28 Nov 2014 | Reducing Harm from Falls
Getting back on her feet after hip surgery became achievable for Phyllis Gibbison, 84, from Hamilton thanks to a team effort at Waikato District Health Board’s Older Persons and Rehabilitation service.
Mrs Gibbison went on the On Your Feet programme as part of her recovery process. “It is marvelous for me. I have got my balance and strength back.”
She is one of the 60 percent of over 75-year-olds who are vulnerable to falling each year. An older person who has had a fall is three times more likely to fall again. It is clinical nurse specialist Sharon Macpherson’s job as one of the assessment team to select what is the best approach for someone.
“It may be that they are to go on the programme, or have an individual physiotherapy session, have a home visit by the occupational therapist or have an appointment with a geriatrician if they have medical concerns,” said Ms Macpherson, “It also may be that they need to be linked up with community agencies to keep them active.”
ON YOUR FEET education and exercise programme is like a mini boot camp for older people.
The six-week course is run as an outpatient clinic and developed for those who are at risk of falling or have been falling, as well as those that have had surgery to help them recover a lot faster. Successful interventions are most commonly based on strength and balance programmes or on multi-factorial risk assessment interventions. The programme is set up as part of a clinic with the patient seen by a nurse, physiotherapist and occupational therapist. This multi-disciplinary approach to their health weighs up the best options for them.
The physiotherapy role involves running the exercise component and completing the risk assessment as well as leading the education session and a follow-up with patient satisfaction surveys.
There has been good feedback from patient satisfaction surveys.
Yes – I’ve loved it!!!
Has definitely helped. Has particularly helped my mental ability – even more so than the physical side of things.
My balance is much better … I feel I am the best (fittest) in the class.
Yes – balance-wise I’m better, I can now stand out of a chair with no hands.
I can walk across the lounge without help – my balance is definitely improving.
Occupational therapists are involved in the screening as well and have a session as part of the programme. They focus more in the home environment to minimise slips, trips and falls and looking at whether or not there is any additional equipment that could make things a lot safer in the home.
ON YOUR FEET started in March after 18 months of development. The service is now looking at promoting the programme to GPs and their patients to catch them before they have their falls.
The ON YOUR FEET programme and the Balance and Falls clinic assessment are currently being considered as a referral option for older persons and rehabilitation falls pathway in Map of Medicine which is the regional clinical pathway tool for GPs and hospital clinicians. Not everyone that comes through the programme has been admitted to hospital.