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LAURA HALCROW 29/01/14 1 Empowering service users and supporting self- management

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The facts: Definition a fall An event which results in a person coming to rest inadvertently on the ground or lower level 2

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Who is at risk of falls? 3

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Falls represent the most frequent type of accident in the over 65s Just under 295,00 people over 65 fall each year in Scotland. 4

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5 1 in 3 fall each year 65+ yrs 1 in 2 fall each year 85+ yrs In the UK, one person fractures their: Hip every 10 minutes, Wrist every 9 minutes Spine every 3 minutes 3% of people who fall are admitted as in- patient

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What % of falls result in a serious injury? 6

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7 10% One in ten!

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What % of falls are reported to a health professional? 8

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9 20-25% are reported Only around 10% receive assessment Makes prevention challenging!

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What is the biggest indicator that a person will have a fall? (i.e. the greatest risk factor) ? 10

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A previous fall Repeat or multiple falls increase the risk of having an injurious fall. 11 Half of all people who fall will fall again within the following year

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Why do we fall? 12

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Why do we fall? 13 Biological reasons (Person-related): Previous history of Falls Medical History - e.g. Parkinsons, dizziness, postural hypotension 4 or more medicines Pain Balance, gait or mobility problem Loss of muscle power Fear of falling Confusion Visual impairment Continence

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Why do we fall? 14 Behavioural reasons: Sedentary lifestyle Poor nutrition and hydration Alcohol Footwear Refusal to use assistive devices

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Why do we fall? 15 Environmental hazards account for about 25 to 45% of the causes of Falls in older people.

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Summary: consequence of falling 16

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Human Cost of a Fall 17 Muscle wasting Death Immobility From immobility Incontinence Fractures Hypothermia Dehydration PHYSICAL Soft tissue damage Pressure sores/ Leg ulceration Pneumonia/Chest Infection Dislocation Sub-dural haematoma

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Human Cost of a Fall 18 Feelings of Uselessness Increased Dependency Carer Stress Emotional Distress Loss of confidence Loss of control Anxiety/Depression PSYCHOLOGICAL Social Isolation/Withdrawal Embarrassment Low self esteem Fear of Further falls

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Falls are not an inevitable consequence of old age 19 Falls are nearly always due to one of more underlying risk factors. Recognising and modifying these risk factors is crucial in preventing falls and injuries. Multi-factorial, individualised interventions, based on risk assessment, can reduce falls by up to 30%. From: Falls and fractures: developing a local joint strategic needs assessment. (DoH 2009)

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Simples! 20 Biological risk factors Behavioural Risk factors Environmental Risk factors Multi factorial Risk factors

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Do you think we can stop all falls? 21

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22 The risk of falling can never be completely removed, but by carrying out a falls risk assessment on an individual, risk factors can be identified and action taken to remove or alter risk where possible There will be cases when an individual remains at high risk of falling despite thorough assessment and management, however, the focus should be on anticipating and preventing problems before they occur.

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Prevention: the evidence Early identification and individualised intervention, based on risk assessment Can reduce falls by up to 30% Sustained strength & balance training Home environment assessment & intervention 23

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Self management 24 Not all people want or need assessment by health and social care staff. Health and social care services are changing to become more person centred and proactive. It involves giving individuals an active role in their own care. It is about giving the person the information and support to make their own decisions and plans to manage their health.

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25 Do you have access/use a PC, tablet or smart phone to access the internet?

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Why use technology? Surveys have shown that 26% of people over 65 use the internet. This rises to 63% for those between 55-63. People are becoming more reliant on technology. Good medium to reach a lot of the public with health information. 26

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What are we planning? 27 An internet based self assessment measure to reduce your falls risk. This will include answering a series of questions and completing activities about your general health, mobility and environment etc. Once completed this will give you an individualised personal action plan which will aid you to self manage your falls risk.

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The Evidence 28 There has been a web site developed by Dr S Nyman to give tailored advice regarding balance exercise activities. This has been proven through studies to be an acceptable and effective method of giving advice to elderly people regarding exercise to prevent falls. There are some websites that offer falls prevention advice. Currently there are no web sites that allow the user to self assess their own falls risk and get information/advice relevant to them.

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What will it look like? 29

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How will it work? 30

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Spot the hazard! 31

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Spot the hazard answers 32 Rug Wires Clutter Bed Clothes Not much space for access Position of sockets Lighting

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Think about your own bedroom 33 Do you have any of these hazards? For example if we identify trailing wires as an issue. The process that will happen through the web site is shown by the diagram. Click on wires Advice re cable ties/fix to skirting board Signposted on to local handyman services.(Care and Repair)

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Please give us your feedback 34 What do you think? Would you use this? Are you interested in being involved with the design/testing of this?