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Fifteen years ago, George Preger of Toronto fell on some black ice and severed a tendon in his knee.
Although he didn't need surgery, it took a year of physiotherapy to heal the injury, which still bothers him some days, and he has been vigilant about avoiding falls ever since.
"I'm very aware that injuries from falls can result in serious, sometimes fatal, complications for older people," says George. "I'm turning 80 next year and wanted to make sure I was doing everything possible to avoid another nasty fall."
George was an ideal candidate for the Toronto Western Hospital's (TWH) Family Health Team Falls Education Program. The five-week pilot program was developed by the primary care clinic specifically for patients who were at risk for falls, or had a fear of falling, but may not require or be able to commit to longer, more intense programs – some of which have waiting lists of over a year.
Focus on fall safety
"Fall safety is an important priority at UHN, but it isn't limited to preventing falls on in-patient units," says Miu-Lin Wong, Health Promotion Coordinator, Family Health Team. "There is little to offer patients who are at risk of falling but still live independently, and we wanted to develop an education program to address that gap."
As part of a focus on fall safety, the Family Health Team realized that there was an opportunity for health promotion and prevention of falls for those of their 16,000 patient who may be at risk.
At registrations, patients check in on an electronic table that has a number of "smart screening" capabilities, one of which identifies risk for falls. The information, followed by individualized assessments provided, helped the team identify which patients would benefit most from the Falls Education Program, or other personalized approaches.
George was one of the nine patients contacted to take part in the sessions. Led by an inter-professional clinical team of a health promotion coordinator, physical therapist, occupational therapist and TWH volunteers, the participants learned about the various topics related to falls prevention such as nutrition, proper footwear, vision, medications, home safety and community supports.
Discussion and exercises
Each session was two hours in length. The first hour involved a discussion between participants and the care team about strategies to decrease their falls risk, followed by an hour of exercises focused on improving balance and increasing participants' overall activity.
At the end of each session, participants were given a fall prevention goal to implement at home and were asked to report back the following week with their level of success or any challenges they encountered that needed to be addressed.
"We developed this program based on the needs of our patients," says Deanna Baker, Physiotherapist who helped lead the program. "All of our participants are active and live independently, so we wanted to give them information tailored to their circumstances in order for them to make any adjustments necessary in their lives to reduce their risk of falling."
Occupational Therapist Karen Azavedo says, "most of our participants weren't aware of some of the strategies we've shared with them."
Reducing risk at early stages
"This program is really focused on reducing fall risk in its earliest stages and working with our patients in a preventative way, rather than when they might need more serious interventions," Karen says.
For George, the program has been a positive experience on many levels. He learned tai-chi, enjoyed the program's friendly and inclusive environment, and has been able to incorporate regular exercise, sometimes with a trainer, into his life.
"The Family Health Team did such a great job with this program," he says. "Accident prevention costs a lot less than having people recuperate in hospital, and I feel confident that the strategies I've learned will help me avoid falls in the future."