Fall prevention program launched in northeast

Fall prevention program launched in northeast

North-East Geriatrics Specialized Services physiotherapist Shaen Gingrich, left, leads Terry Gaffney and Bernadette Sammon through some exercises on the parallel bars during a session of the Frail to Fit Fall Prevention program.

Falls continue to be the leading cause of injury-related hospitalization among community-dwelling seniors over the age of 65.

One in three of those seniors will fall every year. It’s a huge public health issue, said North East Specialized Geriatric Services physiotherapist Shaen Gingrich. Though all age groups experience unintentional falls, older adults are particularly impacted by them. Older individuals are both more likely to experience a fall, and to suffer a more severe injury as a result, according to Falls Among Older Adults, a report published in 2009 by the Sudbury and District Health Unit.

“In Sudbury, our rates are 40 per cent higher than the provincial average,” Gingrich said. There are a number of contributing factors to that statistic, including Northern Ontario’s climate, and a larger population of residents over the age of 65.

“This issue is a mean beast to tackle. We know there are modifiable risk factors associated with falls, and if we can target those risk factors and encourage people to adapt, then we can prevent some of these falls.”

North East Specialized Geriatric Services set out to address this issue at the beginning of 2010, and recently rolled out the Frail to Fit Falls Prevention Program. Gingrich said it took months for her and occupational therapist Melanie Bussoli to search through thousands of articles and pick out fall prevention programs that showed positive results.

“What it boiled down to following this research was that a multifaceted approach to fall prevention is the key,” she said. “We knew it needed to include exercise to improve strength and balance, as well as an educational component.”

Gingrich and Bussoli looked at other regional geriatric fall prevention programs and eventually settled on a program similar to one offered at Toronto Western Hospital. The program is 12 weeks in duration and includes exercise and education components.

“We spent time consulting with organizers of that program, and they’ve been a great resource for us,” said Gingrich.

The intent wasn’t to overlap or take away from any existing services in Sudbury.

“We took an inventory of the available programs (in Sudbury) and, unfortunately, it was a pretty short inventory,” she said. “There really is not a lot offered here.”

Older individuals who are deemed frail usually have several medical conditions affecting them at the same time, said Dr. Jo-Anne Clarke, geriatrician and clinical lead, North East Specialized Geriatric Services.

“They don’t even have to be big things, and can range from a little bit of vision loss, a little bit of hearing impairment, or a little bit of lower extremity weakness,” Clarke said. “It also makes the treatment more complicated because there may be six or seven predisposing factors, as well as one or two precipitating factors, and in order to reduce the risk of falls, you have to address each factor.”

Mortality rate

It takes a multidisciplinary approach from a health-care team made up of social workers, caregivers, nurses and doctors to help prevent unintentional falls. A hip fracture, for example, is one of the most common injuries resulting from a slip or fall, and is as big a fear among the aging population as dementia, Clarke said. That’s because the mortality rate after one year following a hip fracture is 20 per cent, meaning two in 10 people die after suffering a hip fracture.

“People don’t realize just how big an issue this is,” she said. “You can have all the prevention in the world and then you hit a crack in the sidewalk and you fall. We can never guarantee you won’t fall again following this program, but we can help reduce the risk factors.”

Candidates for the program go through a three-hour assessment during which time they meet with Dr. Clarke, Gingrich, Bussoli and several other health-care professionals, who then get together to determine if they are appropriate for the program.

There are two sessions weekly. Mondays are mandatory and start with an hour of education focusing on exercise, nutrition, home modifications, medications, foot wear, incontinence, osteoporosis and arthritis. Seniors then participate in an hour of exercise. There is also a session strictly for exercise offered on Wednesdays, but it is optional.

The Frail to Fit Falls Prevention program had its first intake of nine participants at the beginning of November and is going very well, Gingrich said. Currently, the program is offered only in English, but plans are in the works to offer a French program in the future.

North East Specialized Geriatric Services will continue to measure outcomes to ensure the program is accomplishing its intended objectives, Clarke said.

“We are hoping to be able to increase capacity as much as possible and to offer it regionally.  A mobile unit able to travel to outlying communities for a multidisciplinary assessment would be ideal.”

North East Specialized Geriatric Services celebrated its official opening in November 2009 and operates from the North East Centre of Excellence for Seniors’ Health at Pioneer Manor in Sudbury.

Patients must be referred to North East Specialized Geriatric Services by a health care provider.


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