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Improve health for Vermont's older adults

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Fall-related emergency department visits per 100,000 adults age 65 and older

5,628.42011

Story Behind the Curve

Last Updated: November 2016

Author: Injury Prevention Program Team, Vermont Department of Health

Risk of falls increases with age but falls should not be

considered an inevitable part of the aging process. Because there are many

reasons an individual might fall, and these can act synergistically, falls

prevention must be multifactorial and comprehensive.

Traditionally, the evidence base supports programming that

includes early assessment, exercise, medication management, and safety within

environmental design. Often those individuals at risk of falling (in this

instance, defined as those Vermonters age 65 and older) experience: a fear of

falling, limiting mobility which affects strength and stability, and medication

which may cause drowsiness or impair balance. There has been a wealth of

research on elderly falls prevention interventions that has been incorporated

into a variety of evidenced based programming and strategies. We are working to

more fully incorporate these strategies into Vermont’s community services and

statewide systems.

In recent years, evidence has emerged to support a multifactorial

approach that uses older adults’ own experiences to frame individual falls

prevention strategies. Out of this research came the evidence-based program

FallScape, an in-home, one-on-one series of sessions that combines motivational

interviewing, situational awareness training and authentic learning theory.

In Vermont, the Department of Health offers the FallScape

program, delivered by specially-trained Emergency Medical Services personnel

statewide. The Area Agencies on Aging, community hospitals, and other community

organizations offer Tai Chi and Matter of Balance for elder fall prevention

programming. A listing of nationally determined evidence-based programs can be

found on the website of the National Council

on Aging.

Partners

DAIL,

Vermont EMS Agencies

Vermont Area Agencies on Aging (AAA)

Hospitals

Visiting Nurses Association (VNA)

Support and Services at Home (SASH)

Blueprint for Health

What Works

    Studies show that a combination of behavior changes can significantly reduce falls among older adults. Experts recommend:

    • Participating in a physical activity regimen with balance, strength training, and flexibility components.
    • Consulting with a health professional about getting a fall risk assessment.
    • Having medications reviewed periodically.
    • Getting eyes and ears checked annually.
    • Making sure the home environment is safe and supportive.
Strategy

The Vermont Department of Health received grant funding to run a state falls prevention program for 2014-2017. The falls prevention program goals are to reduce falls related injury and deaths in older adults in Vermont.

  • Strategy
    • Coordinate with Falls Free Coalition and local Area Agencies on Aging (AAA) on a statewide Falls Prevention Awareness Day media messaging.
    • Coordinate with Falls Free Coalition to enhance activities statewide to increase fall prevention programs in communities.
    • Assess number and type of falls prevention programs currently being offered throughout the state through a comprehensive program-directed survey.
    • Assess the numbers/types of stakeholders engaged in efforts to reduce falls among adults over age 60.
    • Deliver the evidence-based program FallScape and use the resulting data, along with EMS falls-related 911 calls data, to support pursuit of reimbursement and evaluate program efficacy.
    • Create a statewide, searchable database accessible to older adults, community organizations and providers to offer information on falls prevention programming and assessment.
    • Work with hospital service areas (HSAs) to establish systems for screening of falls risk and referral to appropriate services
    • National Council on Aging and Administration on Community Living
    • Association of State and Territorial Health Organizations
    • Older American’s Act funding; DAIL provides oversight of the distribution to the Area Agencies on Aging and therefore collaborates with the local AAA’s on programming.
    • Blueprint reimbursement for providers, community health teams and SASH

This work is funded in part by:

  • National Council on Aging and Administration on Community Living
  • Association of State and Territorial Health Organizations
  • Older American’s Act funding; DAIL provides oversight of the distribution to the Area Agencies on Aging and therefore collaborates with the local AAA’s on programming.
  • Blueprint reimbursement for providers, community health teams and SASH

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on injury indicators, check out our Public Health Data Explorer.

What We Do

The Vermont Department of Health (VDH) Falls Prevention Program helps older adults to improve their health, receive education and training, and find resources to prevent falls-related injuries and death. This program is housed within the Division of Emergency Preparedness, Response, and Injury Prevention. Through partnerships with community organizations, such as Area Agencies on Aging (AAAs), Emergency Medical Service (EMS) agencies, and community hospitals and health care providers, VDH coordinates referrals for and trainings on evidenced-based falls prevention programs. VDH continues to build a multifactorial infrastructure focusing on screening and assessment, exercise and strength building, medication management and reconciliation, and home safety. Additionally, VDH is involved in Vermont’s state falls prevention coalition, Falls Free Vermont, which is a collaboration of key stakeholders and health care professionals committed to reducing preventable falls through building capacities related to networking, referral systems, and resources.

Who We Serve

Falls prevention programs are available to Vermont older adults who:

  • Are at risk for falling.
  • Have had previous falls.
  • Worry about falling.

Additionally, VDH serves community partners engaged in falls prevention work through offering resources, data, trainings, and facilitated discussions to staff.

How We Impact

Falls Prevention Screening and Assessment

Falls are preventable and not a normal part of aging. In the U.S., 1 in 4 older adults reported experiencing a fall and an older adult falls every second of every day throughout the country. While the risk of falls increases with age, less than half of older adults talk to their doctor about their fall. In Vermont, 1 in 3 adults ages 65 and older reported having a fall in the past year and falls are the leading cause of accidental deaths in the state.

VDH promotes the use of the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit, which was created to help patients and health care providers with simple, evidenced-based tools through effective education materials, screening and assessment tools, and interventions that prevent falls-related injuries and deaths. Through collaborative partnerships and coordinated activities, VDH is working to build a sustainable statewide falls prevention program that promotes healthy aging and mitigates costly injuries for both older Vermonters and health care systems.

Indications of Progress through Data Collection

VDH uses various databases and data sources to track progress of the state’s falls prevention program. Through review and analysis of data on falls-related injuries and deaths, as well as the number of individuals screened, assessed, and referred to falls prevention programs, VDH continually evaluates this program to ensure there is improvement in health outcomes. The falls prevention program consistently seeks feedback from community members, health care providers, and partnering organizations to continue building a robust statewide falls prevention program.

Why Is This Important?

Falls are the leading cause of injury among older adults. In fact, 1 in every 3 adults ages 65 and older fall each year. Some falls are minor, but others can result in serious injury, such as a broken hip or a head injury, as well as a loss of independence and mobility.

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