organisation name Falls Prevention Project

HACC workers falls prevention training presentation Working together to prevent falls Training package developed by: Banyule Community Health Service (adapted and modified from the Boroondara Primary Care Partnership Step Safely Program) 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. (Downloadable) ---???????????--- In 2005 the Department of Human Services funded the National Ageing Research Institute to review and recommend a set of falls prevention resources for general use. The materials used as the basis for this generic resource were developed by the Banyule Community Health Service under a Service Agreement with the Department of Human Services. This and other falls prevention resources are available from the department’s Aged Care website at: http://www.health.vic.gov.au/agedcare.

Slide 2:<organisation name> Falls Prevention Project

FALLS PREVENTION TRAINING FOR HACC WORKERS Insert Organisation logo

Slide 3:OVERVIEW OF THE TRAINING

Introduction Falls prevention project Falls and older people Prevention of falls Case studies Summary Evaluation

Slide 4:OBJECTIVES OF THE TRAINING

To outline the consequences of falls To demonstrate that falls are preventable To increase your knowledge & ability to identify falls risk factors To provide you with information about local services To involve health and community care providers in the promotion of falls prevention among older people

Slide 5:AIM OF THE FALLS PREVENTION PROJECT

To reduce falls and injuries caused by falls amongst older people living in their own homes Our primary target group is people over the age of 65 and who are living at home

Slide 6:OBJECTIVES OF THE PROJECT

Improve public and professional understanding of falls risks in older people Improve community safety Develop interventions to target special at risk group Improve referral pathways

Slide 7:OBJECTIVES OF THE PROJECT continued

Involve the community in developing appropriate strategies to reduce falls Increase the general target group’s participation in physical activity that enhances strength, balance and social participation

Slide 8:PHILOSOPHY

If older people are given the necessary information and support they will take control of health and environmental issues that influence their lives. Falls and decreased mobility are not an inevitable part of growing older, but can be prevented or minimized through 8 simple steps.

Slide 9:WHAT IS A FALL?

A fall may be described as: “…an event that results in a person coming to rest inadvertently on the ground or other lower level and other than a consequence of the following: Loss of consciousness Sustaining a violent blow Sudden onset of paralysis Epileptic seizure.” (Kellogg, 1987)

Slide 10:LOCATION OF FALLS

WC Laundry Living Living Kitchen Meals Pantry Dining Bathroom Bedroom Entry Garage 50% 9% 7% 4% 25% 5% Source: Victorian Injury Surveillance System

Slide 11:WHERE DO FALLS OCCUR?

65% of falls occur at home 50% in living areas and the bedroom Less than 10 % in bathrooms, toilets or kitchens 25% in public places; mainly on footpaths, in shopping centres and on stairs. Slips, trips and stumbles (35.8% of falls) Falls from chair or bed (8.2%) Falls from stairs (4.0%) Falls from ladders (1.6%) Other and unspecified falls (50.4%) (Cassell & Lee, 2000) Slips, trips and stumbles (35.8% of falls) Falls from chair or bed (8.2%) Falls from stairs (4.0%) Falls from ladders (1.6%) Other and unspecified falls (50.4%) (Cassell & Lee, 2000)

Slide 12:FREQUENCY OF FALLS

> 65 years: 1 in 3 fall at least 1 x year > 80 years: 1 in 2 fall at least 1 x year 1 in 4 people require residential age care after a fall 1 in 5 people will break a bone due to a fall, or have a serious injury Of all injuries for > 80 years: 75% linked to falls

Slide 13:LOCAL DATA

Insert local data for your area - Hospital admissions due to falls - this could be displayed as a graph, table, chart This graph shows: This graph shows:

Slide 14:LOCAL DATA

Insert local data for your area - Emergency presentations due to falls - this could be displayed as a graph, table, chart This graph shows:This graph shows:

Slide 15:COST OF FALLS

In Australia: 1114 deaths (1998) over 45,000 injuries (1998) $498 million in annual health care costs (2001) In Victoria $323 million in direct annual health care costs in 2002/3 (VAED 2002/3) 21,390 public and private hospital admissions in 2002/3 (VAED 2002/3)and 7,808 ED presentations to public hospitals (2001)

Slide 16:CONSEQUENCES OF FALLS

Major cause of injury-related hospitalization for people 65+ 10% - 20% result in fractures or other injury Hip fracture most common serious injury 50% restrict activities after fall - fear of falling For people aged over 65 years: - Fractures account for 80% of fall related deaths. - One half of hospital admissions. - Two thirds of injury related emergency department presentations. For people aged over 65 years: - Fractures account for 80% of fall related deaths. - One half of hospital admissions. - Two thirds of injury related emergency department presentations.

Slide 18:Risk Factors

Intrinsic (personal) Gender: Female Chronic medical conditions e.g. Stroke and Parkinson’s disease On multiple medications and specific medications e.g. psychotropic medication Decreased bone density Low levels of physical activity Balance or walking problems (past history of falls) Impaired cognition Sensory loss / Impaired vision

Slide 19:Risk Factors

Extrinsic (environmental) Home hazards Public places hazards Behavioural Risk taking activities Inappropriate foot wear All these factors may interact to increase the risk of falling

Slide 20:PREVENT FALLS

Falls may seem to be common… But many falls can be prevented!

Slide 21:8 SIMPLE STEPS TO PREVENT FALLS

This is a list of all falls related risks and each one of them needs to be addressed individually to reduce the risk of falls.This is a list of all falls related risks and each one of them needs to be addressed individually to reduce the risk of falls.

Slide 22:8 SIMPLE STEPS TO PREVENT FALLS

Slide 23:YOUR RESPONSIBILITY

As a professional carer: hazard identification risk assessment risk control

Slide 24:SIGNS THAT SOMEONE IS AT RISK OF FALLS

Person: Has loose shoes Has loose clothing Lacks energy Looks tired ‘Furniture walks’ Is dizzy, drowsy and unsteady Is confused and anxious Is short of breath Has had a recent fall or near fall

Slide 25:CASE STUDY 1

Mary is a 75-year-old woman living alone. She has home care fortnightly. She wears bifocals and has osteoarthritis (which mainly affects her spine), and uses a walking stick outside. Mary has had several falls in her garden and in the street over the past six months. She has told you she is having trouble negotiating the steps from the veranda to the garden. Risk Factors for Mary Age & gender Vision (bifocals) Chronic medical condition OA can cause stiffness, and medication issues Walking aid - is it suitable? Previous falls – check circumstances. Osteoarthritis Hazards What you can do Referral to physio and OT ? Referral to doctor Discuss bifocal – refer to optometristRisk Factors for Mary Age & gender Vision (bifocals) Chronic medical condition OA can cause stiffness, and medication issues Walking aid - is it suitable? Previous falls – check circumstances. Osteoarthritis Hazards What you can do Referral to physio and OT ? Referral to doctor Discuss bifocal – refer to optometrist

Slide 26:CASE STUDY 2

John is a 75-year-old and has Parkinson’s disease. He lives in a first floor flat with his wife Betty. You attend for Home Care only. John is currently using the bath and has had several falls when getting in and out of the bath. He rarely leaves the flat and spends most of the day in his dressing gown and slippers. Risk Factors for John Age Chronic medical condition Behavioural issues (clothing, Footwear, ongoing use of bath) Environmental issues (bath) What you can do Refer to OT Talk to family regarding footwear ? Medical referral/review of Parkinson’s diseaseRisk Factors for John Age Chronic medical condition Behavioural issues (clothing, Footwear, ongoing use of bath) Environmental issues (bath) What you can do Refer to OT Talk to family regarding footwear ? Medical referral/review of Parkinson’s disease

Slide 27:CASE STUDY 3

Emily is a 72-year-old woman. She uses the community bus for shopping and is generally well. However she suffers from insomnia, for which she takes medication and you notice she can be drowsy in the mornings. She had two falls getting on the bus over the last several months. Emily is of light build and wears layers of clothing to keep warm. Risk Factors for Emily Age and gender Previous falls Medication Hazards ??Possibility of poor diet and problems with balance and strength What you can do Medical review, re: medication and bone density, alternatives to sleeping tablets Physiotherapy review – safety on steps OT review – maximise community safetyRisk Factors for Emily Age and gender Previous falls Medication Hazards ??Possibility of poor diet and problems with balance and strength What you can do Medical review, re: medication and bone density, alternatives to sleeping tablets Physiotherapy review – safety on steps OT review – maximise community safety

Slide 28:CASE STUDY 4

Another client you see is an 80-year-old woman who has osteoporosis and is in bed with the flu. She expresses a wish for a cup of tea. On the way to the kitchen you nearly trip over something on the floor in the corridor. On attempting to put on the light to see what the obstacle is, you realise that the light bulb has blown. Risk Factors Age and gender Osteoporosis Environmental hazards Diet What you can do OT Assessment Discuss risk factors Organise for the light bulb to be changed Check regarding flu vax Medical review re osteoporosis managementRisk Factors Age and gender Osteoporosis Environmental hazards Diet What you can do OT Assessment Discuss risk factors Organise for the light bulb to be changed Check regarding flu vax Medical review re osteoporosis management

Slide 29:CASE STUDY 5

Your client, Mrs S, is a 97-year-old widow who lives on her own. She has very little family support and she suffers from incontinence. You attend fortnightly for Home Care and she has Meals on Wheels delivered daily. She has told you she is getting up to go to the toilet 2-3 times per night. You noticed that her toilet is at the end of the house. Risk factors Age and Gender Living alone Environmental What you can do OT referral/commode chair Refer to continence nurse Community group – social network (with or without exercise) Risk factors Age and Gender Living alone Environmental What you can do OT referral/commode chair Refer to continence nurse Community group – social network (with or without exercise)

Slide 30:ATTITUDES AND MYTHS

“ This isn’t relevant to me!” “ Changing things around the home can be expensive and difficult” “ I just need to slow down” “ I’ve had that cord running across the lounge room floor for a long time” “ I am not that old and frail yet” Common attitudes and myths about falls that you may encounter:

Slide 31:PROMOTIONAL MATERIALS

Insert list of Falls Prevention materials/handouts here

Slide 32:Acknowledgement

In 2005 the Department of Human Services funded the National Ageing Research Institute to review and recommend a set of falls prevention resources for general use. The materials used as the basis for this generic resource were developed by the Banyule Community Health Service under a Service Agreement with the Department of Human Services. This and other falls prevention resources are available from the Department’s Aged Care website at: http://www.health.vic.gov.au/agedcare