2. 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 forms Availability: Download manual Download PowerPoint presentation Download pre and post evaluation forms 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

3. Falls Prevention Project Falls Prevention Project FALLS PREVENTION TRAINING FOR HACC WORKERS Insert Organisation logo

4. 3 OVERVIEW OF THE TRAINING IntroductionIntroduction Falls prevention projectFalls prevention project Falls and older peopleFalls and older people Prevention of fallsPrevention of falls Case studiesCase studies SummarySummary EvaluationEvaluation

5. 4 OBJECTIVES OF THE 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 identify falls risk factorsTo increase your knowledge & ability to identify falls risk factors To provide you with information about local servicesTo provide you with information about local services To involve health and community care providers in the promotion of falls prevention among older peopleTo involve health and community care providers in the promotion of falls prevention among older people

6. 5 AIM OF THE FALLS PREVENTION PROJECT To reduce falls and injuries caused by falls amongst older people living in their own homesTo 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 homeOur primary target group is people over the age of 65 and who are living at home

7. 6 OBJECTIVES OF THE PROJECT Improve public and professional understanding of falls risks in older peopleImprove public and professional understanding of falls risks in older people Improve community safetyImprove community safety Develop interventions to target special at risk groupDevelop interventions to target special at risk group Improve referral pathwaysImprove referral pathways

8. 7 OBJECTIVES OF THE PROJECT continued Involve the community in developing appropriate strategies to reduce fallsInvolve 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 participationIncrease the general target group’s participation in physical activity that enhances strength, balance and social participation

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

10. 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)

11. LOCATION OF FALLS WC Laundry Living KitchenMeals Pantry Dining Bathroom Bedroom Entry Garage 50% 9% 7% 4% 25% 5% Source: Victorian Injury Surveillance System

12. 11 WHERE DO FALLS 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 kitchensLess than 10 % in bathrooms, toilets or kitchens 25% in public places; mainly on footpaths, in shopping centres and on stairs.25% in public places; mainly on footpaths, in shopping centres and on stairs.

13. 12 FREQUENCY 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 care after a fall1 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 injury1 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 fallsOf all injuries for > 80 years: 75% linked to falls

14. 13 LOCAL DATA Insert local data for your area - Hospital admissions due to falls - this could be displayed as a graph, table, chart

15. 14 LOCAL DATA Insert local data for your area - Emergency presentations due to falls - this could be displayed as a graph, table, chart

16. 15 COST OF FALLS In Australia:In Australia: –1114 deaths (1998) –over 45,000 injuries (1998) –$498 million in annual health care costs (2001) In VictoriaIn 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)

17. 16 CONSEQUENCES OF FALLS Major cause of injury-related hospitalization for people 65+Major cause of injury-related hospitalization 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

18. 17 A fall is a symptom: what is the problem?

19. 18 Risk Factors Intrinsic (personal) 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

20. 19 Risk Factors Extrinsic (environmental)Extrinsic (environmental) –Home hazards –Public places hazards BehaviouralBehavioural –Risk taking activities –Inappropriate foot wear All these factors may interact to increase the risk of falling

21. 20 PREVENT FALLS Falls may seem to be common… But many falls can be prevented!

22. 21 8 SIMPLE STEPS TO PREVENT FALLS Steps 1. General health 2. Medication 3. Eyesight and vision 4. Exercise and fitness Related risk factor 1. Poor general health 2. Medication that influences balance 3. Changes in eyesight and vision 4. Lack of exercise and poor fitness

23. 22 8 SIMPLE STEPS TO PREVENT FALLS Steps 5. Healthy diet 6. Feet and Footwear 7. Home safety 8. Public safety Related risk factor 5. Unhealthy diet 6. Painful feet and unsafe footwear 7. Hazards in the home 8. Hazards in public places

24. 23 YOUR RESPONSIBILITY As a professional carer:As a professional carer: –hazard identification –risk assessment –risk control

25. 24 SIGNS THAT SOMEONE IS AT RISK OF FALLS 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

26. 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.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.

27. 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.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.

28. 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.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.

29. 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.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.

30. 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.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.

31. 30 ATTITUDES AND MYTHS “ This isn’t relevant to me!”“ This isn’t relevant to me!” “ Changing things around the home can be expensive and difficult”“ Changing things around the home can be expensive and difficult” “ I just need to slow down”“ I just need to slow down” “ I’ve had that cord running across the lounge room floor for a long time”“ I’ve had that cord running across the lounge 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 you may encounter:

32. 31 PROMOTIONAL MATERIALS Insert list of Falls Prevention Insert list of Falls Prevention materials/handouts here materials/handouts here