Southern Trust Falls Prevention Service

Southern Trust Falls Prevention Service

Rachel CrozierSHSCT Falls Co-ordinator

IncidenceIncidence

• 1 in 3 women over 65 fall each year• 1 in 5 men over 65 fall each year• Over 85 years old - 1 in 2 people will fall each year• 70% of falls cause injury• 10% of all falls result in fracture and 1% of these is a hip fracture

- often poor outcome• In care homes 60% of residents fall once a year• 30% of all hospital admissions for hip fracture are from nursing

homes

Older people in contact with healthcare professionals should be asked routinely whether

they have fallen in the past year and asked about the frequency, context and characteristics

of the fall/s

NICE CG161 2013: Falls: assessment and prevention of falls in older people

Consequences of FallingConsequences of Falling

Psychological problems, for example, a fear of falling and loss of confidence in being able to move about safely

Loss of mobility, leading to social isolation and depression

Increase in dependency and disability

Hypothermia

Pressure-related injury

Infection

Falls and OsteoporosisFalls and Osteoporosis Osteoporosis, a condition characterised by a reduction in bone

mass and density increases the risk of fracture when an older person falls

Hip fracture is the most common serious injury related to falls in older people

Poor posture or a dowager’s hump from osteoporosis can place a person at higher risk to fall, as the person’s centre of gravity has been altered

Reducing a person’s risk of falling and preventing or treating osteoporosis will help to maintain their independence

Overview – Falls ServiceOverview – Falls Service

Falls team Consultant Physiotherapist Occupational Therapist Nurse

Falls clinics Armagh Dungannon Lurgan Newry

Clinics are held on a weekly basis Assessment in the home if appropriate Comprehensive assessment for over 65’s to determine cause

of falls

Weekly ClinicsWeekly ClinicsNewry – Daisy Hill Hospital

Lurgan – Day Hospital

Armagh – Mullinure Day Hospital (Alternate week to STH)

South Tyrone – Day Hospital (Alternate week to Armagh)

Access to Rapid Access Clinics for Urgent Referrals

Falls Clinic AssessmentFalls Clinic Assessment

Outcome of assessment can include:• Falls education and exercise 8 week class• Offer of community based strength and balance classes• Provision of mobility aids• Provision of aids to assist with day-to-day activities• Changes to medication• Management of hearing, eyesight, bladder or bowel problems• Further investigation regarding osteoporosis• Onward referral for other tests e.g. X-ray, blood tests• Follow up of any needs identified by consultants or health

professionals

Weekly Strength and Balance Classes with Education on Falls

Prevention

Weekly Strength and Balance Classes with Education on Falls

Prevention

Newry – Bramble Wood, Drumalane Lurgan – Day Hospital Mullinure – Day Hospital STH – Day Hospital

Strength and Balance Classes in Local Leisure CentresStrength and Balance Classes in Local Leisure Centres

Newry – Newry Sports Centre – Monday 11am-12 Noon

Portadown – Cascades Leisure Centre – Friday 12 Noon – 1pm

Armagh – Orchard Leisure Centre – Friday 10am – 11am

Dungannon – Dungannon Lesiure Centre - Thursday 11.15am -12.15pm

Falls Co-ordinatorFalls Co-ordinator

Improve falls assessment and referral pathways within A&E, Community and Primary Care settings

Develop new assessment and referral pathways with Northern Ireland Ambulance Service

Co-ordinate referrals to physical activity and health programmes across community settings that are aimed at increasing and/or maintaining mobility, strength and balance for those aged 55+

Deliver training to staff and support staff in delivery of strength and balance classes in day centres, statutory residential settings, independent care homes and community settings

Falls Clinic ReferralFalls Clinic Referral

fallsteam.newry@southerntrust.hscni.net

fallsteam.armagh@southerntrust.hscni.net

fallsteam.lurgan@southerntrust.hscni.net

Rachel CrozierRachel Crozier

Falls Co-ordinator

Mullinure Health and Wellbeing CentreTel: 028 37 412 326

Falls.Coordinator@southerntrust.hscni.net

ReferencesReferences

Department of Health (2001) National service framework for older people, London: Department of Health.

Falls: assessment and prevention of falls in older people; NICE Clinical Guideline (June 2013)

Falls; British Geriatrics Society Best Practice Guidance (July 2007, updated 2010)