Presentation Outline

1. Overview of the:Northern Ireland Home Accident Prevention Strategy 2015-2025and SHSCT Online Falls Directorywww.southerntrust.hscni.net/falls.htmNina Daly, Accident Prevention OfficerPromoting Wellbeing Team June 2015

2. Presentation Outline • Home Accident Prevention Strategy • SHSCT Falls Prevention Directory • Patient/Client Interventions (medication, falls prevention, preventing frailty, health and wellbeing)

3. Northern Ireland Home Accident Prevention Strategy (Feb 2015-’25) • 2 people die every week as a result of a home accident. • 17,000 admissions to hospital • Focus on those most at risk - over 65s & <5s • Social, economic and health disadvantage • www.dhsspsni.gov.uk/show-publications?txtid=76517

4. Northern Ireland Home Accident Prevention Strategy • More likely to have accident and suffer long-term effects • Majority accidental injuries & deaths in the home are falls. • Falls - 71% of all fatal accidents to those aged 65+ • Falls - 480 deaths (288 male; 192 female) between 2001-11 • This equates to just under half (47%) of all unintentional injury & deaths at home.

6. Evidence from Northern Ireland Home Safety Checks • 25% had a home accident in the previous12 months. n=1,512 • 94% of these were falls. n=1,421 • 35% visited their GP. n=2,116 • 45% visited hospital. n=2,721 • Based mainly on 6,048 checks carried out by Home Safety • Officers between April 2012 and March 2014. How many falls go unreported each year? Early intervention, Prevention and Wellness

7. Continued… • 65% took more than 4 types of medication per day. n=3,931 • 33% experienced dizziness or light heads. n=1,995 • 7% had difficulty reading labels on their medication. n=423 • 9% had difficulty collecting or handling their medication. n=544 • 10% of older people had difficulty remembering when to take their medication. n=604 • 13% did not dispose of out-of-date medication or medication not prescribed for them. n=786

8. Continued… • 40% had difficulty getting into or out of the bath or shower. • 28% had difficulty getting on or off the toilet. • 61% had difficulty reaching, bending or putting on shoes. • 17% could not manage the steps outside their home. • 18% had difficulty using the clothes line. • Activities of Daily Living stairs, the

9. Incidence • 1 in 3 women over 65 fall each year • 1 in 5 men over 65 fall each year • Over 85 years old - 1 in 2 people will fall each year • 70% of falls cause injury • 10% of all falls result in fracture and 1% of these is a hip fracture - often poor outcome • In care homes 60% of residents fall once a year • 30% of all hospital admissions for hip fracture are from nursing homes

10. Hip Fractures: Looking ahead Hip fracture is a major public health issue due to an ever increasing ageing population. About 70,000 to 75,000 hip fractures occur each year. The annual cost (including medical and social care) for all UK hip fracture cases is about £2 billion. Demographic projections indicate that the incidences will rise to 91,500 by 2015 and 101,000 in 2020 (British Orthopaedic Association, 2007). Source: Hip Fracture Costing report: June 2011, Implementing NICE Guidance.

11. Summary • Falls – high death rate in Northern Ireland • Falls risk increases with age • Growing population = • increase in falls • increase in hip fractures • greater reliance on health and social care services(acute, community, residential & nursing care) • increase in number of deaths • increase in resources and costs

12. Southern Trust Falls Prevention Directory • www.southerntrust.hscni.net/falls • Launched October 2013 • Primary Target : Older people • Secondary Target Groups : Health professionals, staff and volunteers (all sectors), concerned relatives or friends

13. Growing use of technology to deliver health There is growing number of national, regional and local projects/providers aimed at getting more older people online.Examples include: • Digital Age Project (NI) • Telecommunity Fund • AgeUK’sItea & Biscuits week (Sept 2013) • U3A • Community groups • Southern Regional College • Mens Sheds projects

14. Aim of the Falls Directory To raise awareness of and reduce accidental falls in the home among older people living in the Southern Trust area. Supporting strength, confidence & independence as you get older. health improvement, early intervention and prevention Putting up to date, accurate information at people’s fingertips

15. Objectives of the Falls Directory To: • Prevent frailty, promote bone health & reduce accidents; • Encourage physical activity & healthy lifestyle; • Reduce unnecessary environmental hazards • Encourage people to report falls & seek help early on. • Increase awareness of Trust & other services which can help individuals who have had a fall or are at risk of falling.

16. Content of the Falls Directory • Understanding why falls occur • Conditions linked to falling • Bone health and osteoporosis • Hydration, having enough fluids • Lifestyle factors • Medication

17. Continued… • Making your home safe • Good lighting in the home • Keeping warm and avoiding falls • Aids and equipment that might help • If you have had a fall • Trust staff and services • Other information and services

18. Content around Hydration • How good hydration can assist in preventing treating # ailments. • Age & poor hydration • What can cause dehydration • How to spot the signs of dehydration • The hydration glass – tips for drinking more water • Link to the hydration toolkit for hospitals and healthcare • Links to information on UTIs

19. Content on Aids and Equipment • Trust staff who can assess aids for you • Transforming Community Equipment Scheme • List of participating retailers • Specialist equipment • Personal alarms – links to who provides them (AgeNI, Fold Telecare), how they work • Other sources of equipment/aids

20. Overview – Falls Service Falls clinics Armagh Dungannon Lurgan Newry Falls team • Consultant • Physiotherapist • Occupational Therapist • Nurse • Clinics are held on a weekly basis • Assessment in the home if appropriate • Comprehensive assessment for over 65’s to determine cause of falls

21. Weekly Clinics Newry – Daisy Hill Hospital Lurgan – Day Hospital Armagh – Mullinure Day Hospital (Alternate week to STH) South Tyrone – Day Hospital (Alternate week to Armagh) Access to Rapid Access Clinics for Urgent Referrals

22. Falls Clinic Assessment Outcome of assessment can include: • Falls education and exercise 8 week class • Offer of community based strength and balance classes • Provision of mobility aids • Provision of aids to assist with day-to-day activities • Changes to medication • Management of hearing, eyesight, bladder or bowel problems • Further investigation regarding osteoporosis • Onward referral for other tests e.g. X-ray, blood tests • Follow up of any needs identified by consultants or health professionals

23. Weekly Strength and Balance Classes with Education on Falls Prevention • Newry – Bramble Wood, Drumalane • Lurgan – Day Hospital • Mullinure – Day Hospital • STH – Day Hospital

24. Strength and Balance Classes in Local Leisure Centres • Newry – Newry Sports Centre – Monday 11am-12 Noon • Portadown – Cascades Leisure Centre – Friday 12 Noon – 1pm • Armagh – Orchard Leisure Centre – Friday 10am – 11am • Dungannon – Dungannon Lesiure Centre - Thursday 11.15am -12.15pm

25. Falls Co-ordinator • Improve falls assessment and referral pathways within A&E, Community and Primary Care settings • Develop new assessment and referral pathways with Northern Ireland Ambulance Service • Co-ordinate referrals to physical activity and health programmes across community settings that are aimed at increasing and/or maintaining mobility, strength and balance for those aged 55+ • Deliver training to staff and support staff in delivery of strength and balance classes in day centres, statutory residential settings, independent care homes and community settings

26. Falls Clinic Referral • fallsteam.newry@southerntrust.hscni.net • fallsteam.armagh@southerntrust.hscni.net • fallsteam.lurgan@southerntrust.hscni.net

27. Rachel Rountree Falls Co-ordinator Mullinure Health and Wellbeing Centre Tel: 028 37 412 326 Falls.Coordinator@southerntrust.hscni.net

28. Accessing the Falls Directory www.southerntrust.hscni.net Go to: Healthy Living Section Falls Prevention

29. Accessing the Falls Directory Using Right Hand Menu Go to:Welcome to the Southern Trust’s Falls Directory Add To Your Favourites!

30. Features of the Falls Directory • Easy to Navigate Menu Menu

31. Features of the Falls Directory • Links at the Top • Links at Bottom of each section to take you to the next page Top Links Bottom Links

32. Features of the Falls Directory • Alter font size to make words BIGGER and easier to read Font Size

33. Features of the Falls Directory • Current and up to date information • Numerous internal and external links (underlined, pink text)

34. Features of the Falls Directory Word, powerpoint files, pdf docs taking you to: Leaflets, Booklets, Reports, dvd clips on falls

35. Patient/Client Interventions to reduce falls • Medication • Improve their awareness of: • Poly-pharmacy & falls risk • Medications linked to falling • How to access information on side-effects of medications • Medication management apps • Information/advice available to help with medication management and safety • Medication & alcohol risks, alcohol &mental health support • Swallowing difficulties & how to address this problem • Promote uptake of Medical Use Reviews • Distribute medication safety aids from PWT • Encourage return of old/out of date/ medication • Encourage good hydration

36. Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall/s NICE CG161 2013: Falls: assessment and prevention of falls in older people

37. Patient/Client Interventions to reduce falls • Falls Prevention • Improve their awareness of: • Need to report all falls and getting help early on. • Falls Prevention Directory • Health • Lifestyle • Home safety • Aids and equipment • Bone health and frailty • Falls Services in SHSCT: Falls clinics, SB Classes, FLS • Other services to help support older people maintain their independence and safety at home.

38. Patient/Client Interventions to reduce falls Accident Prevention Alcohol and Drugs Breast Care Cancer Neighbourhood Renewal Area Falls Prevention Financial Wellbeing Healthy Eating Hearty Lives Craigavon Men's Health Mental Health Physical Activity Recovery Safe and Healthy Travel Sexual Health Stop Smoking Services Stroke Prevention Workplace www.southerntrust.hscni.net/124.htm

39. Thank you For further information: Tel: 028 3831 1524 Nina.daly@southerntrust.hscni.net