A Multi-disciplinary approach to falls prevention in the elderly

Authors: Chris Leggett, Julie Jess, Ruth McNamara

Abstract Northern Ireland South Eastern Integrated Care Partnership – Multi-agency Falls Prevention Strategy Background: Falls are the most frequent and serious accident in  people over 65.Falls are  the MAIN cause of disability & death in people over 75.FEAR of falling dramatically reduces quality of lifeStrokes/TIAs and heart  attacks are falling.Fractures from falls are RISING.Fragility fractures cost UK over £2billion/year.Large and rising elderly populationPreventing Falls: NICE (2013) recommend that all older people who have had a fall or are identified as having gait or balance problems should have a multifactorial falls assessment and a multifactorial intervention plan.  NICE have identified the following interventions as being common to successful multifactorial interventions:Strength and Balance training – shown to reduce Falls by 55%Home hazard assessment and interventionVision assessment and referralMedication review with modification/withdrawalImplementation of evidence base requires a multi-professional and multi-agency approach to care provision and raised awareness among public and professionals.SE ICP Falls Multi-professional working group/partnership committee membershipPatient & Carer representativesFalls Co-ordinatorCommunity/voluntary representativeLocal Council representativePhysiotherapistsOTsGPsPharmacistsNIAS ( Northern Ireland Ambulance Service)ICP Project ManagerProblems Identified: Lack of Follow up of patients who fall and call NIAS (N.I. Ambulance Service) Poor Access to Falls Prevention Services/ Strength & Balance ProgrammesLack of Awareness of benefits of Fall Prevention Services Strength & Balance ProgrammesActions: 12 month pilot to provide a co-ordinated Falls service across the entire south eastern locality in conjunction with NIAS (5 day and enhanced weekend service). Referrals made directly from NIAS to the service and all patients referred  receive a multifactorial screening assessment by a Falls Assessor in their own home within 24hrs of a fall. If necessary onward referrals made to AHP, nursing, GP and voluntary sector services to address identified need. Patients  also receive a medication review within 72hrs of the initial referral. Provision of Strength/Balance Programmes in a wide range of community settings including community centres and a GP surgeryOutcomes: 170 NIAS referrals to Falls Prevention Team1284 assessments completed April 2015-16Strength & Balance Programmes for those at risk of FallsRaising awareness of programme benefits: Pharmacies/GPs/Community/Carers/Reducing Falls, Reducing Fear, Reducing FracturesSaving NHS ResourcesBenefits of the service:Clients completing the strength & balance programme67% improve on FES-I (fear of falling outcome measure)54% improve on TUAG (balance and mobility outcome measure)Pharmacy – Medication review61% recommendations made to GP by falls pharmacist were implemented Patient Experience:  73 year old lady referred from GP.  No history of falls but significant fear of falls. Completed 12 week strength and balance program.“My confidence has grown, my balance is so much better now and I don’t have the same fear of falling.  Since starting the class I can get to the bathroom in time.”Next Steps: Further expansion of strength/balance programme in a range of community settings-massive potential to address unmet need and produce significant health gain.

Keywords:

elderly falls prevention integrated care

How to Cite:

Leggett C, Jess J, McNamara R. A Multi-disciplinary approach to falls prevention in the elderly. International Journal of Integrated Care. 2017;17(5):A202.

DOI: http://doi.org/10.5334/ijic.3512Published on 17 Oct 2017