1. Southern Trust Falls Prevention Service Rachel Crozier SHSCT Falls Co-ordinator

2. Incidence 1 in 3 women over 65 fall each year 1 in 5 men over 65 fall each year Over 85 years old - 1 in 2 people will fall each year 70% of falls cause injury 10% of all falls result in fracture and 1% of these is a hip fracture - often poor outcome In care homes 60% of residents fall once a year 30% of all hospital admissions for hip fracture are from nursing homes

3. Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the frequency, context and characteristics of the fall/s NICE CG161 2013: Falls: assessment and prevention of falls in older people

4. Consequences of Falling Psychological problems, for example, a fear of falling and loss of confidence in being able to move about safely Loss of mobility, leading to social isolation and depression Increase in dependency and disability Hypothermia Pressure-related injury Infection

5. Falls and Osteoporosis Osteoporosis, a condition characterised by a reduction in bone mass and density increases the risk of fracture when an older person falls Hip fracture is the most common serious injury related to falls in older people Poor posture or a dowager’s hump from osteoporosis can place a person at higher risk to fall, as the person’s centre of gravity has been altered Reducing a person’s risk of falling and preventing or treating osteoporosis will help to maintain their independence

7. Overview – Falls Service Falls team Consultant Physiotherapist Occupational Therapist Nurse Falls clinics Armagh Dungannon Lurgan Newry Clinics are held on a weekly basis Assessment in the home if appropriate Comprehensive assessment for over 65’s to determine cause of falls

8. Weekly Clinics Newry – Daisy Hill Hospital Lurgan – Day Hospital Armagh – Mullinure Day Hospital (Alternate week to STH) South Tyrone – Day Hospital (Alternate week to Armagh) Access to Rapid Access Clinics for Urgent Referrals

9. Falls Clinic Assessment Outcome of assessment can include: Falls education and exercise 8 week class Offer of community based strength and balance classes Provision of mobility aids Provision of aids to assist with day-to-day activities Changes to medication Management of hearing, eyesight, bladder or bowel problems Further investigation regarding osteoporosis Onward referral for other tests e.g. X-ray, blood tests Follow up of any needs identified by consultants or health professionals

10. Weekly Strength and Balance Classes with Education on Falls Prevention Newry – Bramble Wood, Drumalane Lurgan – Day Hospital Mullinure – Day Hospital STH – Day Hospital

11. Strength and Balance Classes in Local Leisure Centres Newry – Newry Sports Centre – Monday 11am-12 Noon Portadown – Cascades Leisure Centre – Friday 12 Noon – 1pm Armagh – Orchard Leisure Centre – Friday 10am – 11am Dungannon – Dungannon Lesiure Centre - Thursday 11.15am -12.15pm

12. Falls Co-ordinator Improve falls assessment and referral pathways within A&E, Community and Primary Care settings Develop new assessment and referral pathways with Northern Ireland Ambulance Service Co-ordinate referrals to physical activity and health programmes across community settings that are aimed at increasing and/or maintaining mobility, strength and balance for those aged 55+ Deliver training to staff and support staff in delivery of strength and balance classes in day centres, statutory residential settings, independent care homes and community settings

13. Falls Clinic Referral fallsteam.newry@southerntrust.hscni.net fallsteam.armagh@southerntrust.hscni.net fallsteam.lurgan@southerntrust.hscni.net

14. Rachel Crozier Falls Co-ordinator Mullinure Health and Wellbeing Centre Tel: 028 37 412 326 Falls.Coordinator@southerntrust.hscni.net

15. References Department of Health (2001) National service framework for older people, London: Department of Health. Falls: assessment and prevention of falls in older people; NICE Clinical Guideline (June 2013) Falls; British Geriatrics Society Best Practice Guidance (July 2007, updated 2010)