10/22/18. Objectives: Falls and Brain Injuries Among Older Adults Part 1: Connection, Prevention, and Resources October 19, 2018

Transcription

1 Falls and Brain Injries Among Older Adlts Part 1: Connection, Prevention, and Resorces October 19, 2018 Keri Bennett (NE), Chair NASHIA Training and Edcation Committee Webinar Moderator Haleigh Cshen, NASHIA Membership Services and Training & Edcation Coordinator Webinar Organizer No Cost to Attend Certificates of Participation available throgh NASHIA.org ª $10 for Members ª $15 for Potential Members Recording Available ª Link inclded in a follow-p ª Archived at NASHIA.org and NCOA.org for later viewing ª Certificate of Participation will be available after viewing archive Q & A at the end of webinar if time allows Handots Objectives: Impact and prevalence of falls and tramatic brain injries (TBI) among older adlts Risk factors for falls and TBI Fall risk and brain injry detection assessments Resorces and professionals available to assist individals with preventing falls and TBI Strategies for service providers working with older adlts and with individals with TBI Presenter from Rebeccah Wolfkiel, M.P.P Exective Director NASHIA 1

2 Presenter from Gabriela Lawrence-Soto Grant Project Manager Massachsetts Rehabilitation Commission Statewide Head Injry Program (SHIP) Presenter from National Concil on Aging Kathleen Cameron,M.P.H. Senior Director Center for Healthy Aging NCOA Presenter from National Concil on Aging Chelsea Gilchrist, M.G.S. Senior Program Manager Center for Healthy Aging NCOA NASHIA is a nonprofit organization created to assist State government in promoting partnerships and bilding systems to meet the needs of individals with brain injry and their families. The Role of the National Association of State Head Injry Administrators (NASHIA) Only organization to represent State employees working to spport individals with brain injry and their families. Fonded in 1989 Membership: ª State Employees in Varios Agencies Pblic Health, Vocational Rehabilitation, Medicaid, Mental Health, Edcation, Developmental Disabilities, Aging ª Advocacy Organizations ª Health Care and Service Providers ª Individals and Families with Lived Experience Advocacy What We Do ª Fnding: TBI Act programs (ACL/CDC); NIDILRR Research; DOD Research; and VA rehabilitation programs ª Legislation: TBI Act; Jvenile Jstice and Delinqency Prevention Act; Older Americans Act; Violence Against Women Act; and more ª Congressional TBI Taskforce and March TBI Awareness Day Training ª Webinars: Professional Ethics; Person Centered Planning; Partnerships with Protection & Advocacy; and Older Adlt Falls/Brain Injry Series ª Annal SOS Conference Technical Assistance ª State TA: State Plans and State System Development; Dedicated Fnding Sorces/Trst Fnds; Registries; Medicaid Waivers; Brain Injry Concil Development; Advocacy; and more ª Federal TA: HRSA TBI Program TAC; ACL National Center for Advancing Person Centered Planning Systems (NCAPPS) 2

3 State TBI Programs + NCOA Falls Prevention Resorces The Challenge: Addressing the link between falls and brain injries. The Objective: 1) Edcate stakeholders on resorces available to prevent falls. 2) Inspire State systems of care that identify and serve individals that have sstained a falls-related brain injry. Improving the lives of 10 million older adlts by National Concil on Aging 14 Abot NCOA How We Accomplish Or Mission Who We Are: NCOA is the national voice for every American s right to age well Or Vision: A jst and caring society in which each of s, as we age, lives with dignity, prpose, and secrity Innovative Programs: NCOA s online and in-commnity programs empower individals to take small steps that can significantly improve their daily lives. Advocacy: NCOA works in a bipartisan manner to protect and improve federal programs that Americans depend on, like Medicare, Medicaid, and the Older Americans Act. Partnerships: NCOA spports a national network of local partners that provide personalized services to help individals stay healthy and economically secre as they age. Improving the lives of 10 million older adlts by National Concil on Aging 15 Improving the lives of 10 million older adlts by National Concil on Aging 16 NCOA s Center for Healthy Aging National Falls Prevention Resorce Center Goal: Increase the qality and years of healthy life for older adlts and adlts with disabilities Two national resorce centers fnded by the Administration for Commnity Living q Chronic Disease Self- Management Edcation (CDSME) q Falls Prevention Other key areas: Behavioral health, physical activity, immnizations, oral health Increase pblic awareness abot falls prevention Serve as the national clearinghose for tools and resorces Spport and stimlate evidence-based programs and strategies Improving the lives of 10 million older adlts by National Concil on Aging 17 Improving the lives of 10 million older adlts by National Concil on Aging 18 3

4 National Resorce Center Technical Assistance Activities One-on-one spport Learning collaboratives Annal meeting Webinars National Falls Prevention Database Online tools and resorces Best practices Networking Work grops Improving the lives of 10 million older adlts by National Concil on Aging 19 National Falls Free Initiative A thosands-strong and growing network National Action Plan developed in 2005; pdated in 2015 Strong partnerships ACL and the Aging Network CDC s National Center for Injry Prevention and Control National professional and consmer organizations State and local pblic health entities Falls Free is a critical effort to meet Healthy People 2020 goals of redcing older adlt fall-related ED visits by 10% 43 State Falls Prevention Coalitions Improving the lives of 10 million older adlts by National Concil on Aging 20 Older Adlt Falls in the U.S. Falls are common Falls are the leading case of fatal injry and the most common case of nonfatal trama-related hospital admissions among older adlts. One in for Americans aged 65+ falls each year. Every 11 seconds, an older adlt is treated in the emergency room for a fall; every 19 mintes, an older adlt dies from a fall. Falls are costly In 2015, the total cost of fall injries was $50 billion. Medicare and Medicaid sholdered 75% of these costs. The financial toll for older adlt falls is expected to increase as the poplation ages and may reach $101 billion by Sorce: CDC Improving the lives of 10 million older adlts by National Concil on Aging 21 Older Adlt Falls in the U.S. Predictable Physical, behavioral, and environmental risk factors Largely Preventable Everyone has a role to play and can make a difference within their own sphere of inflence. Sorce: CDC Improving the lives of 10 million older adlts by National Concil on Aging 22 Tramatic Brain Injry (TBI) Basics 4

5 Contined TBI Edcation Brain Injry Association of America - United States Brain Injry Alliance Administrators - Archived Webinars on TBI nashia.org Fall - Related TBIs Among Older Adlts. - Wednesday, September 30th, Introdction to Tramatic Brain Injry - Tesday, September 8, Definition of Acqired Brain Injry Non-Tramatic Brain Injry (ABI) No external force to the head An ABI is an inslt to the brain that Has occrred after birth Is not hereditary Is not congenital Acqired Brain Injry (ABI) Tramatic Brain Injry (TBI) An external force to the head Tramatic brain injry is the leading type of brain injry. Frontal lobe injries are common Impairing exective fnction 75% of TBls are concssions Concssions are also known as form of mild-tbi Non-Tramatic How People Acqire Brain Injries Infection (Meningitis, HIV) Neoplastic (tmor, cancer) Vasclar (stroke, anerysm) Metabolic (anoxia, hypoxia) Nerotoxic (lead poisoning) Demyelinating/Dementing (MS, Parkinson) Tramatic Unintentional Cases Falls Motor vehicle Sports/Recreation activities Work/Indstrial related Intentional Cases Assalts or attacks Military combat blast Injry Violent criminal behavior Homicide / Sicide attempts Domestic/ Dating violence Elder/Child abse/shaken baby FRONTAL attention motivation emotions jdgment problem solving decision making speech TEMPORAL memory nderstanding langage smell taste sond Brain Fnction MOTOR AREA volntary movement BRAIN STEM sleep heart rate breathing PARIETAL sense of toch sensations visal perception spatial perception OCCIPITAL sight CEREBELLUM balance coordination skilled motor activity National Epidemic Approximately 5.3 million people are crrently living with a TBI related disability. 2.8 million people were diagnosed with a TBI (CDC). Of this grop there were: 2.5 million Emergency Department visits 282,000 TBI related Hospitalizations 50,000 TBI related Deaths 500,000 0 Estimated nmber of TBI-related ED visits attribted to nintentional falls, 2007 and General Poplation Falls 40.5% Unknown 19% Strck by/against 15.5% Motor vehicle 14.3% Assalts 10.7% Leading Cases of TBI Adlts 65+ years 51 % - Falls 22 % - Unknown (may inclde cases where senior abse is sspected) 18 % - Other (e.g. assalts, strck by object) 9 % - Motor Vehicle Accidents 5

6 Demographics Overall poplation The two age grops at highest risk for TBI are 0 to 4 year olds 15 to 19 year olds Adlts over the Age 65+ The fastest growing TBI poplation Males Males 1.5 to 2 times more likely than Females to sstain TBI Females over the Age 80+ Females more than Males likely to sstain TBI Female longevity Additional Risk Factors for Falls and TBI Strctral changes in the brain (e.g., Atrophy) Complex medical diagnosis Vision changes isse with light sensitivity. Blrred vision, especially with seeing p close Doble vision, Decreased peripheral vision Dizziness, Vertigo 30-65% of people with TBI sffer from balance problems Seizres disorder - develops in 1 in 10 people after injry Chronic pain may occr after TBI Sbstance Use Disorders 10-20% of TBI srvivors develop SUD within the first year of injry. Mental health disorders 50% of TBI srvivors experience depression within the first year of injry. Nearly Two-thirds are affected with 7 years after injry 71% of people with TBI are freqently irritable Increase risk for sicides than general poplation Risk Factors contined Med Management challenges ª Isses with follow throgh or refsal ª Side effects Sedation (e.g., increases fatige and/or balance impairments) Blood thinners (e.g., Comadin) increased bleeding w/ falls Environmental hazards (Hoarding) Vlnerability for abse and exploitation History of previos brain injries (ABI/TBI) TBI Interventions ACUTE INTERVENTIONS ED Services Specialized Inpatient Care Evalation and Treatment by Medical Specialists POST-ACUTE INTERVENTIONS Inpatient / Otpatient Rehabilitation SNF / Long-Term Care Facility Commnity-Based Spports Physical Dizziness Fatige Headache Motor impairment Changes in sensory fnctions sch as hyposensitivity to light or sonds or sensory loss Conseqences of Brain Injries Families & Caregiver Can feel trapped, isolated, abandoned Can become be targets of abse by srvivor Can be annoyed and impatient with srvivor Cognitive Commnication Isses Poor Concentration Disorientation Memory Problems Poor Organization Slow Processing Speeds Poor Initiative Lack Follow Throgh Poor Jdgement Emotional Anger Anxiety Depression Irritability Personality Changes Inability to Control Emotions Service Providers May end services pre-matrely when labeling srvivors as resistant, aggressive, disinterested, not motivated, lazy, or non compliant. Srvivors can overtime brn bridges with service providers Patience, accommodating symptoms of TBI and connecting to brain injry services can help. Brain Injry Detection Assessments & Resorces 6

7 Importance Of Screening Brain Injries are a silent epidemic. People may appear normal. The effects of a Tramatic Brain Injry (TBI) vary for each person. Symptoms of TBIs often go ndiagnosed, misdiagnosed or mistreated. An ndiagnosed brain injry can mask other illness or conditions. Individals may not know they have been exposed to a brain injry or nderstand their limitations as a reslts of the brain injry. Individals are not always connected to brain injry services. Consider screening for a brain injry when yo have a sspicion! The HELPS Brain Injry Screening Tool The OSU TBI ID Method TBI or Something Else? Conditions that may mimic symptoms of TBI inclde: Poor Ntrition UTI Bipolar Disorders Depression Sbstance Use Disorders Sleep Distrbances Headaches / Migraines Learning Disabilities ADHD/ADD Detection Tool #1: The HELPS Brain Injry Screening Tool Developed by developed by M. Picard, D. Scarisbrick, R. Palck, 9/91 It is a nationally recognized easy Screening Tool which can Detects ANY Brain Injry (ABIs and TBIs) Can be applied to ANY Age or sbpoplation Can be implement by ANY person regardless of edcation level In ANY Setting H - Hit yor Head E - Emergency room, Hospital or Doctor L - Lose consciosness, Dazed or Confsed P - Problems experienced since Hitting Head S - Sicknesses To access this tool visit the NASHIA site at Detection Tool #2: OSUTBI-ID Method Ohio State University Tramatic Brain Injry Identification Method - Developed by Dr. John Corrigan and team at the Ohio Valley Center for Brain Injry Prevention and Rehabilitation - Geared for Health care and social service professionals - Standardized procedre for eliciting a person s lifetime history of TBI via a 3-5 minte strctred interview. - Detects history of lifetime exposre of Tramatic Brain injries (Only) - Assess a persons cognitive and emotional state - Can sed to inform approach of treatment and services being provided - To access the tool and edcational video visit www. ohiovalley.org/tbi-id-method/ 7

8 Interdisciplinary Approach Primary Care Physician Nerology Neropsychologists Behavioral Health Services ª Psychologist ª Social Workers ª Sbstance Use Treatment Rehabilitative Therapies ª Physiatrist Brain Injry Spport Grops Case Management Vocational Socialization Opportnities ª Day programs ª Senior Centers ª Recreational grops Transportation ª Physical Therapy Commnity Living Spports ª Occpational Therapy ª Home Making Services ª Speech and Langage Therapy ª Recreational Therapy ª Personal Care Aide ª Money Management Connecting To Brain Injry Services Brain Injry Association of America - United States Brain Injry Alliance - Independent, non-profit national organization Serves for all ages, all types of brain injries srvivors, families, caregivers, professionals and non-professionals. They can connect yo to: Spport Grops for srvivors and caregivers Information and Referral to srvivors, caregivers and professionals Brain Injry Prevention Programs Edcation and Advocacy Strategies for Service Providers Dizziness Fatige Headache Motor Impairment Changes in sensory fnction ü Hypersensitivity to light and or sond Physical Effects of TBI Strategies may inclde: Freqent short breaks or rest periods. Help individal determine best time of day for work, some individals tire in early afternoon, others have more difficlties in the morning. Present information in small segments, watch for signs of overload. Start with shorter shifts, endrance often bilds in time. Review sleep rotine Use of ear plgs or glasses to filter light or sond Adjst lighting when possible Facilitate access to qiet/less stimlating spaces Assist with reinforcing recommendations made by PT/OT/SP therapists and other medical providers Cing to move slowly and se mobility assistive/ adaptive devices as prescribed. Note that fatige and sleep distrbance can affect attention and concentration. Commnication Concentration Disorientation Memory Organization Processing Initiative Jdgement Cognitive Effects of TBI Strategies may inclde: Present info slower, say one thing at a time Be mindfl of pacing. Watch for signs of "overload" or fatige. Ask individal to repeat back or smmarize the info provided. Be patient for response Allow for processing Watch for frstration, person feeling overwhelmed Adjst environment/decrease distractions Develop a memory system, rotine/organization Memory books, calendars/smartphones Discssions -repeat, review, paraphrase Well organized schedles and rotines Clear, repetitive tasks and directions Use labels, high lighters and To Do lists Have appropriate breaks and choices Clear transition rotines Scripts abot sitations Monitor progress and adjst as needed 8

9 Emotional Effects of TBI Strategies may inclde: Remain calm and model appropriate reactions Give sggestions for maintaining and regaining control Avoid sitations that trigger ncontrollable emotional reactions, redirect when possible Encorage rest breaks, review conseqences of behavior with sggestions on how to remedy the problem/isse/sitation. Praise once in control. Redirect and model of sbstitte appropriate behaviors Recommend grop/peer activities to facilitate appropriate behaviors. Praise positive behaviors. Avoid sitations that trigger ncontrollable emotional reactions, redirect when possible. Establish bondaries and focs on progress. Encorage cooperative behavior Redirect inappropriate behavior. Verbalize impact on others. Hold individal accontable for their own actions, natral conseqences are a valable teaching tool. Use role-playing to practice interpersonal skills. Avoid comparisons to how they were prior to injry. Consider peer or grop activities to facilitate appropriate behavior Anger Anxiety Depression Irritability Personality changes Inability to control emotions Fall and Brain Injry Prevention Strategies Edcation Individal Prevention Strategies ª Dissemination of resorces and information abot their risk for falls. Home and Safety evalations ª Decltter/organize for free nobstrcted movement ª Improve lighting and visibility ª Replace or repair damaged flooring, rgs, stairs, railings, etc. Medication Monitoring ª Make sre that side-effects are nderstood by the individal and monitored by the prescribing doctor(s) Home Modifications ª Installation of ramps, bathroom remodels, lifts, electric door opener, etc. Individal Prevention Strategies Aiding them to make better-choices Adjst their day to day habits in a variety of areas, inclding ª Reglar vision checks ª Acqire appropriate adaptive devices and medical eqipment (from eye wear, mobility devices, transfer eqipment, etc.). ª Wearing proper footwear when amblating Rehabilitative Therapies ª Initiate or facilitate toch p of occpational therapy and/or physical therapy Balance Training Programs ª with medical approval connect individals to balance training programs (e.g., Tai-Chi)....and more which will covered by or NCOA partners! REFEFERENCES Center for Disease Control and Prevention (CDC) - CDC - CDC - Brain Injry Association of America - United States Brain Injry Alliance - Taylor, C. A., Bell, J. M., Breiding, M. J., & X, L. (2017). Tramatic Brain Injry-Related Emergency Department Visits, Hospitalizations, and Deaths-United States, 2007 and Morbidity and mortality weekly report. Srveillance smmaries (Washington, DC: 2002), 66(9), OSU-TBI-ID Method - Ohio Valley Center for Brain Injry Prevention and Rehabilitation - HELPS Brain Injry Tool NASHIA handot - The Original HELPS TBI screening tool was developed by M. Picard, D. Scarisbrick, R. Palck, 9/91, International Center for the Disabled TBI-NET, U.S. Department of Edcation, Rehabilitation Services Administration, Grant #H The HELPS tool was pdated by project personnel to reflect recent recommendations by the CDC on the diagnosis of TBI. Model Systems Knowledge Translation Center Tramatic brain Injry - Massachsetts Tramatic Brain Injry in Elders web corse - Gabriela Lawrence-Soto, Grant Project Manager Massachsetts Rehabilitation Commission (MRC) Commnity Based Services Department Statewide Head Injry Program (SHIP) Gabriela.Lawrence-Soto@massmail.state.ma.s 9

10 Fall Risk Factors Yo CAN change Physical inactivity Mscle weakness Home environment Vision Medication Use Fear of falling Social isolation Improper se of assistive devices Yo CAN T change Age Gender Ethnic backgrond Improving the lives of 10 million older adlts by National Concil on Aging 55 Improving the lives of 10 million older adlts by National Concil on Aging 56 Risk Factors for Fall-Related TBI Fall-related TBI prevention Gender men more likely to sffer moderate/ severe TBI than women Medication older adlts taking antiarrhythmic medication more likely to sffer a fall-related TBI Activity dring a fall older adlts who fall climbing stairs or transferring from a chair or bed are more likely to sffer a moderate/severe TBI compared to those who fall while walking Direction of fall older adlts who fall backwards or sideways are more likely to sffer a moderate/severe TBI compared to those who fall forward. Improving the lives of 10 million older adlts by National Concil on Aging 57 Fall prevention can help redce incident of TBI Example: Connectict Collaboration for Fall Prevention Compared the rate of hospitalization for fall-related TBI in older adlts ( 70 years old) between a treatment region or a sal care region. Clinicians in the treatment region translated fall prevention protocols and procedres into clinical practice. Rate of hospitalization for the treatment region was significantly lower compared to sal care. Reslts sggest that engagement of practicing clinicians in the se of evidence-based fall prevention practices may redce hospitalizations for fallrelated TBI. Improving the lives of 10 million older adlts by National Concil on Aging 58 Adverse Conseqences of Falls for Older Adlts Serios injries tramatic brain injries, hip and spinal fractres, brain injries, broken bones, e.g., wrist, femr Increased fear of falling and restriction of activities, social isolation, depression, helplessness Decreased ability to fnction Loss of independence and redced qality of life Increased risk of prematre death Fall Risk Assessment: CDC STEADI Toolkit Stopping Elderly Accidents, Deaths and Injries (STEADI) Toolkit Based on the AGS/BGS Falls Prevention Gidelines (evidencebased) Materials for providers and patients Improving the lives of 10 million older adlts by National Concil on Aging 59 Improving the lives of 10 million older adlts by National Concil on Aging 60 10

11 CDC STEADI Tool Kit Fall Risk Assessment: Checklist Comprehensive Approach Screening Assessment of risk factors Intervention to address risk factors Exercise strength & balance Clinical Geriatric care to address chronic conditions, medication, vision, ntrition Home assessment and modification for fall hazards Fll tool kit available at Available at steadi/pdf/ STEADI- Brochre- StayIndepende nt-508.pdf Improving the lives of 10 million older adlts by National Concil on Aging 61 Improving the lives of 10 million older adlts by National Concil on Aging 62 Fall Risk Assessment Algorithm for fall risk screening, assessment, and intervention Available at steadi/pdf/steadi- Algorithm-508.pdf Fall Risk Fnctional Assessments 30-Second Chair Stand Test 4-Stage Balance Test Timed Up and Go (TUG) Test Measring Orthostatic Blood Pressre Improving the lives of 10 million older adlts by National Concil on Aging 63 Improving the lives of 10 million older adlts by National Concil on Aging 64 Postral Hypotension STEADI Resorces for Clients and Patients Checking PH rotinely in all elders is critical and often overlooked. PH is defined as > 20 mmhg drop in systolic Bp or > 10 mmhg drop in diastolic Does the elder report falling back into chair dring sit to stand? Improving the lives of 10 million older adlts by National Concil on Aging 65 Improving the lives of 10 million older adlts by National Concil on Aging 66 11

12 Falls Prevention Professionals Falls Prevention Professionals Occpational Therapists Physical Therapists Home Safety and Modification Experts Improving the lives of 10 million older adlts by National Concil on Aging 67 Improving the lives of 10 million older adlts by National Concil on Aging 68 Falls Prevention Professionals State Falls Prevention Coalitions Pharmacists Commnity-Based Exercise and Fall Prevention Program Leaders (i.e., senior centers, YMCA) Professionals in aging and health care (i.e., Area Agencies on Aging) Improving the lives of 10 million older adlts by National Concil on Aging 69 Improving the lives of 10 million older adlts by National Concil on Aging 70 Falls Prevention Coalitions National Fall Prevention Awareness Day (FPAD) Health Care Providers Pblic Health Home Health Fire Department EMS/1st Responders Professional Associations (OT, PT, RN) Senior Hosing Many Others Aging Services Network FPAD is held each year on the first day of fall: September 23, 2019 Raise awareness abot how to prevent fallrelated injries among older adlts. View the FPAD Impact Reports for event, activity, and partnership ideas Pblic awareness activities Professional edcation Physical activity events Falls risk screening fairs Medication review Enrolling older adlts in evidence-based falls prevention programs Improving the lives of 10 million older adlts by National Concil on Aging 71 Improving the lives of 10 million older adlts by National Concil on Aging 72 12

13 FPAD Resorces General Resorces Marketing & Media Past Activities Advocacy How to Get Involved Visit Falls Prevention Resorces Improving the lives of 10 million older adlts by National Concil on Aging 73 Improving the lives of 10 million older adlts by National Concil on Aging 74 NCOA Falls Prevention Resorce Clearinghose Filter by Adience o Older Adlts & Caregivers o o Professionals Advocates Filter by Type o Docment o o o o Video Template Webinar Image Visit resorcetype/fallsprevention/ Improving the lives of 10 million older adlts by National Concil on Aging 75 Infographics and Handots Falls Prevention Fact Sheet 6 Steps to Prevent a Fall Infographic 6 Steps to Protect Yor Loved One from a Fall Winterize to Prevent Falls Osteoarthritis and Falls Osteoporosis and Falls Falls Prevention Programs: Saving Lives, Saving Money Infographic Improving the lives of 10 million older adlts by National Concil on Aging 76 Videos 6 Steps to Prevent a Fall Yo Have the Power to Prevent a Fall Medication Management Tips and Strategies Navigating Otdoor Fall Hazards 18 Steps to Modify Yor Home Falls Free Video Contest Winners Caregiver Edcation Falls Prevention Conversation Gide for Caregivers Why falls prevention is important. Caregivers can participate, too! Falls prevention basics. Step 1: Is it time to talk? Step 2: Who and how to talk to others who may be involved. Step 3: Develop a falls prevention action plan. Perspectives: Yo are not alone. Additional Resorces. Improving the lives of 10 million older adlts by National Concil on Aging 77 Improving the lives of 10 million older adlts by National Concil on Aging 78 13

14 Home Safety Home Safety and Home Modification Resorce Inventories Evidence-Based Programs, Best Practices in Home Modification Home Assessment Tools Home Modification Fnding Resorces Visit: Medication Management ASCP/NCOA Falls Risk Redction Toolkit Falls Risk Checklist Falls Application Cases Commnications Docments Bild Yor Referral Network Bibliography Visit: Improving the lives of 10 million older adlts by National Concil on Aging 79 Improving the lives of 10 million older adlts by National Concil on Aging 80 Medication Management Join Us! Bemedwise.org o Medication Use Safety Training for Seniors (MUST for Seniors): Toolkit provides edcational materials on avoiding medicine mishaps, managing side effects, and improving medicine se knowledge. Beers Criteria for Potentially Inappropriate Medication Use in Older Adlts Medication-related interventions o HomeMeds Medication Safety Program o Screening, Brief Intervention and Referral to Treatment o Medication reviews and brown bags Visit ncoa.org and sign p for enews on social media Donate to spport NCOA s work: ncoa.org/donate Share NCOA s free, trsted tools with older adlts o BenefitsCheckUp.org o EconomicCheckUp.org o MyMedicareMatters.org Improving the lives of 10 million older adlts by National Concil on Aging 81 Improving the lives of 10 million older adlts by National Concil on Aging 82 Thank Yo! Kathleen Cameron, MPH Senior Director Center for Healthy Aging kathleen.cameron@ncoa.org Chelsea Gilchrist, MGS Senior Program Manager Center for Healthy Aging chelsea.gilchrist@ncoa.org Qestions? Please send yor qestions to the moderator on the chat board. Improving the lives of 10 million older adlts by National Concil on Aging 83 14

15 Part Two Coming Soon Falls and Brain Injries Among Older Adlts, Part 2: Partnerships, Programs, and Pblic Policies November (Date 12:00 pm - 1:30 pm Eastern Part two will highlight commnity-based programs and prevention initiatives, state and commnity partnerships between professionals in the falls and brain injry prevention networks, and pblic policy connected to systems and partnerships. Not a Member? Join NASHIA Today! Rebeccah Wolfkiel Exective Director PO Box 1878 Alabaster, AL execdirector@nashia.org Haleigh Cshen Member Services and Training & Edcation Coordinator memberservices@nashia.org 15