Fall-related injuries lead to significant healthcare utilization and result in consistent pains and functional disorders in elderly patients. The relevant fall prevention program, “Multi-Faceted Prevention”, introduces the strategy aimed at reducing the risk factors of falling. The program was designed for a nursing home in South Florida, although proposed interventions might be, likewise, implemented in other types of health care organizations.
The generation of the proposed measures was based on the scientific assumption that muscle weakness, psychological fear, and poor balance constitute the three principal factors contributing to falls (MacAuley & Best, 2008). The key benefit of this program is its multi-faceted character, thus, it offers a varied intervention, and employs a complex approach to the solution of the problem. Researchers report that this type of program is most efficient in fall prevention (Cusimano, Kwok, & Spadafora, 2008).
In the framework of the relevant fall prevention program, the implementation of a series of interventions is proposed.
The first intervention suggested is a walking program aimed at improving general balance, ankle strengths and the speed of walking. According to experts’ opinion, exercise sessions should be regular and sustainable in order to provide effective results (MacAuley & Best, 2008). Therefore, it is suggested that short walking sessions are practiced every day in the course of three months. The efficiency of this intervention is scientifically grounded. The results of the research show that a walking course does not only reduce the risk of falling but also assists in improving fall-related outcomes in elderly patients (Schoenfelder, 2000).
Another implementation concerning physical aspect is training that includes a set of exercises focused on the strength, flexibility, and endurance. Specialists note that general physical improvements contribute significantly to the elimination of the risks of falling (El-Khoury, Cassou, Charles, & Dargent-Molina, 2013).
The next intervention that the fall prevention program proposes is the implementation of regular group discussions in order to help elderly patients share their experience and eliminate psychological fears connected with falling. According to research, the relevant measure constitutes an integral part of multi-faceted fall prevention program (El-Khoury et al., 2013). Group discussions should be carried out on the regular basis, with the minimum frequency of once a week.
The last two interventions focus on reducing the fear of falling in elderly people. Thus, it is suggested to perform two types of seminars: assertiveness training and cognitive restructuring. The first procedure is aimed at helping the patients acquire self-confidence, whereas the latter is supposed to assist them in replacing negative thinking patterns by a positive approach. Practice shows that the psychological side of fall prevention is often neglected. Meanwhile, statistic reports that fears represent one of the key factors of falling risks (MacAuley & Best, 2008).
The implementation of the described interventions requires specific training. First of all, in order to provide effective physical therapy, it is required that a coach has, at least, eight hours of the relevant training, possesses an instructor certificate and updates its annually. Secondly, in order to carry out psychological training proposed in the program, it is recommended that a registered nurse receives the relevant certificate and fulfills a short-term course on psychological therapy.
One of the benefits of the proposed fall prevention program is a limited number of items required for its realization. Thus, one might need the following set: a medium size gym; a medium size room for psychological training with ten-twelve tables, chairs, and a TV-set; attendance sheets, participant workbooks.
The approximate cost of the implementation of the fall prevention program is $1000. The detailed calculations are represented below:
- Equipment: $500
- Course materials (the calculations performed for a group of ten participants): $300
- Additional expenses: $200
It is essential to point out that the entry cost is significantly higher than the amount of further expenses required for carrying out the program.
The principal aim of the prevention program proposed is to reduce the risks of falling in elderly people as well as to minimize the fall-related outcomes of falls. Therefore, it is possible to point out the relevant key targets:
- Improving the general physical state (strength, flexibility, balance, endurance) in elderly patients with the help of exercises and walking sessions.
- Eliminating psychological fears of falling by creating a favorable environment and providing specific psychological training.
- Encouraging experience-sharing in elderly patients, helping them to change their general attitude to the problem.
The program offers a series of measures that will help to evaluate the targeted outcomes and estimate the efficiency of each intervention. First, and foremost, it is recommended to carry out an initial survey during the first class of the psychology training. The survey might be performed several times throughout the course period. Moreover, it is essential to collect the relevant statistics regarding the falls and their outcomes in the organization. The data collection should be performed twice: at the beginning and at the end of the program. Finally, it is critical to organize the final class evaluation encouraging the participants to share their impressions and recommendations on the course utility, benefits, and drawbacks.
Cusimano, M.D., Kwok, J., & Spadafora, K. (2008). Effectiveness of multifaceted fall-prevention programs for the elderly in residential care. Injury Prevention Journal, 14(2), 113-122.
El-Khoury, F., Cassou, B., Charles, M.A., & Dargent-Molina, P. (2013). The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. British Medical Journal, 347(1), 1-13. doi: 10.1136/bmj.f6234
MacAuley, D., & Best, T. (2008). Evidence-based Sports Medicine. Malden, Massachusetts: John Wiley & Sons.
Schoenfelder, D.P. (2000). A fall prevention program for elderly individuals. Exercise in long-term care settings. Journal of Gerontological Nursing, 26(3), 43-51.