Client Equilibrium at James Milson Village

As all Aged Care managers and allied health professionals can attest, resident falls are a major risk for all Aged Care Facilities...and for a variety of reasons.

When clients present for admission to a facility they often possess significantly poorer mobility and balance skills than they do at home as they have been supported in the home environment for lengthier periods of time. A significant number of clients have also had falls prior to admission resulting in major injuries, mainly fractures. Falls have a significant impact on the frail and aged's quality of life, i.e. self-confidence, avoidance of participation in exercise/activities and falls are often associated with depression. James Milson Village (JMV) is committed to providing the highest level of care to each resident thus making JMV a no-fall safe haven for the elderly. Care Plans at JMV identify ways resident can function at their maximum level of independence.

JMV is working in partnership with Blisscare Australia to provide Physiotherapy services to the residents. The Physiotherapy Team at JMV consists of 3 full time Physiotherapists and one part time Physiotherapy assistant.

Working within national guidelines that generate effective exercises for Falls Prevention requires a targeted approach, designed and delivered by trained professionals. The JMV Physiotherapy Team led by Manjinder Gaba (Senior PT and Certified Postural Stability Instructor {Falls Specific Training from Later Life, UK}) has designed and implemented the Blisscare Active Falls Prevention Program. The program aims to reduce the falls rate within the facility and to increase awareness of falls and falls prevention.

JMV Management recently requested the Physiotherapy Team to screen all Hostel residents so as to assess their risk of falls using Falls Risk Assessment Tool (FRAT). Assessment of balance and lower limb strength has been undertaken for the residents at risk of falls using reliable and validated outcome measures. Measures which are good predictors of falls have been used and data of risk factors, number of falls and attendance are being measured and collected.

A robust, 16 intervention program consisting of bi-weekly sessions of 1 hr each has been implemented. Each session includes education component where residents interact actively with Physios and discuss factors leading to falls and prevention strategies. The exercise class follows the education session. The exercise program used is evidence based Falls Management Exercises (FaME) with OTAGO exercises as core exercises but is progressed to more challenging balance exercises. The exercise classes are balance specific, individually tailored and targeted training for dynamic balance, strength, bone, endurance, flexibility, gait and functional skills, training to improve 'righting' skills to avoid a fall.

Residents, prescribed as per guidelines, were assessed for pre-existing health issues (such as Diabetes, Cardiac conditions, etc) before any client was allowed to commence the exercise classes. A Senior physiotherapist and a physiotherapy assistant conduct the classes.

Pre-intervention data of number of falls and functional outcome measures has been collected. Following 16-week program, the pre and post intervention data will be analysed to measure the effectiveness of the program; however, even at this early stage of the program we can report that the residents have taken on these exercise classes with enthusiasm and determination. We are seeing quite a change in the well-being of the Clients...not to mention some radiant smiles.

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