While falling down is usually played for jokes on television and the Internet, for millions of older Americans it's no laughing matter.
Every 18 seconds, an older adult is in the emergency room because of a fall, according to the Centers for Disease Control and Prevention.
That translates into a person 65 or older dying, due to a fall, every 35 minutes, according to the CDC.
"Most falls are never reported. People don't go to the hospital, they just go home, and they're injured, they nurse their injuries themselves," saidNational Council on Aging CEO Jim Firman.
It means the person's loved ones or spouses often become caretakers. Lillian Sacks is one such person. Eight years ago her husband, Julian Sacks, fell while riding the subway.
"He's been on a steady decline since that time," she said.
During the summer, Julian fell again.
"He said, 'I can't take this anymore. I don't wanna live anymore,'" said 81-year-old Lillian. "He stopped eating."
The couple's more than 25-year love story ended when he died in August.
The Sacks' story is not unusual. Annually, 1.8 million older adults are treated for falls, which results in $20 billion in direct costs. And as baby boomers age en masse, the costs are expected to more than double in the next decade to $54 billion.
"This is absolutely a public health crisis," said Sen. Barbara Mikulski, D-Md. "Over the next 10 years, our baby boomers will be coming of age. Twenty percent of our population will be over the age of 65."
Mikulski led a six-year fight for the first fall-prevention bill to study the impact of falls on health care costs.
"Many of those falls are due to quite preventable factors, like weakening, losing strength, bad footwear, medication interactions," said Jule Kardachi, who co-founded the FallStop...Move Strong Program four years ago to help older adults prevent falls. "We address all of that...in our class."
FallStop combines strength training to help balance, and practical tips to minimize risks. What began as a handful of students in the group has grown into a business with proven results.
"For every person, without exception," Kardachi said, "their risk went from either high to moderate or low, or from moderate to low risk or outside the risk range. So we know it works."
Kardachi believes the results are important because about a third of people who fall die within a year from complications.
The exercises taught in the class aren't easy, but for 88-year-old Joe Siegel they literally and figuratively keep him going.
"She's not going to give you a minute to breathe," he said of the class instructor. His favorite part is "when it ends."
But for Siegel's daughter, Hudj Siegel, it means peace of mind.
"I think the people in the group care about each other and they check in and it means a lot," she said. "I think it's very much as psychological as physiological."
The classes strengthen muscles to keep clients from shuffling. They also learn to reduce clutter at home to prevent tripping and they're taught how to navigate the real world, such as how to get in and out of a car.
These are lessons which Lillian Sacks uses to ensure her safety.
"When I'm not concentrating on my posture and the way I'm walking, I feel like an old lady. I'm hunched over. And when I start thinking about walking properly," she said, "I feel stronger, and I feel more optimistic about the future."