An Investment In Aging a Fall Prevention Program

1
An Investment In Aginga Fall Prevention Program

• Speakers
• Vince Caraffi, R.S., MPH
• Angela Townsend, R.S.
• Program Coordinator
• April Vince, LSW, MSAA
• Cuyahoga County Board of Health

2
Definition of a Fall

• Anyone inadvertently coming to rest on the ground
  or a lower level in absence of trauma and other
  overwhelming medical events.

3
Fall related statistics

• Incidence one in three Americans over the age of
  65 will suffer a fall each year
• Falls are the leading cause of injury deaths for
  those seniors 65 and older
• Falls account for 87 of all fractures in those
  seniors 65 and older
• 
  Rubenstein 1998

4
Risk Factors for Falls

• Medication
• Impaired vision
• Medical conditions
• Decreased strength
• Fear of falling
• Gait/balance issues
• Environment
• Age 65 older
• Living alone
• Tinetti 1994

5
Costs Associated with Falls

• Injuries
• 30-50 of falls result in minor injuries
• 10 result in major injuries (half of them are
  fractures)
• Poor outcome of a hip fractures
• Contributing factor in 35 of nursing home
  admissions
• 15 die in hospital
• 
  Rizzo 1998

6
Financial Costs of Falls

• Fall related injuries account for 6 of all
  medical injuries for persons age 65 and older in
  the United States
• Medical expenditures in 2000 were estimated at 17
  million dollars
• Campbell 2002

7
Local Data

• Population 65 older Living Alone
• Brooklyn 11,586 2,537 (21.9) 390 (15.4)
• Brook Park 21,218 3,628 (17.1) 391
  (10.8)
• Parma 85,655 16,788 (19.6) 2,283 (13.6)
• Parma Hts. 21,659 5,436 (25.1) 1,098
  (20.2)
• Seven Hills 12,080 3,116 (25.8) 383
  (12.3)
• Total 152,198 31,505 (20.7) 4545 (14.4)
• 2000 Census

8
Falls in Cuyahoga County

• Cuyahoga County falls into the 90th percentile
  nationally among 307 counties with the highest
  numbers of deaths resulting from unintentional
  falls.

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Where do you Start?
10
An Idea

• The easiest way to eat an elephant is one bite at
  a time
• What would be the first step in creating a fall
  prevention program?
• Which organization in your county/city is the one
  stop shop for health issues regarding seniors?
• Are falls the most important public health issue
  concerning seniors?

11
Results of the Initial Project

• Since 2003 we have educated 2,000 seniors at risk
  of falling. Educational sessions are offered at
  senior centers, church groups, local YMCAS.
  Sessions focus on eliminating the fear of falling
  and the risk factors attributed to fall related
  mortality and morbidity.
• In addition to the educational sessions this
  office conducted 75 home visits identifying
  structural issues in the community dwellings of
  those seniors at risk.
• The number of risk factors in the home consisted
  of lack of structural items hand rails, grab
  bars, clutter and poor lighting. In addition we
  noted improper or no use of prescribed assistive
  devices, lack of socialization, poly-pharmacy and
  limited physical activity.

12
Review of Pilot Project

• Barriers
• Recruitment for home assessments.
• Financial means to make structural modifications
  to the home.
• Limited awareness in Cuyahoga County of the
  susceptibility and the severity of a fall related
  incident.
• Current educational settings did not motivate
  behavioral change.

• Successes
• Community buy-in.
• Family assistance to help those family members at
  risk of falling.
• Interest from additional communities and senior
  care organizations.
• An increased awareness regarding the
  lifestyles/behaviors of those seniors at risk of
  falling.
• A foundation for future growth.

13
Overcoming the Barriers

• Recruitment
• Working with DOD City of Gar. Hts, News media,
  City Newsletter, benefit of working with
  organizations with existing relationships and
  trust with the population being targeted.
• Structural Modifications to Home
• DOD, City of Cleveland Hts. Building Department
  willing to support structural improvements to
  homes.
• Our initial project increased the awareness among
  communities.
• Community leaders are requesting the same program
  for their constituents.
• Matter of Balance
• Motivating behavioral change.

14
Partnerships

• Western Reserve Area Agency on Aging
• Local Seniors Centers
• Local City Government (Parma, Garfield Hts.,
  Cleveland Hts.)
• Cuyahoga County Department of Development
• Parma General Community Hospital
• Jewish Community Federation
• Fairhill Center on Aging

15
Questions

• Contact Person
• April Vince, LSW,MSSA
• Program Manager
• 216-201-2001 ext. 1538