if they suffer a fall," she said.
On April 8, Congress passed the Safety of Seniors Act. It became law at the end of April and will pave the way for more research on the best ways to prevent falls.
Education about falls also takes place outside of the medical setting.
For example, San Diego County helps fund the nonprofit groups Jewish Family Service and Interfaith Community Services to conduct home-safety inspections for people who have suffered a fall or may be prone to one. Studies show that about two-thirds of all serious falls occur in the home.
Most fall-prevention measures may seem like common sense. But people often take risks because they fail to recognize how easy they could suffer a fall, health officials said.
The greatest causes of falls are people tripping or stumbling over something, such as a rug or door threshold, said Price, the former chairwoman of the county's Fall Prevention Task Force.
Other household dangers include insufficient lighting; clutter around the house; people reaching too high, low or far forward for something; floors and other surfaces that are slippery; shoes and slippers without proper anti-skid soles; clothes that might cause a person to trip; and lack of handrails.
Also, health experts advise older adults to talk with their doctors about medications and eyesight problems that may cause distortions in depth and distance.
They stress the importance of nutrition as well. Poor eating habits can lead to diabetes, which can lead to reduced sensitivity in the feet and lower limbs, which heightens the risk for falls.
Then there's the pivotal role of exercise.
Accumulating evidence shows that people younger than 65 who don't exercise regularly are more likely to eventually suffer a fall compared with those who do, said Judy Stevens, an epidemiologist at the Centers for Disease Control and Prevention.
Nationwide, groups are promoting exercise programs for seniors and about-to-be seniors. These classes help people build certain muscles so that if they do lose their balance, they will have more strength to regain their footing. Some of the programs even teach people ways to fall that could minimize head injuries.
One good exercise is tai chi, because its increases balance and leg strength, said Stevens, who co-wrote "Preventing Falls: What Works," a new book filled with exercise programs, home repairs and medical assessments designed to prevent falls.
For prevention efforts to succeed, health officials said, baby boomers must acknowledge that aging raises their risk of falls and lengthens their recovery time.
Dr. Kevin Haynes, a San Diego gastroenterologist at Scripps Mercy Hospital, learned first-hand that older adults don't bounce back as easily as 20-year-olds.
While trying to get Halloween decorations from a garage shelf in 2005, "I did a stupid thing," he said. "On the top of the ladder where it says, 'Don't step there,' I stepped there. I flew out seven feet onto a concrete floor."
Haynes, who was about 50 at the time, fractured his right heel in three places. For months, if he had to go any distance, he had to use a wheelchair.
Now, he said, his right foot still hurts from time to time.
© Copley News Service
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