Knowledge rises on falls prevention
A promising trial of a strength and balance exercise program in aged care has resulted in a 55 per cent reduction in the rate of falls among residents.
A promising trial of a strength and balance exercise program in aged care has resulted in a 55 per cent reduction in the rate of falls among residents.
The SUNBEAM trial (Strength and Balance Exercise in Aged Care) consisted of individually prescribed progressive resistance training plus balance exercises performed in a group setting for 50 hours over a 25-week period, followed by a six-month maintenance program.
It involved 221 aged care residents from 16 facilities in New South Wales and Queensland, half of whom participated in SUNBEAM, with the other half following their normal care regime.
The results, which were published recently in the Journal of the American Medical Directors Association, show a significant drop in the rate of falls among participants, said lead investigator Jennie Hewitt.
Ms Hewitt, positive living co-ordinator at Feros Care, a physiotherapist and PhD candidate at the University of Sydney, has spent the past six years developing an evidence base for the prevention and management of physical injuries among aged care residents.
The 55 per cent reduction in falls rate among the SUNBEAM participants was “bigger than in any other study to date,” Ms Hewitt told Australian Ageing Agenda.
“There was also a considerable difference in participants’ balance and mobility.”
She said the residents were also “incredibly positive” about their experience.
“People were telling us that the program was changing their lives. Some were newly able to get in and out of the car and go out with their family. You could see them walking tall and proud when they came in,” Ms Hewitt said.
Older people in residential care facilities are up to three times more likely to experience a fall than their counterparts in the community.
An Australian study published in the latest Australasian Journal on Ageing suggests that reliable falls risk assessment tools for facilities are still being developed and that more research is needed to determine the best choice tool for residential care.
Ms Hewitt said she hoped the results of her study would lead to resistance training and balance exercises being incorporated into funded physiotherapy services in aged care.
Feros Care is taking steps towards this by supporting physiotherapy students on placement to deliver restorative programs “rather than just pain management activities such as TENS [transcutaneous electrical nerve stimulation] and massage,” she said.
Ms Hewitt will present the results of her research to Aged Care Minister Ken Wyatt at a Deans Forum in Canberra next month.
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I would hope that residents care plans already have physical assessments built into them, once at intake into a supported facility and then as part of the resident’s annual review.
Individuals with an identified history of slips, trips and falls should be given should be given a red flag for follow up therapy/prevention strategies outside the intake and annual review.
Once a physiotherapist has assessed the resident, other staff can assist helping the resident participate in their program.
While a gym set up would be ideal, so many activities can be undertaken in groups in lounge areas.
The key challenge is to change our thinking from what the resident can’t do to what can be done and is there a goal we can help the individual achieve.
I would be very interested in the SUNBEAM programme and hope that it will be rolled out to all facilities.
Are Lifestyle Officers able to undergo the appropriate training so that we can implement it into our exercise programme?
I already do some balance exercises (learned through EMAA) and use light weight dumbbells and have found that residents are very focused and like it a great deal.
Any program to strengthen older people to prevent falls is admirable. But a reminder to providers that older people lose muscle strength more quickly than in previous year and any program needs to be supplement with daily exercises to be sustainable.
Also appropriate aids are necessary. More and better aids are available. I find walking sticks useless in prevent falls and more likely to cause one. Walkers/Rollators are the best option at present but patients/clients need to be coached in their use.