Falls

The case for prioritising falls prevention is clear. Falls are generally caused by preventable risk factors, which if minimised, would not only greatly reduce health and social care costs but also improve the quality of life of individuals most at risk of falls. Preventing falls requires a multifaceted approach, involving population health strategies such as promoting physical activity, ensuring safe environments and optimising healthcare systems to identify and manage fall risks among individuals.

Prioritise exercise programmes as a fall prevention strategy

Exercise programmes, particularly strength and balance programmes, are the most effective intervention to reduce both the risk and rate of falls amongst older people. Moreover, they have wide reaching physical, mental and social health benefits beyond that of falls prevention e.g. reductions in fragility fractures via strengthening of bones and muscles, improved weight management, multiple cardiovascular benefits, and often reduced feelings of loneliness and isolation if delivered in groups. Hence, in a resource limited setting the case for exercise programmes couldn’t be stronger. A prioritisation of exercise programmes for older adults would alone promote each of the three key areas identified in the North Tyneside ageing well strategy: being healthy, being active, being connected.

Considerations: 

• Agencies and service providers across North Tyneside should work together to develop standardised, evidence-based exercise programmes and seek to ensure equitable access across the local authority region.

Increase attempts to identify older people at risk of falls

Far too many people are identified as being at risk after being admitted to hospital with a fall. Falls tend to lead to deconditioning either through injury, fear of falling or both, increasing the risk of falling even more. The most effective approach to falls prevention is to identify and support individuals at risk of falling before they fall.

Considerations:

• Healthcare professionals to be given training on identifying individuals at risk of falling. Once identified, individuals should be offered self-referral to exercise programmes, and a ‘multifactorial risk assessment’ delivered by primary care teams.
• For individuals deemed at high risk of falling it would be good practice to have a home hazard assessment carried out by occupational therapists.

Improve detection and treatment of osteoporosis

No matter the extend of falls prevention work, it is inevitable falls will continue to occur amongst the older population. It is therefore important to also consider how to minimise the impact and burden of falls when they occur. Osteoporosis increases the risk of fractures following a fall yet is often undiagnosed until after a fracture occurs. Intensifying efforts to identify, and adequately treat, osteoporosis would represent a relatively simple and cost-effective approach to reducing the risk of fractures following a fall.

Considerations:

• A joint strategic needs assessment should be carried out for osteoporosis