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A non-profit service and advocacy organization © 2011 National Council on Aging
Bonita Lynn Beattie, PT, MPT, MHA
Vice President, Injury Prevention,
National Falls Free© Initiative
National Council on Aging
Preventing Falls: Whose Role Is It?
March 2012
Emily Watson, MPH
Senior Program Associate
Center for Healthy Aging
National Council on Aging
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A non-profit service and advocacy organization © 2011 National Council on Aging
NCOA - National Council on Aging
NCOA is a nonprofit service and advocacy organization.
Our mission is to improve the lives of millions of older
adults, especially those who are vulnerable and
disadvantaged.
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A non-profit service and advocacy organization © 2011 National Council on Aging
How NCOA accomplishes its mission
Collaborative Leadership
NCOA brings together nonprofit
organizations, businesses, and
government to address key challenges
of an aging society.
Innovation NCOA helps to develop and ―bring to
scale‖ innovative services that improve
health and financial well-being.
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A non-profit service and advocacy organization © 2011 National Council on Aging
How NCOA accomplishes its mission
Advocacy
NCOA is the leading national voice
and advocate for vulnerable and
disadvantaged older adults and
the organizations that help them.
Services
NCOA works with thousands of
organizations across the country
to help seniors find jobs and
benefits, improve their health and
live independently.
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A non-profit service and advocacy organization © 2011 National Council on Aging
Learning Objectives
1. Understand the magnitude and impact of older adult
falls and fall-related injuries.
2. Identify proven methods for preventing falls and tools
for screening, assessing, and referring older adults to
appropriate resources.
3. Provide user-friendly information and resources on
collaborating with partners to address falls prevention.
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A non-profit service and advocacy organization © 2011 National Council on Aging
Common
Predictable largely
Preventable
Everyone has a role to play and can make a difference within their own sphere of influence
Older Adult Falls, Falls Related
Injuries and Deaths
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A non-profit service and advocacy organization © 2011 National Council on Aging
National Council on Aging
Falls Free© Initiative
Coalition of 70 national organizations, professional
associations and federal agencies; and 40 states
working collaboratively to reduce falls and fall-
related injuries among older adults
Working to bring Health Care, Public Health and
Aging together
Falls Free© supported by
• The Archstone Foundation 2004-2012
• Home Safety Council 2004-2008
• CDC National Center for Injury Prevention &
Control 2007-current
• US Administration on Aging 2007-current
• Humana, Inc 2011-current
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A non-profit service and advocacy organization © 2011 National Council on Aging
Hawaii
AK
MT
ID
WA
CO
WY
NV
CA
NM AZ
MN
KS
TX
IA
WI
IL
KY
TN
IN OH
MI
AL MS
AR
LA
GA
FL
SC
WV VA
NC
PA
VT
RI
ME
NH OR
SD
ND
MO
OK
NE
NY
CT NJ
MD
DE
Northern Marianas
Guam
MA
States operating or developing Fall Prevention Coalitions (February 2012)
State Coalitions on Fall Prevention: Working Collaboratively to Make a Difference
www.ncoa.org/fallsmap
State Coalitions on Fall Prevention
Workgroup
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A non-profit service and advocacy organization © 2011 National Council on Aging
Intersection of Public Health, Aging/Disability
Services and Health Care Sectors
Falls Prevention,
CDSMP, DSMP
Public
Health
Health Care
Delivery
Aging/
Disability
Services
ADRC/Care Transitions
Evidence-based Activities
and Programs
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A non-profit service and advocacy organization © 2012 National Council on Aging
Falls are Common
Many older adults think ―Falling happens to other
people, not to me‖ The truth is 1 in 3 older adults—
about 13 million—fall every year in the U.S.
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A non-profit service and advocacy organization © 2011 National Council on Aging
Did You Know?
2.3 million ED visits (2010), does not include:
• the direct admissions, new study demonstrates 31% increase in
admissions for falls (2001-2008)
• those who fall and self treat, limit activities or see a provider other
than at the ED
• those ―pick up with out transport‖ fallers
20,000 deaths (2009), does not include:
• those non-immediate deaths precipitated by the fall
$28.2 Billion (2010 dollars), does not include:
• indirect costs, caregiver costs, employer costs, opportunity costs…
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A non-profit service and advocacy organization © 2011 National Council on Aging
New Hampshire visual representing Fatalities due to falls in 2010
Who Ultimately Pays the Cost?
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A non-profit service and advocacy organization © 2011 National Council on Aging
Fall Risk Factors
• Intrinsic
• Extrinsic
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A non-profit service and advocacy organization © 2011 National Council on Aging
Intrinsic Factors
• Older age
• Female
• Chronic diseases
• Mentally impaired
• Medication side-
effects
• Muscle weakness
• Gait & balance
problems
• Poor vision
• Postural dizziness
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A non-profit service and advocacy organization © 2011 National Council on Aging
Leading Fall Risk Factors
__________
Rubenstein, Age & Aging, 2006
Risk Factor Relative Risk
Muscle weakness 4.9
Balance problems 3.2
Gait problems 3.0
Poor vision 2.8
Limited mobility 2.5
Cognitive impairment 2.4
Functional limitations 2.0
Postural hypotension 1.9
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A non-profit service and advocacy organization © 2011 National Council on Aging
Extrinsic Factors
• Clutter & tripping hazards
• No stair railings or grab bars
• Dim lighting
• Sidewalk damage
• Snow/ice
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A non-profit service and advocacy organization © 2012 National Council on Aging
Preventing Falls: What Works
Maximize vision
Review and manage
medications
Improve home safety
Exercise for strength and
balance
Clinical assessment
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A non-profit service and advocacy organization © 2011 National Council on Aging
Effective Fall Prevention
Clinical assessment,
treatment, referral & follow-up
_______
Gillespie, Cochrane Database Systematic Review, 2003
AGS, Clinical Practice Guidelines, 2010
borrowed from CDC - STEADI
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A non-profit service and advocacy organization © 2011 National Council on Aging
Overview of Toolkit Content
STEADI: Stopping Elderly Accidents,
Deaths and Injuries
•Provider resources
•Training materials
•Patient education
www.cdc.gov/injury/STEADI
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A non-profit service and advocacy organization © 2011 National Council on Aging
STEADI
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A non-profit service and advocacy organization © 2011 National Council on Aging
Provider Pocket Guide
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A non-profit service and advocacy organization © 2011 National Council on Aging
Referral Forms
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A non-profit service and advocacy organization © 2011 National Council on Aging
Training Materials
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A non-profit service and advocacy organization © 2011 National Council on Aging
Training Materials SPECIALISTS FALL PREVENTION CLASSES
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A non-profit service and advocacy organization © 2011 National Council on Aging
Assessment Tools
• Stay Independent brochure for self-risk
assessment
• Instructions for
–3 standardized gait & balance tests
–orthostatic blood pressure measurement
• Fall Risk Checklist for summarizing risk
assessment findings
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A non-profit service and advocacy organization © 2011 National Council on Aging
Patient Self-Assessment
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A non-profit service and advocacy organization © 2011 National Council on Aging
Patient Education
• 3 CDC
brochures
• Sit to stand
chair exercise
instructions
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A non-profit service and advocacy organization © 2011 National Council on Aging
Intersection of Public Health, Aging/Disability
Services and Health Care Sectors
Falls Prevention,
CDSMP, DSMP
Public
Health
Health Care
Delivery
Aging/
Disability
Services
ADRC/Care Transitions
Evidence-based Activities
and Programs
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A non-profit service and advocacy organization © 2011 National Council on Aging
Evidence-based programs
Evidence-based programs, services and
resources to older adults targeting
prevention through risk reduction – must
be accessible to those at most risk
Community infrastructure of integrated
services and programs
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A non-profit service and advocacy organization © 2011 National Council on Aging
Stepping On Fall Prevention Program
2-hour classes once a week for 7 weeks
Stepping On is designed to empower older adults to carry out health
behaviors that:
o reduce the risks of falls,
o improve self-management, and
o increase quality of life
The program includes instruction or provides information on:
o Balance
o Strength building
o Home environmental safety
o Vision
o Management of medication
More information on phconnect.org site
Slides adapted from CDC
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A non-profit service and advocacy organization © 2011 National Council on Aging
A physical therapist (PT) visits patient four times at home over the first 2
months and visits again for a booster session at 6 months
During the visits, the PT prescribes
a set of in-home exercises and a walking plan
Strength training
Balance and stability
Active range of motion
Walking plan
Participants are encouraged to complete
the exercises three times a week and to walk
outside the home at least two times a week
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A non-profit service and advocacy organization © 2011 National Council on Aging
Yang Style
12 weeks or more, 3 times a week, with each class lasting one hour (one hour at home)
Delivered by a trained Tai Chi Instructor
Eight forms taught in a progressive fashion
Master Trainers: Dr. Fuzhong Li and YMCA of USA Faculty Trainers
More information on phconnect.org site
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A non-profit service and advocacy organization © 2011 National Council on Aging
Return on Investment of Falls Prevention Programs
Tai Chi Moving for Better Balance
o $1.60 return on a $1 investment in direct medical costs
Stepping On Fall Prevention Program o $70 return on a $100 investment in direct
medical costs
Otago Exercise Program delivered to persons aged 80 and older
o $1 return on a $1 investment in direct medical costs
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A non-profit service and advocacy organization © 2011 National Council on Aging
How Will We Make a Real Difference?
Local, state and national
collaboration that promotes &
sustains salience, belief and
behavior change among key
stakeholders:
Older Adults
Caregivers/family members
Health Care and other service
providers
POLICYMAKERS
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A non-profit service and advocacy organization © 2011 National Council on Aging
What Does that Difference Look Like?
Broad awareness to the issue – falls
are not an inevitable part of aging
Training and education to providers
Evidence-based programs, services and
resources to older adults targeting
prevention through risk reduction –
must be accessible to those at most risk
Provide seamless transitions to
community programs from health care
and vice versa
Local, state and national collaboration that brings:
Broad Community Engagement
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A non-profit service and advocacy organization © 2012 National Council on Aging
Get involved in your coalition
• Learn what is going on in
your area and contact
your state coalition lead
to get involved.
• URL:
www.ncoa.org/fallsmap
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A non-profit service and advocacy organization © 2012 National Council on Aging
Falls Prevention Awareness Day
• First day of Fall
• 2012 is the 5th annual
national Falls Prevention
Awareness Day (FPAD)
• 43 states, DC and Puerto
Rico participated in 2011,
bringing national awareness
to this important issue.
FPAD 2012
Saturday, September 22nd
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A non-profit service and advocacy organization © 2012 National Council on Aging
Partnering with the Aging Network
• The Older Americans’ Act (OAA) was passed in 1965 response to
concern about a lack of community social services for older persons.
• The act created the aging network to provide services for community-
dwelling older adults and established the Administration on Aging (AoA)
as the Federal agency focused on older persons.
Source: http://www.aoa.gov/AoA_programs/OAA/index.aspx
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A non-profit service and advocacy organization © 2012 National Council on Aging
The Aging Network: Today
• The OAA funds the delivery of social and nutrition
services for older adults through a national network of
– 56 State agencies on aging
– 629 Area Agencies on Aging
– 20,000 service providers
– 44 Tribal organizations .
• These community-based organizations serve as the
bridge between clinical treatment and home.
Source: http://www.aoa.gov/AoA_programs/OAA/index.aspx
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A non-profit service and advocacy organization © 2011 National Council on Aging
Putting the Pieces Together
Among coalitions many challenges, how to
integrate the contributions of many to affect a
community model of falls prevention.
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A non-profit service and advocacy organization © 2011 National Council on Aging
Common
Predictable
largely
Preventable
Everyone has a role to play and can make a difference within their own sphere of influence.
To Wrap Up
Top Related