COMMUNITY ALARM TELECARE SERVICE SESSION 2 FALLS

ELDERLY POPULATION 78,000 people aged 65+ in Grampian 37.500 live in the city 15.000 fallers

WHAT IS A FALL? “ an event which results in a person coming to rest inadvertently on the ground or other lower level, and other than a consequence of sudden onset paralysis or seizure” WHO (2004)

WHO FALLS AND WHERE 1 in 3 of those aged 65+ 1 in 2 of those aged 85+ 65+ fall in the garden, stairs, and kitchen. 85+ fall in the bedroom and bathroom

CONSEQUENCES OF A FALL 300,000 fractures per year Main cause of death due to injury in over 65’s 6000+ hip factures in Scotland per annum.

EXERCISE Draw one body per group using materials provided. Draw/write intrinsic (person related) risk factors inside the body. Draw/write extrinsic (environment related) risk factors outside the body. Draw/write behavioural (activity related) risk factors in any free space!

HOW DOES TELECARE MONITOR AND PREVENT FALLS? Can telecare equipment stop someone falling? The answer is No, it won’t stop someone from falling, but can aid preventing a fall by: making the users environment safer eg automatic lighting in dark areas of the users home; or lights attached to a bed sensor for when a person gets up during the night Telecare DOES act as a quick response to someone who has fallen – ensuring immediate assistance is given. Can Telecare stop someone from falling NO – it can act as a quick response to someone who has fallen Telecare can help prevent falls by making the users environment safer EG automatic lighting in dark areas OR Lights can be attached to a bed sensor for when a user gets up during the night Although this type of equipment can be complicated for some users But Charlie will go into the equipment in more detail and what the complications are later on.

FALLS AND THE FALL DETECTOR If a user is at risk of falls and: They have enough dexterity to press the pendant; and They have the capacity to understand what the pendant is for and why they should wear it A basic community alarm and pendant is all this is required. Thus giving the user peace of mind, that should they fall they can press for assistance. If a user is prone to falling FD is not always the answer If they have the Capacity and Dexterity to know when to press a pendant Basic CA/Pend – all is required Sometimes FD is overkill Review visits – FD never worn, often in a drawer somewhere – person can press pendant

TELECARE EQUIPMENT call to the monitoring centre, A fall detector will raise an automatic call to the monitoring centre, who in turn will arrange assistance through a responder. In some cases the addition of a bed sensor with an absence time will be required as a back up. The bed sensor will raise an automatic call to the monitoring centre, should the user get out of bed and not return within the preset absence time, eg 10, 20 minutes. FD sends an automatic call to a monitoring centre. Ideal for: Users who can’t press a pendant Don’t have the capacity to raise an alert Take Blackouts or prone to collapsing with no warning – not able to press for help In some cases a bed sensor can be fitted as a back up to the FD Sometimes all that is required is Bed Sens if user only falls when rising from bed at night – As I said Charlie will go into this in more detail later

ASSESSING FOR TELECARE IN RELATION TO FALLS Telecare will alert AFTER a fall and help: Reduce anxiety ie lying on floor Accelerate response What to Consider When Assessing: Look at Risks in Environment - can these be alleviated ability to transfer - chair/bed/toilet Attitude to fall - one off – can they remember incident - dizziness – blackouts TC can help prevent, but in the event it doesn’t it can alert AFTER the fall and this Reduces anxiety for user – as it prevents them lying for a long time before being found as a quick response for help is alerted through TC When assessing look at risks within the users home Can these be alleviated What is their ability to transfer to chair/bed/toilet It may be other equipment that is required not telecare The users attitude to the fall - Is it a one off Can they remember the incident Was it just a dizzy spell or did they blackout The more you know the easier it will be to know what equipment is required to help.

ASSESSING FOR TELECARE IN RELATION TO FALLS Age - likelihood that falls will increase Sight – spectacles Medication – review – side affects of medication Long Term Medical Condition – Dementia - Parkinson's Confirmed History of Falls – why, where and when do these happen Reluctance to Speak about Falls – fear of care Consider age of user – likelihood that falls will increase if elderly Sight – Spectacles – needing a good clean is their prescription correct when was the last time their eyes was tested Medication – does it require renewed Is falling /unsteadiness a side affect of their medication Have they got a long term condition – dementia, parkinsons, huntingtons this could be the cause of their falls and again with these conditions falling will only get worse Confirm the history of their falls Why do they happen - Where do they happen When do they happen eg is it always night when getting out of bed Bear in mind some people are reluctant to speak about falls (may hide the fact) fear of going into care

ASSESSING FOR TELECARE IN RELATION TO FALLS Criteria for Fall Detector “Fall Detectors should only be considered if a user experiences blackouts or is unable or unwilling to press a pendant alarm” Alternatives: Pendant/consider other telecare Standard Equipment Falls Prevention Programme Because FDs were being requested so much and after 6 week review Many were being returned we implemented Criteria for the supply of FDs “Read Criteria from Slide” If user doesn’t fit this criteria – consider alternatives: Pendant or other telecare Standard Equipment – OT/NHS Referral to Falls Prevention Programme