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Working together to prevent falls

Developed by: Banyule Community Health (adapted and modified from the Boroondara (now Inner East) Primary Care Partnership Step Safely Program)Format: Manual, PowerPoint presentation and evaluation formsAvailability: Download manual <PDF version> <Word version>Download PowerPoint presentation <PDF version> <PowerPoint version> Download pre and post evaluation forms <PDF version> <Word version>

This HACC workers falls prevention training manual provides an overview of a one hour training session aimed at local government home and community care staff. The aim of the session is to inform participants of the consequences of falls, demonstrate that falls are preventable, increase the knowledge and ability of staff to identify falls risk factors, and to involve HACC service providers in promoting falls prevention among seniors. The training manual includes an outline for each topic covered in the training session (activity, goals, resources and timing), additional references for facilitators and is accompanied by a PowerPoint presentation that includes 5 case studies, and pre and post evaluation questionnaires. The resource requires organisations to include local falls prevention service information and falls data, and provide falls prevention handouts available from the organisation for distribution to participants. If your organisation does not currently have any suitable handouts go to ‘seniors resources’ on this website: (Downloadable)

In 2009 the Department of Health funded Northern Health, in conjunction with National Ageing Research Institute, to review falls prevention resources for the Department of Health’s website. The materials used as the basis of this generic resource were developed by Banyule Community Health (adapted and modified from the Boroondara (now Inner East) Primary Care Partnership Step Safely Program) under a Service Agreement with the Department of Human Services, now the Department of Health. Other resources to maintain health and wellbeing of older people are available from www.health.vic.gov.au/agedcare.

HACC workers falls prevention training presentation

<organisation name> Falls <organisation name> Falls Prevention ProjectPrevention Project

FALLS PREVENTION TRAINING FOR FALLS PREVENTION TRAINING FOR HACC WORKERSHACC WORKERS

Insert

Organisation logo

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OVERVIEW OF THE OVERVIEW OF THE TRAININGTRAINING

• IntroductionIntroduction

• Falls prevention projectFalls prevention project

• Falls and older peopleFalls and older people

• Prevention of fallsPrevention of falls

• Case studiesCase studies

• SummarySummary

• EvaluationEvaluation

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OBJECTIVES OF THE OBJECTIVES OF THE TRAINING TRAINING

• To outline the consequences of fallsTo outline the consequences of falls• To demonstrate that falls are preventableTo demonstrate that falls are preventable• To increase your knowledge & ability to To increase your knowledge & ability to

identify falls riskidentify falls risk factors factors• To provide you with information about local To provide you with information about local

servicesservices• To involve health and community care To involve health and community care

providers in the promotion of falls prevention providers in the promotion of falls prevention among older people among older people

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AIM OF THE FALLS AIM OF THE FALLS PREVENTION PROJECTPREVENTION PROJECT

• To reduce falls and injuries caused by falls To reduce falls and injuries caused by falls amongst older people living in their own amongst older people living in their own homes homes

• Our primary target group is people over the Our primary target group is people over the age of 65 and who are living at homeage of 65 and who are living at home

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OBJECTIVES OF THE PROJECTOBJECTIVES OF THE PROJECT

• Improve public and professional Improve public and professional understanding of falls risks in older peopleunderstanding of falls risks in older people

• Improve community safetyImprove community safety

• Develop interventions to target special at risk Develop interventions to target special at risk groupgroup

• Improve referral pathwaysImprove referral pathways

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OBJECTIVES OF THE PROJECT OBJECTIVES OF THE PROJECT continued continued

• Involve the community in developing Involve the community in developing appropriate strategies to reduce fallsappropriate strategies to reduce falls

• Increase the general target group’s Increase the general target group’s participation in physical activity that enhances participation in physical activity that enhances strength, balance and social participationstrength, balance and social participation

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PHILOSOPHYPHILOSOPHY

• If older people are given the necessary If older people are given the necessary information and support they will take information and support they will take control of health and environmental control of health and environmental issues that influence their lives.issues that influence their lives.

• Falls and decreased mobility are not an Falls and decreased mobility are not an inevitable part of growing older, but can inevitable part of growing older, but can be prevented or minimized through 8 be prevented or minimized through 8 simple steps. simple steps.

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WHAT IS A FALL?WHAT IS A FALL?

A fall may be described as:A fall may be described as:“…“…an event that results in a person coming to an event that results in a person coming to

rest inadvertently on the ground or other lower rest inadvertently on the ground or other lower level and other than a consequence of the level and other than a consequence of the following:following:- Loss of consciousnessLoss of consciousness- Sustaining a violent blowSustaining a violent blow- Sudden onset of paralysisSudden onset of paralysis

- Epileptic seizure.”Epileptic seizure.” (Kellogg, 1987)(Kellogg, 1987)

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LOCATION OF FALLSLOCATION OF FALLS

WC Laundry

Living

Living

Kitchen Meals

PantryDining

Bathroom

BedroomEntry

Garage

50%

9% 7%

4%

25%

5%

Source:

Victorian Injury Surveillance System

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WHERE DO FALLS WHERE DO FALLS OCCUR?OCCUR?

• 65% of falls occur at home65% of falls occur at home

• 50% in living areas and the bedroom50% in living areas and the bedroom

• Less than 10 % in bathrooms, toilets or Less than 10 % in bathrooms, toilets or kitchenskitchens

• 25% in public places; mainly on footpaths, in 25% in public places; mainly on footpaths, in shopping centres and on stairs.shopping centres and on stairs.

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FREQUENCY OF FALLSFREQUENCY OF FALLS

• > 65 years: 1 in 3 fall at least 1 x year> 65 years: 1 in 3 fall at least 1 x year• > 80 years: 1 in 2 fall at least 1 x year> 80 years: 1 in 2 fall at least 1 x year• 1 in 4 people require residential age 1 in 4 people require residential age

care after a fallcare after a fall• 1 in 5 people will break a bone due to a 1 in 5 people will break a bone due to a

fall, or have a serious injuryfall, or have a serious injury• Of all injuries for > 80 years: 75% linked Of all injuries for > 80 years: 75% linked

to fallsto falls

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LOCAL DATALOCAL DATA

Insert local data for your area -

Hospital admissions due to falls - this could be displayed as a graph, table, chart

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LOCAL DATALOCAL DATA

Insert local data for your area -

Emergency presentations due to falls - this could be displayed as a graph, table, chart

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COST OF FALLSCOST OF FALLS• In Australia:In Australia:

– 1114 deaths (1998) 1114 deaths (1998)

– over 45,000 injuries (1998) over 45,000 injuries (1998)

– $498 million in annual health care costs (2001)$498 million in annual health care costs (2001)

• In Victoria In Victoria – $323 million in direct annual health care costs in 2002/3 $323 million in direct annual health care costs in 2002/3

(VAED 2002/3)(VAED 2002/3)

– 21,390 public and private hospital admissions in 2002/3 21,390 public and private hospital admissions in 2002/3 (VAED 2002/3)and (VAED 2002/3)and

– 7,808 ED presentations to public hospitals (2001)7,808 ED presentations to public hospitals (2001)

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CONSEQUENCES OF CONSEQUENCES OF FALLSFALLS

• Major cause of injury-related hospitalization Major cause of injury-related hospitalization for people 65+for people 65+

• 10% - 20% result in fractures or other injury10% - 20% result in fractures or other injury

• Hip fracture most common serious injuryHip fracture most common serious injury

• 50% restrict activities after fall50% restrict activities after fall

- fear of falling- fear of falling

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A fall is a symptom: A fall is a symptom: what is the problem?what is the problem?

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Risk FactorsRisk Factors

• Intrinsic (personal)Intrinsic (personal)– Gender: Female Gender: Female – Chronic medical conditions e.g. Stroke and Chronic medical conditions e.g. Stroke and

Parkinson’s diseaseParkinson’s disease– On multiple medications and specific medications On multiple medications and specific medications

e.g. psychotropic medicatione.g. psychotropic medication– Decreased bone densityDecreased bone density– Low levels of physical activityLow levels of physical activity– Balance or walking problems (past history of falls)Balance or walking problems (past history of falls)– Impaired cognitionImpaired cognition– Sensory loss / Impaired visionSensory loss / Impaired vision

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Risk FactorsRisk Factors

• Extrinsic (environmental)Extrinsic (environmental)– Home hazardsHome hazards– Public places hazardsPublic places hazards

• BehaviouralBehavioural– Risk taking activitiesRisk taking activities– Inappropriate foot wearInappropriate foot wear

All these factors may interact to All these factors may interact to increase the risk of fallingincrease the risk of falling

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PREVENT FALLSPREVENT FALLS

Falls may seem to be common…Falls may seem to be common…

But many falls can be prevented!But many falls can be prevented!

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8 SIMPLE STEPS TO 8 SIMPLE STEPS TO PREVENT FALLSPREVENT FALLS

StepsSteps1. General health1. General health

2. Medication2. Medication

3. Eyesight and 3. Eyesight and visionvision

4. Exercise and 4. Exercise and fitnessfitness

Related risk factorRelated risk factor1. Poor general health1. Poor general health

2. Medication that influences 2. Medication that influences balancebalance

3. Changes in eyesight and vision3. Changes in eyesight and vision

4. Lack of exercise and poor 4. Lack of exercise and poor fitnessfitness

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8 SIMPLE STEPS TO 8 SIMPLE STEPS TO PREVENT FALLSPREVENT FALLS

StepsSteps5. Healthy diet5. Healthy diet

6. Feet and Footwear6. Feet and Footwear

7. Home safety7. Home safety

8. Public safety8. Public safety

Related risk factorRelated risk factor5. Unhealthy diet5. Unhealthy diet

6. Painful feet and unsafe 6. Painful feet and unsafe footwearfootwear

7. Hazards in the home7. Hazards in the home

8. Hazards in public places8. Hazards in public places

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YOUR RESPONSIBILITYYOUR RESPONSIBILITY

• As a professional carer:As a professional carer:

– hazard identificationhazard identification– risk assessmentrisk assessment– risk control risk control

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SIGNS THAT SOMEONE IS SIGNS THAT SOMEONE IS AT RISK OF FALLSAT RISK OF FALLS

Person:Person:• Has loose shoesHas loose shoes• Has loose clothingHas loose clothing• Lacks energyLacks energy• Looks tiredLooks tired• ‘‘Furniture walks’Furniture walks’• Is dizzy, drowsy and unsteadyIs dizzy, drowsy and unsteady• Is confused and anxiousIs confused and anxious• Is short of breathIs short of breath• Has had a recent fall or near fallHas had a recent fall or near fall

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CASE STUDY 1CASE STUDY 1

• Mary is a 75-year-old woman living alone. She Mary is a 75-year-old woman living alone. She has home care fortnightly. She wears bifocals has home care fortnightly. She wears bifocals and has osteoarthritis (which mainly affects her and has osteoarthritis (which mainly affects her spine), and uses a walking stick outside. Mary spine), and uses a walking stick outside. Mary has had several falls in her garden and in the has had several falls in her garden and in the street over the past six months. She has told street over the past six months. She has told you she is having trouble negotiating the steps you she is having trouble negotiating the steps from the veranda to the garden. from the veranda to the garden.

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CASE STUDY 2CASE STUDY 2

• John is a 75-year-old and has John is a 75-year-old and has Parkinson’s disease. He lives in a first Parkinson’s disease. He lives in a first floor flat with his wife Betty. You attend floor flat with his wife Betty. You attend for Home Care only. John is currently for Home Care only. John is currently using the bath and has had several falls using the bath and has had several falls when getting in and out of the bath. He when getting in and out of the bath. He rarely leaves the flat and spends most of rarely leaves the flat and spends most of the day in his dressing gown and the day in his dressing gown and slippers.slippers.

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CASE STUDY 3CASE STUDY 3

• Emily is a 72-year-old woman. She uses the Emily is a 72-year-old woman. She uses the community bus for shopping and is generally community bus for shopping and is generally well. However she suffers from insomnia, for well. However she suffers from insomnia, for which she takes medication and you notice which she takes medication and you notice she can be drowsy in the mornings. She had she can be drowsy in the mornings. She had two falls getting on the bus over the last two falls getting on the bus over the last several months. Emily is of light build and several months. Emily is of light build and wears layers of clothing to keep warm.wears layers of clothing to keep warm.

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CASE STUDY 4CASE STUDY 4

• Another client you see is an 80-year-old Another client you see is an 80-year-old woman who has osteoporosis and is in woman who has osteoporosis and is in bed with the flu. She expresses a wish bed with the flu. She expresses a wish for a cup of tea. On the way to the for a cup of tea. On the way to the kitchen you nearly trip over something kitchen you nearly trip over something on the floor in the corridor. On on the floor in the corridor. On attempting to put on the light to see what attempting to put on the light to see what the obstacle is, you realise that the light the obstacle is, you realise that the light bulb has blown.bulb has blown.

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CASE STUDY 5CASE STUDY 5

• Your client, Mrs S, is a 97-year-old Your client, Mrs S, is a 97-year-old widow who lives on her own. She has widow who lives on her own. She has very little family support and she suffers very little family support and she suffers from incontinence. You attend fortnightly from incontinence. You attend fortnightly for Home Care and she has for Home Care and she has Meals on Meals on WheelsWheels delivered daily. She has told you delivered daily. She has told you she is getting up to go to the toilet 2-3 she is getting up to go to the toilet 2-3 times per night. You noticed that her times per night. You noticed that her toilet is at the end of the house. toilet is at the end of the house.

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ATTITUDES AND MYTHSATTITUDES AND MYTHS

• “ “ This isn’t relevant to me!”This isn’t relevant to me!”• “ “ Changing things around the home can be Changing things around the home can be

expensive and difficult”expensive and difficult”• “ “ I just need to slow down”I just need to slow down”• “ “ I’ve had that cord running across the I’ve had that cord running across the lounge lounge

room floor for a long time”room floor for a long time”• “ “ I am not that old and frail yet”I am not that old and frail yet”

Common attitudes and myths about falls that Common attitudes and myths about falls that you may encounter:you may encounter:

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PROMOTIONAL PROMOTIONAL MATERIALSMATERIALS

Insert list of Falls Prevention Insert list of Falls Prevention materials/handouts herematerials/handouts here