Impact of Falls on Older People: How to Assess the Risks and Implement Prevention Strategies, The

Chapter 8: The Impact of Falls on Older People: How to Assess the Risks and Implement Prevention Strategies

Overview:

• Outlines both intrinsic and extrinsic risk factors for falling
• Provides and explains comprehensive medical, physical and psychological assessment
• Examines fall prevention programs and assesses their effectiveness
• Supplies readers with easy to complete forms for assessment of an ageing person

Description:

Falls and their consequences are a major public health problem among ageing people. This chapter delves into the risk factors of falling both in the home and hospital among older people and disputes whether prevention plans are truly effective. It also includes and explains how to assess an ageing person, with forms and lists which the reader is able to complete with ease.

Topics:

• The facts
• Risk factors for falling
• Health promotion and falls prevention
• Falls risk screening tools
• Comprehensive assessment
  • Medical
  • Physical
  • Psychological
  • functional performance and environmental assessments
• Falls Prevention Programs — are they effective?
  • Programs targeting behavioural modification
  • Programs targeting medical factors
  • Programs targeting physical factors
  • Programs targeting psychological factors
  • Programs targeting environmental review and modification
  • Programs targeting multiple risk factors
  • Injury minimisation programs
• Transition between hospital and home
• Australian resources/contacts
• References
• Appendix 8.1 Screening Assessment for Falls Evaluation (Safe)
• Appendix 8.2 Falls Risk Assessment Tool (FRAT) for Aged Care Facilities

Speaker / Author:

Keith Hill

Bachelor of Applied Science (Physiotherapy), Graduate Diploma of Physiotherapy, Doctor of Philosophy. Physiotherapist and Senior Research Fellow, National Ageing Research Institute, Parkville, Victoria, Australia.

Keith has 20 years’ experience as a physiotherapist involved in rehabilitation and aged care. He developed the physiotherapy assessment process for the specialist Falls and Balance Clinic which was established jointly between the National Ageing Research Institute and Melbourne Extended Care and Rehabilitation Service in 1988. At present Keith is co-director of the Falls and Balance Clinic. Keith completed a PhD entitled ‘Balance studies in older people’ in 1998. He has been involved in the development of a new clinical measure of balance (the Step Test) and an expanded measure of fear of falling (the Modified Falls Efficacy Scale). He coordinates several falls-related projects and research initiatives and has published 12 papers in the areas of balance and mobility assessment and management.

Jennifer Schwarz

Bachelor of Medicine, Bachelor of Surgery, Graduate Diploma of Education, Fellow of the Royal Australasian College of Physicians, Senior Consultant Physician in Geriatric Medicine, Melbourne Extended Care and Rehabilitation Service, Parkville.

Jenny has been a geriatrician since 1987. She has been working in the area of falls and balance problems in older people since 1990. She is co-director of the Falls and Balance Clinic based at the Melbourne Extended Care and Rehabilitation Service, the first such clinic in Australia. She also works at the recently established Falls and Balance Service at Bundoora Extended Care Centre. She was a member of the Department of Human Services (Vic.) working party that developed guidelines for the development of Falls and Mobility Clinic services for Victoria. Jenny’s other interests are in the fields of medical education and ethical issues in aged care.

Robyn Smith

Bachelor of Applied Science (Occupational Therapy), Graduate Diploma in Gerontology, Master of Public Health. Director, Public Health Division, National Ageing Research Institute.

About five years ago Robyn moved from work as a clinical occupational therapist specialising in adult rehabilitation and acute geriatrics to full-time research. She has held a number of positions with the Occupational Therapy Association at both state and national level. At present she is Chair of the National Advisory Group — Aged Care for OT Australia — National. She is also a member of the Australian Association of Gerontology and of the Public Health Association of Australia. Robyn’s research has included work on community rehabilitation centres, community support services, home-based rehabilitation services, hospital readmissions, in-patient respite services and health promotion. Her main interests are health service systems, the measurement of health outcomes, evidence-based clinical practice and health promotion.

Belinda Gilsenan

Registered Nurse, Bachelor of Arts, Postgraduate Diploma of Arts. Project Officer, National Ageing Research Institute.

As a nurse Belinda worked for a number of years in geriatric rehabilitation and at the same time completed a Bachelor of Arts. Her Honours thesis explored the involvement of older adult organisations in the policy-making process in Australia. Her work in the area of falls prevention has included the development of a national database of community-based falls prevention programs which incorporates a critical appraisal of each program. More recently she has been working with staff and residents in aged care facilities to promote an awareness of falls risk factors and to institute a falls risk screening process for all new residents.

Karen Bull

Bachelor of Applied Science (Occupational Therapy) Occupational Therapist, Peninsula Falls Prevention Service, Mount Eliza, Aged Care and Rehabilitation Service, Peninsula Health Care Network, Mount Eliza, Victoria.

Karen is a team member of the Peninsula Falls Prevention Service and the Peninsula Falls and Balance Clinic. Her primary role is as Coordinator for the ‘Foothold on Safety’ Program throughout the Peninsula Health Care Network. Through collaborative planning and interventions the program aims to develop partnerships with local health services regarding falls-related issues. Programs include falls awareness-raising activities, promotion and program development of physical activity for older people, training and education of health care workers and facilitating policy and procedure change within aged care services and local government.

Professional Reviews: