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July 3, 1996

An 85-Year-Old Woman With a History of Falls

Author Affiliations

Dr Lipsitz is associate professor of medicine, Harvard Medical School, and codirector, Research and Training Institute, Hebrew Rehabilitation Center for Aged, Boston, Mass.

JAMA. 1996;276(1):59-66. doi:10.1001/jama.1996.03540010061031

Dr Delbanco:  Mrs R is an 85-year-old widowed retired municipal worker who is the mother of 2 sons, one of whom is unmarried and lives with her in an urban community near Boston, Mass. Born in Italy, Mrs R came to the United States as a teenager and worked until retiring 10 years ago because of progressive arthritic pain and accompanying unsteadiness. She has no income other than Social Security, receives Medicare, and is eligible for lifesaving free medications at the Beth Israel Hospital, where she has been cared for by a general internist, Dr B, for more than 20 years. In recent years her medical problems have focused on difficulty walking and several falls and near falls, resulting in her being virtually homebound. She lives on the first floor of a house with a few steep steps outside the entrance, which limit her ability to move in and out