International Forum on Ageing g in Place and Age Friendly Cities (9-12 Oct, 2009; Akita, Japan) Katherine K.L. Wong

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1 International Forum on Ageing g in Place and Age Friendly Cities (9-12 Oct, 2009; Akita, Japan) NO FALL COMMUNITY ~ FALL AND FRACTURE PREVENTION PROGRAM Katherine K.L. Wong District Director

2 Background Old urban area of Hong Kong High density 15% aged at 60 & above Mainly old private building Poor living environment Frail elders with ADL disability became home bound. Quality of Life (QOL) affected. Implementation of mass scale, multilevel fall prevention movement in old urban community

3 What problems do elders encounter? Result of the community survey launched in Aug, 2004, shown that : 1. Target: 176 successful respondents (N=176) who are elders aged 60yrs % households living in poor environment, having 3 or more items are not friendly to elders 3. 30% households have 3 or more items triggered fall risk at home 4. 40% experienced recurrent falls and 37.5% unsteady walkers, show higher tendency to explain fear of going outside independently 5. Restrict autonomy but increase dependency

4 What problems do elders encounter? Result of the community survey launched in Aug, 2004, shown that : 1. 85% have 1or above chronic diseases % scored 8 or above out of 15 in GDS, higher possibilities to have depression 3. Most of falls are multi-factorial causes while most of them can be potentially preventable

5 Objectives : Educate staffs, volunteers on professional knowledge Early identification and proactive intervention ti strategies Awareness enhancement of elders and their family care- givers

6 Comprehensive Program Multi-disciplinary i li collaboration Train the Trainer Approach Fall Prevention Ambassador Tai Chi Master Lighten your Life project Mobile Chairlift Lending Service Physiotherapy Exercise (group and individual sessions), Vibration Therapy

7 Service Protocol Fall Risk Screening Test CUHK Home safety assessment High Moderate Low Match with various services to the needy Physiotherapy Assistant Exercise device Community (Individual Educational Sessions) Talks Home modifications Physiotherapy y Minor works Exercise and repairs Simplified Group p Tai Chi 10 Movements Rehabilitation Community Exercise Educational Introduction Group Talks for Stroke of Com. Patients Resources Simplified Tai Chi 10 Movements Vibration Therapy (Individual Mobile Session) exhibition booths Introduction of Com. Resources Making referral to medical sector Mobile exhibition

8 Service Strategy Strategic Alliance 1) Department of Orthopaedics & Traumatology, CUHK 2) Physiotherapy Department, Kowloon Central Cluster, Hospital Authority 3) Department of Rehabilitation Sciences, the Hong Kong Polytechnic University 4) Tai Chi Association 5) Local Organizations, schools, churches, social services units, etc. 6) School of Nursing, the Hong Kong Polytechnic University 7) Medical Sector

9 Service Strategy t Community Educate on fall prevention Elders & Care-givers Enhance self awareness Volunteers Frontline Staff Offer support to elders Professional Staff Strategic planning and implementation Avoid fall in service delivery

10 Equipped with knowledge of elderly fall and fracture prevention Planning and Delivery of District Wide Fall Prevention Programmes; Enhance client safety and avoid fall in course of service delivery

11 Training for Staff Epidemiology of elderly fall and fractures in Hong Kong Pathology of osteoporosis, causes of falls and prevention measures Fall Risk Screening Test CUHK Home safety assessment Use of Assistant Device and Rehabilitation Equipment Assessment for Chairlift

12 Volunteers are equipped with knowledge on home safety assessment & fall risk assessment Spread message of fall prevention and provide support to elders in need

13 Training for volunteers Fall Prevention Ambassador Project Workshop on Fall Risk Screening Test CUHK Workshop on Assessment of Home Safety Training of Volunteer Tai Chi Masters Training on Operation of Vibration Platform

14 Elders & their family care-givers are equipped with knowledge & training on fall prevention Enhancing the elder's health & mobility eliminating environmental hazards Reduction of fall risk

15 Fall Prevention Ambassador Madam Ma, 76yr/F, Stroke, fall history, feeling isolated and lonely. Fall Risk Assessment Test Home safety assessment Regular concern visits Home modification Minor works and repair Present assistant device It s so great! I feel more secure to live here. I can go freely inside and outside my sweet home.

16 Lighten your life Project Recruit the residents as volunteers With technical skills in minor works and repair Replace the bulbs to improve the lighting of public places (benefit for 80 households ) Secure environment I haven t think about it s really a great burden to elders with disability.

17 Mobile Chairlift Service Appeal donation through the media Easy access for social services Make connection with the society and enjoy their social life without physical barrier Accessible opportunities to enjoy the recreational and cultural activities We enjoy and love to have picnic!

18 Physiotherapy Exercise N=59p Pre-test and Post test 3 Assessment tools : 30 second chair stand/ single leg standing/ timed up & go Assessment area : Level of improvement of Lower limb muscle strength & balance Findings: 30 second chair stand: 98% single leg standing : 67% Time up & go:83%

19 Vibration Therapy N=52p Pre-test and Post test Assessment tool:functional reach & Balance Master Findings: Functional reach:65.4% Reaction time:59.6% Movement velocity:59.6% End-point excursion:75% Maximum excursion : 76.9% Directional control:67.3%

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