Reducing Falls in Older People

Reducing fallsThe impact of falls on older people’s lives is serious. Around 60% of deaths and three-quarters of serious injuries to the over-65s are caused by falls. Every year, over 1,500 people over the age of 65 are killed by an accidental fall in the home.

In addition:

  • 80% of deaths from accidents are in the over-65 age group
  • 67% of non-fatal falls happen to an older person in the home
  • 42% of fallers have at least an 18% reduction in activity after a fall

The first initiative of the Healthy Communities Collaborative was a one-year pilot falls reduction programme in 2002 involving three disadvantaged communities – Gateshead, Easington and Northampton. Its objectives were to:

  • Reduce falls in older people by 30% in one year
  • Create a template for multi-agency working
  • Remove barriers which prevent organisations from engaging with communities
  • Build social capital to stimulate a desire in the communities to move on to other topics.

In addition, the personal growth and development of a section of the population which was sometimes undervalued, and an increased sense of community in the programme areas, were very important.

This programme is now completed. If you are interested in working with the Improvement Foundation please go to How we can help or click here to contact us.

Who is involved

Initially, teams were recruited across three communities – Gateshead, Easington and Northampton – to test the idea over the one-year pilot. The teams consisted of community members and staff from relevant local agencies, including the voluntary sector. Deliberately, there were a greater proportion of community members than practitioners in each team.

What we are doing

The Health Development Agency carried out a review of the published evidence for falls reduction and distilled some key changes. These were:

  • Programmes based on risk assessments and tailored to individuals are most successful
  • Individually-tailored, home-based exercise programmes reduce falls, especially those based on T’ai Chi
  • Hip protectors substantially reduce hip fractures in high-risk populations.

In addition, we know that medication and physical activity help to prevent and manage osteoporosis.

The Improvement Foundation was supported by colleagues from the Health Development Agency who collated a set of evidence on What Works in Reducing Falls in Older People. Using this evidence, they were able to present practical examples of effective measures that could be adopted by the teams and adapted for use in their own areas. 

Key results

CHANGE PRINCIPLES MEASURES RESULTS POPULATION COVERAGE PARTICIPANTS

Raise awareness of the need for change in a topic area

Enable communities to lead the process supported by ‘insulated professionals’

Focus energy on common goals

Enhance social systems

Raise expectations

Falls in over 65 year olds: Number of falls in the team area - from ambulance data.

Number of fallers in the identified care home/residential facilities.

Social Capital
Aimed to assess the impact of the HCC intervention relating to social capital in each of the team areas by asking a variety of questions relating to residents’ sense of community and also relating to falls

32% decrease in falls handled by the ambulance service

Social capital
13% increase in general population  of people who thought their area was a good place to live

48% increase in participants who thought they could change attitudes and improve things in their area

Sustainability
Of 21 HCC sites since 2002, only one site has failed to sustain the work in one form or another

570,000 people in most deprived communities

Total team members = 1,140 people

Of those 800 were lay people

Others: local statutory and non-statutory agency staff