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LIFE ElderCare’s
                  Fall Prevention
                  Program




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Fall risk to senior health
             35% of people 65+ fall each year
             Every 18 seconds someone 60+ is taken to the ER
                  for a fall [16% of all ER visits]
             #1 reason for entry into long-term care facilities
             Leading cause of injury death in older adults –
                  every 35 minutes
             Over 1.3 million older Californians fall each year

                  many sustain hip fractures, head injury or death




Maureen Parent,                California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator    April 18, 2011                   www.lifeeldercare.org
Falls can be prevented
             Over 44 million baby boomers live at home with
                  an elderly or sick parent
             Another 25 million at-risk elderly live alone and
                  are unprotected from devastating falls
             Research shows that an individualized, multi-
                  factorial fall prevention program is the best
                  approach to fall risk reduction




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Goal: Reduce falls, improve quality of life

             Evidence-based program for frail, homebound seniors:
                   We work with the 60% at greatest risk for a fall and the
                        people who are most costly for the community to care for.
                   Those who are often precluded from participating in other
                        programs due to co-morbidities or serious medical conditions.
                   Average age is 88, the oldest client was 100.


                  Holistic, individualized program, addressing each
                  of the clients needs in:
                   Balance & Gait
                   Environment
                   Medications



Maureen Parent,                     California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator         April 18, 2011                   www.lifeeldercare.org
Exercise is key
             Exercise has a positive impact far beyond the
                  physical, especially for the elderly:

                   Delay of dementia and Alzheimer's
                   Improved brain function, far more than Sudoku
                   Improved longevity
                   Parkinson's: 14 additional months of independent living
                              Sometimes just holding the line is true success for a client
                              based on their numerous conditions, declining health and
                              advancing age.




Maureen Parent,                        California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator            April 18, 2011                   www.lifeeldercare.org
Benefit of a Certified Fitness Trainer

                               Assesses balance, gait, posture and
                                 muscle strength

                               Identified risk factors form the basis
                                 of an individualized exercise
                                 program

                               The routine is sent to the
                                 participant’s primary care physician
                                 for approval



Maureen Parent,                California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator    April 18, 2011                   www.lifeeldercare.org
Unitek College, Department of Nursing


                 Unitek College partners since
                      program inception in 2005

                 Seven years of uninterrupted service

                 Licensed Vocational nursing program

                 LVN to RN program




Maureen Parent,                California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator    April 18, 2011                   www.lifeeldercare.org
 1,589 nursing students trained in Fall
                                  Prevention, home health and geriatric
                                  care
                                        Students gain valuable experience in
                                        geriatric care and we are able to offer
                                         high quality care, free of charge, to
                                                      the seniors.

                               2,092 seniors served
                               36,044 hours of service
                               Average cost of unending care per
                                  senior: $500




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Intake Evaluation
                                  Medical history

                                  Medications

                                  Activities of Daily Living [ADL’s/IADL’s]

                                  Subjective survey of clients perceived
                                       strength, agility, confidence to stop a fall

                                  History of falls
                                  MMSE – Folstein Mini-Mental

                                  Geriatric Mood Score




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
High Quality Follow-Up
            One hour, weekly exercise appointments include:
                   Significant medical event(s) since the previous visit

                   Edema or unusual physical changes such as fatigue or confusion

                   Fall(s): cause and severity

                   Compliance with medical condition self-care such as diabetes and high
                        blood pressure
                   Blood pressure pre/post workouts

                   Frequency of workouts

                   Establishment and adherence to personal healthy living goals




Maureen Parent,                     California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator         April 18, 2011                   www.lifeeldercare.org
Educating Nurses about
                                Falls
            Education on the prevention of falls and fall injuries should be
            included in nursing curricula and on-going education with specific
            attention to:

                             Promoting safe mobility

                             Risk assessment

                             Multidisciplinary strategies

                             Risk management including post-fall follow-up”
                              Registered Nurses Association of Ontario, 2005




Maureen Parent,                         California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator             April 18, 2011                   www.lifeeldercare.org
Education on Healthy Living
                   How to get up from a fall

                   Dehydration

                   Vitamin D

                   Educate about community resources

                   Establish and motive to achieve compelling goals

                   Ensure client safety through training, motivation
                        and physical strengthening
                   Provides companionship, comfort and reassurance




Maureen Parent,                    California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator        April 18, 2011                   www.lifeeldercare.org
Home Modification

                    Unitek LVN students complete simple forms to
                         assess client’s home for possible fall safety
                         hazards
                    LIFE ElderCare provides minor modifications




Maureen Parent,                   California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator       April 18, 2011                   www.lifeeldercare.org
Medication Management
                   Touro University, School of Pharmacy
                   Unitek LVN students search database for
                    interactions of client’s drugs
                   In-home teaching of pharmacist’s medication
                    review
                   Complete medication list provided to client, to
                    take to doctor and pharmacy visits
                   List of client medications shared with PCP




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Continuum of Care
            Unitek Registered Nursing students
               Integral aspect of never ending care: Sustainability
                   Complete physical, psycho-social and environmental
                     work-up
                   Review key issues and concerns
                   Devise a care plan
                   Help client to set motivating goals
                   Supervise exercise workouts
                   Educate on pharmacist provided medication review
                   Educate on conditions and community resources




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Fall Prevention Works
                              Stanford University, Business School Alumni

                                 Risk of Falling (Berg & Tinetti Assessment of Balance/Gait
                                                            Test)

                        58%


                                41%
                                                                                 32%                Pre-Program
                                                29%     27%                                         Post-Program

                                                                           13%



                         High Risk             Moderate Risk                Low Risk




Maureen Parent,                           California Wellness Foundation           LIFE ElderCare, Inc.
Fall Prevention Coordinator               April 18, 2011                           www.lifeeldercare.org
Program Results
                                                   Post Program: Noticeable or Vast Improvements




                                                                                                                             %
                                                                                                                                                         Balance




                                                                                                                       d, 72
                                                                                                                                                         Strength
                                                                                                                                                         Flexibility




                                                     , 65%




                                                                                                                    Moo
                                                                                     3%




                                                                                                                                                 %
                                                                                                                                                         Energy




                                                                                                                                                    63
                                                                                    gy, 6
                                                 ngth
                                                                                                                                                         Stamina




                                                                                                            58%




                                                                                                                                              fall,
                                                                                                                                                         Mobility




                                                                                                55%
                                                                            %



                                                                                Ener
                                             Stre
                                        5%




                                                                                                                                         nt a
                                                                       y, 55
                                                                                                                                                         Mood




                                                                                                          ility,
                                    e, 5




                                                                                                ina,
                                                                                                                                                         Ability to prevent a fall




                                                                                                                                         e
                                                                                                       Mob
                                                                 ibilit




                                                                                                                                     prev
                                 anc




                                                                                            Stam
                              Bal




                                                             Flex




                                                                                                                                  ty to
Maureen Parent,                                        California Wellness Foundation                                            Abili
                                                                                                                   LIFE ElderCare, Inc.
Fall Prevention Coordinator                            April 18, 2011                                              www.lifeeldercare.org
Dissemination
                Centers for Medicare & Medicaid Services –
                     Quality Improvement organizations in PA & CA

                Home Health Quality Improvement: “Best Practices in Fall
                     Prevention”

                Alameda County, Afghan Coalition Health Promoters
                     adopted this program

                California: Contra Costa County MOW group – adopted this
                     program. Launch June 2012



Maureen Parent,                    California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator        April 18, 2011                   www.lifeeldercare.org
Partnerships are
               THE key to our success
             The success of the program is dependent on our
                  partners
 each contributing their strengths,
                  knowledge and expertise to benefit frail, at-risk
                  seniors

             Without our partners we would be unable to deliver
                  this highly effective, much-loved program

             One final partner. . .




Maureen Parent,               California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator   April 18, 2011                   www.lifeeldercare.org
Mary Anderson
             The woman who brought the Fall Prevention concept to
                  LIFE ElderCare

             Hired me, became my E.D. and my friend

               “You don’t give back to the same people who give to you.
               Not at all. You give to different people and they in turn will give
               to someone entirely different. Not you. That’s the sloppy
               economy of gift and love.”

                                Lorrie Moore Who Will Run the Frog Hospital?




Maureen Parent,                 California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator     April 18, 2011                   www.lifeeldercare.org
 Maureen Parent
                                 510-673-7594
                                 mparent@lifeelderc.hostpilot.com



                               LIFE ElderCare website
                                 www.lifeeldercare.org




Maureen Parent,                     California Wellness Foundation   LIFE ElderCare, Inc.
Fall Prevention Coordinator         April 18, 2011                   www.lifeeldercare.org

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LIFE ElderCare Fall Prevention

  • 1. LIFE ElderCare’s Fall Prevention Program Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 2. Fall risk to senior health  35% of people 65+ fall each year  Every 18 seconds someone 60+ is taken to the ER for a fall [16% of all ER visits]  #1 reason for entry into long-term care facilities  Leading cause of injury death in older adults – every 35 minutes  Over 1.3 million older Californians fall each year
 many sustain hip fractures, head injury or death Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 3. Falls can be prevented  Over 44 million baby boomers live at home with an elderly or sick parent  Another 25 million at-risk elderly live alone and are unprotected from devastating falls  Research shows that an individualized, multi- factorial fall prevention program is the best approach to fall risk reduction Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 4. Goal: Reduce falls, improve quality of life  Evidence-based program for frail, homebound seniors:  We work with the 60% at greatest risk for a fall and the people who are most costly for the community to care for.  Those who are often precluded from participating in other programs due to co-morbidities or serious medical conditions.  Average age is 88, the oldest client was 100. Holistic, individualized program, addressing each of the clients needs in:  Balance & Gait  Environment  Medications Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 5. Exercise is key  Exercise has a positive impact far beyond the physical, especially for the elderly:  Delay of dementia and Alzheimer's  Improved brain function, far more than Sudoku  Improved longevity  Parkinson's: 14 additional months of independent living Sometimes just holding the line is true success for a client based on their numerous conditions, declining health and advancing age. Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 6. Benefit of a Certified Fitness Trainer  Assesses balance, gait, posture and muscle strength  Identified risk factors form the basis of an individualized exercise program  The routine is sent to the participant’s primary care physician for approval Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 7. Unitek College, Department of Nursing  Unitek College partners since program inception in 2005  Seven years of uninterrupted service  Licensed Vocational nursing program  LVN to RN program Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 8.  1,589 nursing students trained in Fall Prevention, home health and geriatric care Students gain valuable experience in geriatric care and we are able to offer high quality care, free of charge, to the seniors.  2,092 seniors served  36,044 hours of service  Average cost of unending care per senior: $500 Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 9. Intake Evaluation  Medical history  Medications  Activities of Daily Living [ADL’s/IADL’s]  Subjective survey of clients perceived strength, agility, confidence to stop a fall  History of falls  MMSE – Folstein Mini-Mental  Geriatric Mood Score Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 10. High Quality Follow-Up One hour, weekly exercise appointments include:  Significant medical event(s) since the previous visit  Edema or unusual physical changes such as fatigue or confusion  Fall(s): cause and severity  Compliance with medical condition self-care such as diabetes and high blood pressure  Blood pressure pre/post workouts  Frequency of workouts  Establishment and adherence to personal healthy living goals Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 11. Educating Nurses about Falls Education on the prevention of falls and fall injuries should be included in nursing curricula and on-going education with specific attention to:  Promoting safe mobility  Risk assessment  Multidisciplinary strategies  Risk management including post-fall follow-up” Registered Nurses Association of Ontario, 2005 Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 12. Education on Healthy Living  How to get up from a fall  Dehydration  Vitamin D  Educate about community resources  Establish and motive to achieve compelling goals  Ensure client safety through training, motivation and physical strengthening  Provides companionship, comfort and reassurance Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 13. Home Modification  Unitek LVN students complete simple forms to assess client’s home for possible fall safety hazards  LIFE ElderCare provides minor modifications Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 14. Medication Management  Touro University, School of Pharmacy  Unitek LVN students search database for interactions of client’s drugs  In-home teaching of pharmacist’s medication review  Complete medication list provided to client, to take to doctor and pharmacy visits  List of client medications shared with PCP Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 15. Continuum of Care Unitek Registered Nursing students Integral aspect of never ending care: Sustainability  Complete physical, psycho-social and environmental work-up  Review key issues and concerns  Devise a care plan  Help client to set motivating goals  Supervise exercise workouts  Educate on pharmacist provided medication review  Educate on conditions and community resources Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 16. Fall Prevention Works Stanford University, Business School Alumni Risk of Falling (Berg & Tinetti Assessment of Balance/Gait Test) 58% 41% 32% Pre-Program 29% 27% Post-Program 13% High Risk Moderate Risk Low Risk Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 17. Program Results Post Program: Noticeable or Vast Improvements % Balance d, 72 Strength Flexibility , 65% Moo 3% % Energy 63 gy, 6 ngth Stamina 58% fall, Mobility 55% % Ener Stre 5% nt a y, 55 Mood ility, e, 5 ina, Ability to prevent a fall e Mob ibilit prev anc Stam Bal Flex ty to Maureen Parent, California Wellness Foundation Abili LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 18. Dissemination  Centers for Medicare & Medicaid Services – Quality Improvement organizations in PA & CA  Home Health Quality Improvement: “Best Practices in Fall Prevention”  Alameda County, Afghan Coalition Health Promoters adopted this program  California: Contra Costa County MOW group – adopted this program. Launch June 2012 Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 19. Partnerships are THE key to our success  The success of the program is dependent on our partners
 each contributing their strengths, knowledge and expertise to benefit frail, at-risk seniors  Without our partners we would be unable to deliver this highly effective, much-loved program  One final partner. . . Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 20. Mary Anderson  The woman who brought the Fall Prevention concept to LIFE ElderCare  Hired me, became my E.D. and my friend “You don’t give back to the same people who give to you. Not at all. You give to different people and they in turn will give to someone entirely different. Not you. That’s the sloppy economy of gift and love.” Lorrie Moore Who Will Run the Frog Hospital? Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org
  • 21.  Maureen Parent  510-673-7594  mparent@lifeelderc.hostpilot.com  LIFE ElderCare website  www.lifeeldercare.org Maureen Parent, California Wellness Foundation LIFE ElderCare, Inc. Fall Prevention Coordinator April 18, 2011 www.lifeeldercare.org