A Matter of Balance:

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Sponsored by The National Council on the Aging
and CareSource
Healthy Aging Briefing Series
A Matter of Balance Managing Concerns about
Falls
WELCOME
This session will begin promptly at 130pm
ESTPlease mute your phone

Personal introductions are not necessaryThe
moderator will be on the line shortly
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A Matter of Balance Managing Concerns about
Falls Volunteer Lay Leader Model April 20,
2006 Peggy Haynes, MPA Elaine McMahon, MS,
RN MaineHealths Partnership for Healthy
Aging Portland, ME
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Session Objectives

• Identify a practical, community-based strategy to
  address falls and fear of falling
• Understand the importance of fall prevention for
  older adults
• Identify strategies for broad-based program
  dissemination

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Falls Epidemiology of the Problem

• Major cause of injury and death for older adults
• Falls are the leading cause of injury
  hospitalization in Maine Healthy Maine 2010
• 1/3 to 1/2 of older adults acknowledge fear of
  falls
• Fear of falling is associated with
• depression
• decreased mobility and social activity
• increased frailty
• increased risk for falls as a result of
  deconditioning

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Why fall interventions?

• Falls in older adults are
• Common
• Morbid
• Predictable
• Preventable

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Administration on Aging Grant

• 2003 AoA launched a three year public/private
  partnership to increase older peoples access to
  programs that have proven to be effective in
  reducing their risk of disease, disability and
  injury.
• Grant Goals
• Test whether a volunteer lay leader model is
  successful as compared with original research
• Maintain fidelity to the original MOB curriculum
• Share our approach with others in Maine and
  around the country
• AoA Grant 90AM2780

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A Matter of BalanceVolunteer Lay Leader Model

• Partners
• Southern Maine Agency on Aging
• MaineHealths Partnership for Healthy Aging
• Maine Medical Center Division of Geriatrics
• University of Southern Maine, School of Social
  Work
• Guided by a Project Advisory Committee
• A Matter of Balance participant and coach
• AARP Maine
• City of Portland
• Maine Center for Disease Control and Prevention
• Maine Nutrition Network
• Maine Office of Elder Services
• Maine State Housing Authority
• New England Rehabilitation Hospital
• Osher Lifelong Learning Institute
• University of New England, Geriatric Education
  Center

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A Matter of BalanceOriginal Model

• Research by the Roybal Center for Enhancement of
  Late-Life Function at Boston University.
• Designed to reduce the fear of falling and
  increase the activity levels of older adults who
  have concerns about falls.
• Tennsdedt, S., Howland, J., Lachman, M.,
  Peterson, E., Kasten, L. Jette, A. (1998). A
  randomized, controlled trail of a group
  intervention to reduce fear of falling and
  associated activity restriction in older adults.
  Journal of Gerontology, Psychological Sciences,
  54B (6), P384-P392.

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A Matter of BalanceManaging Concerns About Falls

• Designed to benefit community-dwelling older
  adults who
• Are concerned about falls
• Have sustained a fall in the past
• Restrict activities because of concerns about
  falling
• Are interested in improving flexibility, balance
  and strength
• Are age 60 or older, ambulatory and able to
  problem-solve.
• Eight 2-hour classes designed to help
  participants learn
• To view falls and fear of falling as controllable
• To set realistic goals for increasing activity
• To change their environment to reduce fall risk
  factors
• To promote exercise to increase strength and
  balance

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A Matter of BalanceVolunteer Lay Leader Model

• Model Program Adaptations
• Classes taught by volunteer lay leaders instead
  of healthcare professionals
• Participant workbook developed and coach manual
  modified
• Exercises modified
• Healthcare connection via guest therapist
• Participants recruited through
• Community organizations newsletters
• Outreach presentations to
• Aging network
• Community centers faith-based organizations
• Clubs, libraries, social gatherings
• Physician practices
• Housing coordinators

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Maintaining Fidelity

• Original research curriculum used
• Two day coach training based on original A Matter
  of Balance leader manual
• Health care professionals and master trainers
  observe volunteer coaches during
• two day training
• a MOB/VLL class
• Use of a mentor model new volunteers are paired
  with an experienced coach

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A Matter of Balance Outcomes

• Participant Outcomes
• 97 - more comfortable talking about fear of
  falling
• 97 - feel comfortable increasing activity
• 99 - plan to continue exercising
• 98 - would recommend A Matter of Balance
• who agree to strongly agree

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Outcomes Participant Comments

• I am more aware of my surroundings. I take time
  to do things and dont hurry.
• Although I still fear falling, the course helped
  me to cope with the fear so that it does not
  limit my life and keeps me aware of ways to avoid
  fallingso far so good!
• I have more pep in not being afraid.
• A Matter of Balance program made me realize that
  Im responsible for me. It raised my self-esteem.

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Dissemination

• Phases
• Initial phase York Cumberland County
• First eighteen months design, develop and
  demonstrate
• During the second half of year two Request for
  Partner process identified Master Trainer sites
  statewide
• During year three add Master Trainer sites
  statewide, prepare national dissemination, work
  with NHCOA for Spanish translation

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Request for Partners
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Dissemination with Statewide Partners Master
Trainer Sites

• Master Trainers Sites
• Agencies on Aging
• Regional Hospitals
• Healthy Maine Partnerships
• YMCA
• Responsibilities
• A Master Trainer is responsible for recruiting
  and teaching the curriculum to coaches and
  providing guidance and support, sponsoring
  classes, and recruiting participants.

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Dissemination Activity

• 14 Master Trainer sites have been established in
  Maine with 31 Master trainers
• 617 older adult participants
• 114 volunteer coaches trained statewide

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A Matter of Balance Research Report March 2006
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Significant Outcomes

• MOB Volunteer Lay Leader

• MOB Original Research

• 6 Weeks
• Falls Management
• Falls Efficacy
• Falls Control
• Exercise Level
• Social Activity
• 6 Months
• Falls Management
• Falls Efficacy
• Falls Control
• Exercise Level
• Monthly Falls
• 12 Months
• Falls Management
• Exercise level

• 6 Weeks
• Falls Management
• Falls Efficacy
• 6 Months
• Falls
• Management
• 12 months
• Falls Management
• Falls Efficacy
• plt.05 plt.01 plt.001

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Preliminary State Wide Findings

• Comparison of First and Last Class
• Falls Management
• Modified PACE
• Falls control Overcome Fear NS
• Social Activity - NS
• N65

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Cost to Implement

• Supplies
• Training
• Marketing
• Sponsorship

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A Matter of Balance Class Sites
Master Trainers and Coach Training Sites
A Matter of Balance Facilitator Training
Dissemination Profile
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MaineHealths PARTNERSHIP FOR HEALTHY AGING is
pleased to offer A MATTER OF BALANCE M A N A G I
N G C O N C E R N S A B O U T FA LLS
Volunteer Lay Leader Model Master Trainer
Session Wednesday, June 7 and Thursday, June 8,
2006 Hilton Garden Inn 5 Park Street Freeport,
Maine For more information please e-mail
PFHA_at_mmc.org
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A Matter of BalanceVolunteer Lay Leader Model

• For more information please contact
• Partnership for Healthy Aging
• 465 Congress Street, Suite 301
• Portland, Maine 04101
• [phone] pfha_at_mmc.org