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Turn Your Back on Falls! PARC Conference 2007 …Building Momentum February 5th 2007. Julie Lévesque Chair Ottawa Falls Prevention Coalition Agente de planification, programmation et recherche, Santé publique Outaouais. Turn Your Back on Falls: The Stand Up! experience in Ottawa 2005-2006. - PowerPoint PPT Presentation
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Turn Your Back on Falls!PARC Conference 2007…Building MomentumFebruary 5th 2007
Turn Your Back on Falls!PARC Conference 2007…Building MomentumFebruary 5th 2007 Julie Lévesque
Chair Ottawa Falls Prevention CoalitionAgente de planification, programmation et recherche, Santé publique Outaouais
2
Turn Your Back on Falls: The Stand Up! experience in Ottawa 2005-2006
Turn Your Back on Falls: The Stand Up! experience in Ottawa 2005-2006 The magnitude of the problem:
Statistics on Falls An Evidenced Based Falls
Prevention Program: Stand Up! PIED
What is it? How good is it?
The Ottawa experience with this program
3
Falls StatisticsFalls Statistics 1 in 3 adults age 65 and over, fall
every year:
88,995 (2001) 29,665 falls
221,680 (2028) 73,893 falls
Falls major cause of hospitalisation
Factor in nearly half of all nursing home admissions
4
Falls and InjuriesFalls and Injuries Almost half of seniors who fall
experience a minor injury, and 5 to 25% sustain a serious injury such as a fracture or a sprain. (Alexander, Rivara, Wolf, American journal of public health1992)
Even without a serious injury, a fall often cause a loss of confidence and curtailment of activities leading to a decline on health and function.
5
Falls in OttawaFalls in Ottawa
In Ottawa for 2003, 6290 seniors required medical intervention and hospitalization because of a fall-related injury
6
Falls StatisticsFalls Statistics
2006, Ontario cost of unintentional falls
seniors 55+, $962 million
(Smartrisk).
Burden on informal caregivers (wives
and daughters)
7
8
9
10Source: The Ontario Injury Compass is produced by SMARTRISK
11Source: The Ontario Injury Compass is produced by SMARTRISK
12
Hospitalization rate due to Falls by age group City of Ottawa, 2002-2004
Hospitalization rate due to Falls by age group City of Ottawa, 2002-2004
0
1000
2000
3000
4000
5000
6000
1997
1998
1999
2000
2001
2002
2003
Year
Rat
e/10
0,00
0
65-74
75-84
85+
0
1000
2000
3000
4000
5000
6000
1997
1998
1999
2000
2001
2002
2003
Year
Rat
e/10
0,00
0
65-74
75-84
85+
13
Hospitalization rate due to Falls by age group and gender, Ottawa 2002 - 2004
Hospitalization rate due to Falls by age group and gender, Ottawa 2002 - 2004
0
1000
2000
3000
4000
5000
6000
7000
65-74
75-84
85+ 65-74
75-84
85+ 65-74
75-84
85+
2001 2002 2003
Year
Rat
e/10
0,00
0
Males
Females
14
0
2000
4000
6000
8000
10000
12000
14000
2002 2003
Year
Rate
/100,0
00
65-74
75-84
85+
Emergency room visit rate due to Falls by age group, Ottawa 2002-2003
Emergency room visit rate due to Falls by age group, Ottawa 2002-2003
15
0
2000
4000
6000
8000
10000
12000
14000
16000
65-74 75-84 85+ 65-74 75-84 85+
2002 2003
Year
Rat
e/10
0,00
0
Males
Females
Emergency room visit rate due to Falls by age group and gender, Ottawa 2002-2003
Emergency room visit rate due to Falls by age group and gender, Ottawa 2002-2003
16
Stand Up! PIED- Montréal Québec- 1996Stand Up! PIED- Montréal Québec- 1996
Developed in close collaboration with community workers, P.I.E.D.* is aimed at reducing three of the risk factors associated with falls:
Impaired balance Dangers in the home
Unsafe behaviours
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Stand Up! PIEDStand Up! PIED
1. To improve balance and leg strength
2. To develop the ability to make adjustment in the home and adopt
safer behaviours
3. To enhance a feeling of effectiveness related to fall
prevention
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Stand Up! PIEDStand Up! PIED
4. To help maintain bone density;
5. To encourage regular practice of physical activity.
19
Stand Up! PIEDStand Up! PIED
The program lasts 12 w eeks and consists of
three components:1. Group exercises to improve
balance and muscle strength (Tai
Chi)
2. Exercises at home
3. Information sessions on fall
prevention
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VideoVideo
21
Exercises
at home
1 X week
20-30min
A multifactorial program - 12 weeks
15 to 20 participants age 60 and over
Group
Exercises
2 X week
one hour
Prevention
sessions
1 X week
30 min
The Stand Up! programThe Stand Up! program
22
23
Physical activities for individuals or groupsMunicipal recreationPrivate recreation centresCommunity agenciesActive Life Program(Fitness walking groups)Safety promotionPublic policiesSafer environments
Stand Up! Program (PIED)
Integrated program of dynamic balance
Home Care Falls Prevention Program Regional pilot project -fall prevention for seniors living at home MARCHE program: Mobilization program for the elderly to reduce falls in the home
Preventive Medical Intervention Approach
Elderly peoplein the population
Older adultswith risk factors
PROMOTION PREVENTION
O.A. LIVING AT HOME O.A. HOSPITALIZED/LTC
REHABILITATIVE CARE
For the population at large For the individual
High-risk older adultswith a history of falls
Older adults withinjury or disability
Communitydevelopment interventions
Preventivemedical
interventions
Older adultsin the population
Non-personalizedmultifactorialinterventions
Personalizedmultifactorialinterventions
Adaptation/readaptationinterventions
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Evaluation of Stand Up! Montreal- Outaouais and OttawaEvaluation of Stand Up! Montreal- Outaouais and Ottawa
1996 in Montreal2004-2006 Outaouais2005 Ottawa
Looked at: Profile of participants Levels of participation and satisfaction Effects on balance and lower
extremities strength
25
http://santepub-mtl.qc.ca/english/elderly.html
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REPORT January 2007
Stand Up! \ PIED
Falls Prevention Program for seniors in Somerset West- a pilot 2005
Ottawa Public Health
Ginette.asselin@ottawa.ca
27
Montréal:
3 groups 1996 36 participants
participation rate 73%
28
PROFILE OF PARTICIPANTS- Outaouais Fall 2004 to Spring 2006
PROFILE OF PARTICIPANTS- Outaouais Fall 2004 to Spring 2006
12 groups: 167 participants 143 remained with the program until the end
Registrations: 272 registrations, including 105 waivers before the 1st meeting and 24 withdrawals after the 1st meeting
Age : Average: 70Median: 70Variation: 52-89Age groups: 50-59: 10% (17)
60-69: 34% (57)70-79: 41% (68)>80: 15% (25)
Gender: Female: 92% (154)Male: 8% (13)
Fall in the past 12 months:
Yes: 26%No: 74%
29
Participation in Stand Up! Ottawa Participation in Stand Up! Ottawa
14 women, 2 men Youngest 59 y. o. oldest 90 y.o. mean age of 74.8
Number of participants at entry into program
Number of participants at end of program
Overall participation rate in weekly group exercise
sessions
Retention
16(1 starting week 3)
12 70.3%75%
(12/16)
30
EFFECTIVENESS- Outaouais experienceEFFECTIVENESS- Outaouais experience
Balance:
Overall, there was an average improvement in 4 tests and significant improvement in >1/4 tests in 7/12 groups
Muscular strength:Overall, there was average and significant improvement in 1/1 test in 9/12 groups
31
0
10
20
30
40
50
Functional reach Tandem (e.o.) Tandem (e.c.) Sit-to-stand** Unipodal
Initial/Pre program Final/ Post program
Results Ottawa Pilot 2005 Balance and strength testing
32
SATISFACTION of Participants:SATISFACTION of Participants:
Satisfaction level: Very satisfied and satisfied (content, atmosphere and facilitator)
Improved balance and leg muscular strength observed throughout the program
Desire to continue the physical activity on their own or to remain with the PIED program
Social network, respect among participants
33
SATISFACTION of Co-facilitators:SATISFACTION of Co-facilitators:
Liked the experience, sense of feeling useful, liked the atmosphere, participant acceptance
Ready to do it again in alternating shifts (significant availability for just 1 person)
Progress observed in participants
34
SATISFACTION of Facilitators:SATISFACTION of Facilitators: High level of competence, responsibility, creativity,
etc.
Interest in the group, in the community, in promotion/prevention, etc. vis-à-vis their respective educational background
Diversification of the daily approach
Difficulties managing the caseload despite additional time being granted to prepare meetings or having substitute workers on certain territories
The co-facilitation of workers facilitated the implementation of the program on certain territories
Participant progress observed and achieved through the administration of tests
35
Lessons learned- what’s needed to deliver this programLessons learned- what’s needed to deliver this program
Trained professionals (health or physical activity specialists)
One day training and peer mentoring is necessary for professional staff to be able to deliver the program independently.
The Program tools are easy to use and well received by the participants.
36
Lessons learned- what’s needed to deliver this programLessons learned- what’s needed to deliver this program
Consistent, on time and as scheduled
If more than 15 participants two staff should be present
A committed Seniors’ serving Agency and seniors group
Ongoing professional support Ottawa Public Health.
Safety of participants is paramountFor QA deliver as program protocol
37
Recommandations:Recommandations:
Increase # registrations to 30 (waiting list) No repeat twice in a row at the same place or 2 groups at
the same time, same place Press releases, brochures, posters, presentations and
word of mouth best to promote and recruit- start 2 months prior to planned start of program
Start mid September and end of February are best.
Repeat pre- and post-program tests under the same conditions
Adjust the material and exercises (weight transfer, hygiene…)
38
Stand Up! PIED after the pilot…Stand Up! PIED after the pilot…
4 groups in 2006… New Horizons Funds
39
Budgetary considerationsBudgetary considerations
To deliver a program within your community : community agency partner
two trained professionals (88 hours total)
a safe comfortable facility
equipement as per program protocol ( $700 to 750$)
40
Roles of partners- Public HealthRoles of partners- Public Health
Regional operational mechanism for implementation
Securing budgets Organize training Support implementation
Promotion of programme; Recruitment of participants; Purchase of materials or
equipment; Tools for implementing
programme; Training and upgrading for
professionals
Delivery of Programme as support
Evaluation, recommendation
41
Roles of partners- Seniors’ Health Social Service AgencyRoles of partners- Seniors’ Health Social Service Agency Mobilize partners in making the Stand Up
Programme accessible and available. Participate in delivering training on the
programme. Implement the programme:
Promotion of programme; Recruitment of participants; Pre/post programme assessment of
participants (Weeks 1 and 12); Facilitation of 20 sessions over 10
weeks. Participate in assessing the programme
and developing recommendations
42
Role of seniors’ community groups/ associationsRole of seniors’ community groups/ associations
Define the extent of their participation in the implementation of the Programme
Promotion of programme and recruitment of participants
Assist with logistics for sessions (reserving rooms and
audiovisual equipment, setting up rooms, etc.)
Provide feedback re success or difficulties
43
Finale… Stand Up in OttawaFinale… Stand Up in Ottawa
Become an integral part of community based seniors health programming on a regular basis in Ottawa.
A new solution for groups interested in preventing falls among seniors.
44
For more information…For more information…
Ginette.asselin@ottawa.ca
(613) 580-6744 ext.26236
http://santepub-mtl.qc.ca/programmechute/
standup.html
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