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Marlene Hellenbrand went to get Christmas decorations in her basement at Waunakee when she fell down the stairs and died at the age of 74.
Jack Kammer from Madison tried to clear the snow from his parable so he could watch basketball. He fell and died two months later at age 84.
Dorothy Seeman was up at night to use the bathroom of her apartment in Janesville. Fourteen hours later, she was found on the floor with cuts and bruises. After short stays in the hospital and in a retirement home, she died at age 85.
"It was a very fast downward spiral," said Angie Sullivan, Seeman's granddaughter.
Wisconsin has the country's highest death toll among seniors, according to a report last year by the Centers for Disease Control and Prevention. Some 1,365 residents aged 65 and over died from a fall in 2016, more than twice the national average.
Marlene, the wife of 54-year-old Marv Hellenbrand, died on November 26 when she fell into the basement staircase of their Waunakee home. They had decorated their house for Christmas, but she apparently went down for more ornaments, said Marv Hellenbrand and her daughter, Stacey Royston, who found her. "She's never finished decorating," said Marv.
In Wisconsin, falls are more numerous than breast and prostate cancers combined. The falls resulted in approximately 129,000 emergency room visits and nearly 16,000 hospitalizations in 2017, according to the state 's Department of Health Services. Medical expenses related to falls, paid primarily through taxpayer funded Medicare and Medicaid programs, exceeded $ 1 billion.
It is unclear why Wisconsin is at the top of the fatal falls, but experts cite several possible reasons: freezing winters; excessive consumption of alcohol, including among the elderly; the population is older and whiter than the American average; and officials here could point to falls as the cause of death better than in other states.
"It's multifactorial," said Dr. Jane Mahoney, UW-Madison's geriatrician, who has done extensive research on falls. "You add to the alcohol, the winter climate … relationship differences … all playing a role."
In Wisconsin, the fatal death rate among seniors, which has always been ranked first among states, has increased by 50% between 2007 and 2016, an increase over that of 31% nationally. As the state's seniors population grows six times faster than the general population by 2040, the burden of falls is expected to increase.
Inez Hartel, who lives near Fort Atkinson, has fallen several times, breaking the pelvis and skull. She is assessed by Dr. Gerald Pankratz, Geriatrician, at Mobility and Falls Clinic at UW Health.
The state legislature has approved $ 200,000 per year for falls prevention and other efforts for healthy aging in 2015. Two years later, when advocates asked for $ 600,000 per year, the legislator has totally abandoned the funding. The biennial budget proposed by Governor Tony Evers, released Thursday, provides $ 250,000 per year.
"This is an incredibly prudent investment in money and humanity," said Betsy Abramson, executive director of the Wisconsin Institute for Healthy Aging. "How the state can not invest in prevention in this area is beyond me."
Melissa Heinz, injury and violence prevention coordinator at the state's Department of Health, said some of the funds allocated to local health departments and resource centers on aging and disability is used to help prevent falls. However, there is no state money for the reduction of falls, as is the case for other problems such as poisoning, child abuse and road accidents.
"Fall prevention is a major concern, but it is not specifically identified as being more important than all other public health issues," said Heinz.
However, she said: "We must absolutely make people aware of the risk of falling, especially among the elderly."
Winter time
In Wisconsin, the month with the most deaths due to falls is December, followed by January, March, and November, according to a Wisconsin State Journal analysis of data from falls in the states from 2014 to 2017.
Cold temperatures and snow, which can make sidewalks slippery, could be a reason. But other considerations call into question the influence of the winter climate on the rate of fatal falls.
Jack Kammer, a Madison dentist who died after falling in front of his home in 2010, was shown two years earlier, when he had published a book on his annual annual Holiday Lights exhibition on University Avenue.
Some states with similar winters – Vermont, Minnesota, Colorado and South Dakota – rank immediately after Wisconsin in the CDC report. But others, like Michigan, Illinois and Indiana, have low rates, which presents a mixed picture.
Weather may be a contributing factor for outdoor falls, but most falls among older adults occur in the interior, said CDC Health Scientist Elizabeth Burns and lead author of the report on falls. Deaths attributed to falls may occur months later and be reported in subsequent seasons, making it difficult to identify the role of the weather, Burns said.
"This is not a slam dunk," she said.
Excessive consumption
The distinction does not fade between people aged 65 and over: 8.8% of people in the state reported excessive alcohol consumption and 6.3% excessive alcohol consumption in 2017 compared to 4.9% nationally, according to the CDC.
According to the state's Department of Health, out of a total of 1,383 life-threatening falls among Wisconsin's seniors in 2017, about 443 were related to alcohol consumption.
As older people in Wisconsin are more likely to drink too much, it makes sense that the high rate of fatal falls in the state stems in part from alcohol consumption, said Dr. Gerald Pankratz, a geriatrician who runs the clinic. UW Health from Mobility and Falls.
As people get older, their stomachs and livers break down alcohol more slowly and their brains retain alcohol longer, Pankratz said.
"It takes less to be intoxicated, and you're intoxicated longer," he said. "The intoxication will definitely have a negative impact on your balance and your judgment."
Marv Hellenbrand stated that his wife, Marlene, sometimes used a walker at her home in Waunakee. He got rid of the rugs and installed some support bars in the bathroom to prevent it from falling, but she died in November from a fall in the bathroom. stairs of the basement.
Wisconsin had 12,963 bars and restaurants licensed to sell alcohol in 2017, double the national average, according to the Beverage Information Group, which publishes data on the beverage alcohol sector.
Some municipalities have approved "click and collect" policies that allow customers to order groceries online, including alcohol, and pick up the goods in their vehicles. This could be particularly interesting for seniors with mobility impairments, said Julia Sherman, coordinator of the Wisconsin Alcohol Policy Project at UW-Madison Law School.
"We're making alcohol consumption all the time," Sherman said.
Demographics
The demographics could help explain the high rate of fatal falls in Wisconsin. About 16.5% of the state's population is 65 or older, compared with 15.6% nationally. The CDC adjusts this difference in its rankings, Burns said.
But 2.1% of the state's residents are at least 85, compared to 1.8% nationally, which the CDC might not consider, Burns said. This group is more likely to die from falls, she said.
In Wisconsin, 87.3% of whites and 6.7% of blacks. At the national level, the figures are 76.6% and 13.4%.
Nationally, among older adults, blacks report 24% fewer falls than whites, according to a 2014 study by the Journal of Aging and Health. Older blacks may be less likely to fall because they are less mobile or more likely to live with parents, which protects them from falls, researchers said.
Reporting fatal falls
Wisconsin may report deaths from falls more extensively than other states, which makes its fatal falls rate seem comparatively higher. "I think the Wisconsin data is probably more complete," Burns said.
Dr. Brian Peterson, a medical examiner in Milwaukee County, the most populous county in the state, said deaths that appeared to be due to pneumonia or other conditions could be the result of falls from previous months. If the investigators do not ask the right questions, they may not find out and report it, he said.
"We are more attentive and more cautious," said Peterson.
Angie Sullivan's grandmother, Dorothy Seeman, died at the age of 85 after falling in her bathroom at Janesville in 2012. Sullivan, who is now working in promoting the health of Seniors and leading fall prevention courses, said several measures could have helped Seeman avoid the fall. including the support bars and exit from a seizure medication.
Death investigators in Wisconsin are trained to be more aware of the falls, said Barry Irmen, director of operations for the Dane County Medical Examiner's office, which includes Madison and is the second most populous county in the world.
Wisconsin's death reporting requirements are similar to those in other states. But Michelle Smith, head of the state registry of the state's health department, said the state urged forensic and coroners to reinstate death certificates if the information were incomplete, which could help improve fall data.
Still, Dr. Jonathan Lucas, Los Angeles County Medical Examiner, the most populous county in California, said he and his colleagues were thoroughly investigating the falls. California had the fifth-lowest fatal death rate among seniors in 2016, with rates lower than one-third of Wisconsin's.
"I am confident that we identify these deaths," said Lucas. "It's hard to believe that a big difference is due only on the record."
"She did not listen to me"
Hellenbrand, who died falling down the stairs at the end of November, was suffering from Parkinson's disease, which affects the balance. She sometimes used a walker and her husband got rid of the rugs and put support bars in the bathroom to prevent falls.
"I told her that she should not go up and down the stairs unless I'm at home," said Marv Hellenbrand, former chief of Waunakee's fire department.
A recent photo of Marlene Hellenbrand, left, is shown next to an old photo of her with her husband Marv Hellenbrand. Marlene Hellenbrand used shoes for tap dancing before developing Parkinson's disease. In November, she died when she fell into the basement staircase of the couple's house in Waunakee.
When she died, he was in a pharmacy to take one of his meds. "I guess she did not listen," he said.
The couple had adorned their home for Christmas, but she apparently went to look for other ornaments in the basement. "She never finished decorating," he said.
Kammer, a well-known dentist in Madison for placing tens of thousands of Christmas lights every year along University Avenue, died in May 2010, two months after his fall.
He climbed a ladder to try to get to his parable but fell hitting his head against the side of the house, said his son Chris Kammer of Madison. "He intended to watch March Madness," said Chris Kammer.
Jack Kammer was relatively healthy. After the fall, he was operated on for the head injury but did not recover.
"Obviously, he would not have died (at that time) if he had not fallen," said Chris Kammer.
Steps to prevent falls
Seeman also lived independently in her main apartment before falling in her bathroom in 2012. She was found 14 hours later after missing a hair appointment.
The fall did not cause him a fracture, and his scratches and bruises were not serious. But while she was lying on the floor, her skin began to tarnish, causing an open sore, said Sullivan, her granddaughter.
Seeman never regained the ability to walk unassisted and died five weeks later in a retirement home. "It's amazing how fast she came down," said Sullivan.
Photographs of Dorothy Seeman, who died after falling in her bathroom and lying on the floor for 14 hours, are on display in the home of her granddaughter, Angie Sullivan, in the Milton area.
Sullivan, who lives near Milton, now works to promote the health of seniors and teaches fall prevention classes.
Her grandmother did not have a support bar in her bathroom, nor a raised toilet seat or night light. She did not have a mobile phone or warning system and no one was watching her every morning. She took an unnecessary antiepileptic drug, which can harm the balance until it falls.
Sullivan now realizes – and teaches – the importance of such precautions.
"There are some very simple things people do not think about that can really make an impact," she said.
This article was funded by a journalism scholarship from the American Society of Gerontology, the Network of Journalists on the Generations and the John A. Hartford Foundation.
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